November 10, 1995

Implants

I am amazed at the risks that a few women are willing to take to enlarge their breasts. I think of those women as boobies.

Manufacturers of silicone breast implants are in the process of settling law suits from women who have had breast implants and have had a wide variety of problems that they attribute to the implants. The amount involved is well over 4 billion dollars.

I find it strange that the liability is focused on the manufacturers of the implants. No liability is assigned to the physician who recommended the procedure as safe, performed it and pocketed a big fee. No liability is assigned to the hospital where the procedure was performed. No contributory liability is assigned to the woman who was foolish enough to have the implant despite its possible side effects.

It has been known for more than 40 years that almost anything that is implanted into the appropriate strain of mouse will produce cancer. Those substances include mineral oil, lucite plastic, and even something as inert as glass. We can extrapolate that certain suceptible people will get cancer or have other problems as a consequence of almost anything permanently implanted in the body.

The saving grace is that the production of cancer takes time. A person in his sixties with an artificial hip is not likely to live long enough to get cancer from the implant. Even if he did, the benefits of the implanted hip far outweighs the relatively small cancer risk. The same is true of heart valves and a variety of other prostheses. Some implanted plastics are life saving and are clearly worth the risk. Scientists involved in working with implants have been working for a long time in an attempt to find substances that will cause fewer problems, and they have been fairly successful.

What about a woman who has a life-saving mastectomy for breast cancer? In the past, she would have gotten a custom-made padded brassiere. It looked like, and even felt like a breast. It was essentially the same as those breast implants, but it was outside and posed no hazard whatever to the wearer. You can still buy well crafted padded bras to conceal a mastectomy or to give the appearance of larger breasts.

Added to the cancer risk, there is always some risk from surgery, and the more extensive the surgery, the more the risk. Even something as simple and as common as having one's ears pierced has a tiny element of risk; the risk is related to the competence of the person who does it. There is a risk of infection from any procedure where the body is cut or pierced. If general anesthesia is required, there is an additional risk.

There are a number of conditions where surgery is either life saving or life enhancing. Plastic surgery is a marvelous art and science. Ask anyone who has had a child born with a harelip, or anyone who has been disfigured in an accident, what it can do. Unfortunately, the bread and butter for a plastic surgeon is based on human vanity -usually female vanity.

We accept certain risks, and we should accept them. There are risks inherent in living, in walking, in bicycling, in driving a car or flying in an airplane. There is something called the risk-benefit ratio. If the risk is low and the benefits are high, it is obviously worth the risk. If the risk is high and the benefits are small, a prudent person will not do it. I can't understand why a woman with attractive small breasts would want them to be big, badly enough to risk her life and health for it.

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