Women's implants creating grave health risks

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Breast Roulette

Despite The Risks, More & More Women Are

Getting Implants In Order To Feel 'Normal'

By Shari Graydon

The Globe and Mail

2-10-5

 

Diana Dickieson loved her new breasts. She had always been

frustrated by her boyish figure, which failed to develop much in the way of

curves even after she had become a mother. But breast implants made the

self-employed hairdresser feel more feminine.

 

Other people didn't particularly notice, she explains from her salon

in Nelson, B.C. " I'd always worn a padded bra, and the implants I got were

really small. "

 

But they made a big difference to how she felt -- emotionally and,

eventually, physically.

 

Just a couple of months after her implant surgery, the glands in her

neck and chest became very swollen, she developed kidney pain, her hair fell

out and she stopped menstruating. Unable to diagnose the problem, her family

doctor sent her to a gynecologist. Focusing on the lapsed period, he

recommended she undergo hormone therapy, a treatment usually prescribed for

menopausal women. She was 24.

 

Neither physician thought that her implants were in any way related

to her problems, and dismissed her questions about a possible link.

 

" I had been really fit and healthy, " she says, " and now I was a

basket case. I got the flu and colds all the time, I developed all these

food allergies... I couldn't eat; I would be doubled over in pain, crying...

My husband didn't know what to do. "

 

Finally, in desperation, Ms. Dickieson turned to the Internet in

search of some answers.

 

Discovering women with implants who had the same symptoms, she

printed off pages of research and testimonials and marched them down to her

doctor's office. He called a few hours later. " You need to get those

implants out, " he told her.

 

Two years later, she has much more energy, but continues to suffer

from food allergies, kidney damage and night chills. " I was healthy before,

but I've wrecked my body. And there are thousands of women like me. I feel

sick about it. "

 

How representative is Ms. Dickieson's experience? Did her implants

cause her symptoms? The truth is that no one really knows. Most of the

available research hasn't tracked patients over a long period of time.

 

But many women have experienced a range of health symptoms

debilitating enough to have their implants removed, and the U.S. Food and

Drug Administration continues to caution women against the possibility of

serious effects. One Canadian official estimates that women who with breast

implants use the health-care system up to 10 times more often.

 

Despite the bad press implants garnered in the early nineties when

silicone ones were banned over health concerns, women are seeking

breast-augmentation surgery in record numbers. Over the past decade, the

figure for implant operations in North America increased seven-fold.

 

The women typically fall into two categories: those in their late

teens or early 20s who have not yet had children and are not satisfied with

what nature gave them, and women in their 30s unable to come to terms with

their post-childbirth bodies. Most of them say they just want to look

" normal, " even when their own partners disagree.

 

Shelley (all the women identified by their first names only have

asked to have their identities protected), a Calgary fundraiser and mother

of two, says, " I just wanted to look like what North American women are

supposed to look like. "

 

Depending on the source of your information, what North American

women " are supposed to look like " has become increasingly artificial. But

since implants are now evident on many of the most photographed pop singers

and Hollywood stars, it's increasingly difficult to tell what " normal " is

any more.

 

" A particular breast shape is being marketed through the media, "

says Diane Pacom, a sociology professor at the University of Ottawa who

studies the influence of popular culture. " We're buying into the image of a

perfect breast. But it's manufactured. "

 

Some plastic surgeons credit Pamela Anderson. Ever since the world's

most famous surgically assisted starlet bounced her way down a California

beach in the hit TV series Baywatch, implants have had a particularly high

profile.

 

In recent months, a Calgary bar and an Ottawa radio station both

made headlines by sponsoring breast-implant giveaway contests. If the

promotions didn't set out to define larger breasts as " normal, " they

certainly reinforced them as " desirable. "

 

And each generated hundreds of applicants.

 

Lucy, a 39-year-old nurse living in Ottawa, wasn't one of them.

 

By the time the local pop-music station started promoting its

" Breast Christmas Ever " contest, she already had her implants. Married, with

one child, she had undergone augmentation surgery 18 months before in

pursuit of a more proportional look.

 

" I lost 60 pounds after my pregnancy, " she says. " I went from a size

14 to a size 5, and my breasts lost all their form. I couldn't look at

myself. "

 

Her experience isn't uncommon.

 

Shelley, in addition to her implants, receives regular injections of

Botox. " It's in vogue among professionals, " she says. " I get it every four

months to make myself look better. "

 

She is as happy with her implants as she is with the Botox. Although

she describes her post-surgery experience as " more painful than childbirth, "

four years later, Shelley loves the end result. She talks about being able

to wear evening gowns without having to stuff her bra and says that even

though her husband doesn't think her implants feel natural, he sees that

she's happier.

 

In contrast to the stereotype of men being universally attracted to

super-sized profiles like that of Ms. Anderson, Marie's boyfriend also

preferred her breasts in their natural state. Lucy says her husband actively

discouraged her from the surgery, insisting that she didn't need larger

breasts and expressing concerns about the health risks.

 

Nancy, who works in the cash office of a Vancouver grocery store,

says her husband was fine with the idea of implants, " as long as he didn't

have to pay for them. " As it turned out, she needed a loan to help cover the

costs because of the major complications she experienced within 24 hours of

her initial surgery. One breast developed a hematoma, she began to bleed

through the bandages, and there was a lot of swelling. The subsequent

emergency operation left her more scarred and $11,000 in debt.

