PERSPECTIVE ON WOMEN’S HEALTH : Draw the Line at the Knife : Why gamble on the unproven safety of breast implants? Is a shapely silhouette worth the risk of cancer?

If tiny feet suddenly became fashionable, would American women subject themselves to foot-binding? Would the medical Establishment support such a practice? Would feminists remain silent while women padded around on crushed bones? Of course not. But another form of mutilation, breast implants, has been around for years, only recently becoming the subject of controversy.

Public Citizen, a Washington-based watchdog group critical of breast implants, reports that about 155,000 of 2.3 million women who had implants suffered serious complications, including infections and leaks or ruptures of the silicone implant material into their bodies. This figure does not even count the women who have cancer that will go undetected because of their breast implants, which can mask lumps or tumors that might have been detected by manual examination and can make mammograms difficult to evaluate.

For these reasons, the National Women’s Health Network, an advocacy group, filed a claim with the Federal Trade Commission against plastic surgeons’ groups. The health network accuses them of “false and misleading” advertising in their lobbying efforts to seduce women onto the operating table. The health network is also urging the Food and Drug Administration to ban implants until research determines their safety.

Women’s cancer support groups around the country are rallying against implants as well. Mammograms detect 85% of breast cancers. Go to a women’s cancer support group and you’ll find a room filled with women who had negative mammograms less than one year before their cancer was diagnosed. At worst, breast implants may prove to cause cancer, as well as obscure evidence of the disease.

One year ago, women were told that one out of 10 could expect to receive a diagnosis of breast cancer someday. Now, the rate has risen to one out of nine. As breast cancer reaches epidemic proportions, absent any explanation for the rise, advocacy of breast implants is downright irresponsible.

An FDA panel has just rejected the safety data of the leading implant manufacturer, the Dow Corning Wright Co. Until further data can assure women’s health, the FDA at the very least should label implants dangerous, require informed consent and scrutinize plastic surgeons’ advertising claims.

Women, for their part, must resist the idea that large breasts bring happiness. I know that women who have had mastectomies feel mutilated and have a particular claim to implants, but even they face special hazards from reconstruction. Women need to know the dangers lurking behind promises of a shapely silhouette.

Fearful of federal regulation, plastic surgeons are fighting back with a vengeance. Their national organization is waging a $4-million dollar campaign to stop the FDA from banning even some breast implants. They have cleverly retained satisfied recipients, mostly former cancer patients, as spokeswomen to elicit public sympathy.

Plastic surgeons have an obvious stake in fueling the growing belief that one is obliged to have a perfect body. The mania for physical perfection, however, is a danger to women’s health. Not only do women diet insanely and suffer from eating disorders; they also subject themselves to the knife to suction out fat, round out buttocks, reverse the character of faces and change the size of breasts.

The United Nations’ Declaration of Human Rights prohibits the mutilation of the human body. Westerners regard foot-binding, dowry deaths, clitoridectomies (the surgical castration of the clitoris and labia) and similar “customs” practiced in other cultures--as violations of both the human body and human rights. The fact that American women willingly undergo implant surgery, and that the practice is considered routine, should not disguise its barbaric nature.

The truth is, women haven’t yet won the right to be judged for their character and talents rather than their appearance. To find and keep husbands and jobs, many women will seek male approval of their appearance. But we don’t have to endanger our lives. Let’s draw the line at the knife.