 

" It took me a year to feel comfortable with them, like they weren't

going to burst, " she says. Lying on her stomach gave her " the

heebie-jeebies, " and she kept herself hunched over because of the pain. Two

years later, however, she says it was all worth it.

 

Marie echoes this sentiment, despite her own suffering. She felt

like she had been " run over by a truck " after her initial operation: " I had

a hard time breathing and talking. I couldn't sit up or lie down on my own.

I was in so much pain, I couldn't even open the pill bottle. And then the

day after the surgery, my left breast dropped because the implant shifted. "

 

As a result, the scar that was supposed to be hidden in the fold

beneath her breast is now visible on the breast itself, and one of her

nipples is higher than the other. In addition, she says, " I can always feel

the implant on that side; it feels very heavy, really uncomfortable. It

looks like an egg; it doesn't look normal. The surgeon said if he were to

try to fix it, I'd have a huge bruise, huge scars. I didn't pay $6,000 to

have it look this way! "

 

Although breast cancer affects one in nine North American women,

post-mastectomy reconstruction accounts for less than 10 per cent of

breast-augmentation patients. The vast majority of women who get implants

for the first time are, as Diana Dickieson was, healthy.

 

Epidemiologist Aleina Tweed recently published research conducted

through the B.C. Centre of Excellence in Women's Health finding that women

with implants had much more interaction with health-care providers than

women without, and were four times more likely to be admitted to hospital.

 

Pierre Blais, a former senior scientific adviser to Health and

Welfare Canada who now conducts research on removed implants and serves as

an expert witness on behalf of those suing implant manufacturers, suggests

that Ms. Tweed's figures are " optimistic. "

 

He believes that the rate of health-care use among implanted women

is six to 10 times greater. Arguing that implant-design technology hasn't

significantly changed in 30 years, Dr. Blais calls implants " a mortgage on

the user's health and wealth. "

 

Indeed, 40 per cent of the women in Ms. Tweed's admittedly

small-scale study had had their implants permanently removed. Fifty per cent

had been diagnosed with at least one chronic illness; a third had lost or

quit their jobs, or reduced their hours because of health problems; and more

than half had difficulty doing housework or recreational activities because

of health problems. A majority of these women reported that their health

problems began after their initial implant surgery.

 

But Ottawa-based plastic surgeon Bryan Callaghan, who has been

performing breast implants for more than 20 years, says there is no evidence

that definitively links implants to the range of symptoms or diseases

reported by women such as Ms. Dickieson, or those in Ms. Tweed's study. Of

the hundreds of patients he has operated on, he says, fewer than 2 per cent

have returned requesting removal as a result of health concerns.

 

Based on her research, Ms. Tweed's view is that " for some women

implants seem to be safe, but for some women they're not. We don't know why.

And so we don't know what we should screen for. "

 

In addition to the lack of long-term data, she says, many women are

reluctant to come forward. She and others have called for a national

breast-implant registry, like the one proposed last year in a private

member's bill in Parliament. She believes that a registry would allow

researchers to collect the data necessary to put to rest the ongoing debate

between plastic surgeons and manufacturers, who defend implants, and those

like Dr. Blais and many women themselves, who continue to raise serious

concerns.

 

In the meantime, women who want implants appear prepared to believe

the former sources, and to discount the troubling information available from

the latter.

 

But as Ms. Dickieson asks, her voice filled with anguish, " Why would

you take the risk? "

 

- Shari Graydon is the Ottawa-based author of In Your Face - The

Culture of Beauty and You (Annick Press, 2004).

 

The down side

 

The U.S. Food and Drug Administration, in fulfilling its

health-protection mandate, has conducted a systematic review of available

scientific research. Its website features a comprehensive on-line handbook

about the health implications of breast implants, which includes the

following information:

 

Breast implants will not last a lifetime. Either because of rupture

or other complications, they will probably need to be removed.

 

Many of the changes to a woman's breast after implantation may be

cosmetically undesirable and irreversible.

 

Once implants have been removed, patients may experience

unacceptable dimpling, puckering, wrinkling, loss of breast tissue, or other

undesirable cosmetic changes of the breast.

 

Non-surgical treatments or subsequent operations may be required to

treat a range of complications including asymmetry, breast pain, capsular

contracture, chest-wall deformity, delayed healing, bleeding, infection,

inflammation, necrosis, nipple sensitivity, rupture, scarring or rippling,

among others.

 

For more information about what is known about the health

implications of breast implants, including a review of the research relating

to neurological and connective tissue diseases from a neutral source, see:

http://www.fda.gov/cdrh/breastimplants/handbook2004

 

In Canada see:

http://www.hc-sc.gc.ca/english/women/facts_issues/facts_implants.htm

 

Cosmetic changes

 

The number of breast augmentations has steadily

increased in North America since 1992 even though a

moratorium was imposed on silicone implants that year.

Breast augment-ations performed

1992 32,607

1994 39,247

1996 87,704

1998 132,378

2000 187,755

2002 236,888

 

Breast-implant removals performed

1992 18,297

1994 28,655

1996 3,013

1998 32,262

2000 37,984

2002 43,507

 

The data represents procedures performed by American Society of

Plastic Surgeons members certified by the American Board of Plastic Surgery

or the Royal College of Physicians and Surgeons of Canada.

 

SOURCE: AMERICAN SOCIETY OF PLASTIC SURGEONS

 

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