Biology 103
2003 Second Paper
On Serendip

Breast augmentation is rapidly becoming a common procedure among women in the United States. Shows detailing the surgery on TV station such as MTV and VH1 show mothers and their daughters getting implants together and teenage girls thrilled with their new 34-D chests. What most of these shows don't mention are the possible risks and painful recovery that come with the procedure. That breast implants are becoming more and more an accepted part of popular culture raises several questions. Are implants as safe and easy as they seem? Are women getting implants because they expect them to radically change their lives? More importantly, does our culture really believe that breast implants somehow improve a woman's quality of life?

There are two kinds of breast implants. Silicone implants, currently under review for re-approval by the FDA, consist of a silicone pouch filled with a silicone gel. Saline implants, currently the only implants available unless a woman is part of a medical trial, are simply a silicone pouch that is filled with saline solution once it is implanted in the woman ((1)). The risks associated with both kinds of implant include implant rupture, capsular contraction (where the scar tissue around the implant tightens), calcium deposits in the tissue surrounding the implant, infection, hematoma, delayed wound healing, a possible atrophy of breast tissue and an increased difficulty for medical professionals when reading mammograms ((2)). Rupture and capsular contraction are fairly common with both kinds of implant, and require that the patient undergo surgery to correct the problem. In fact, about 20% of women who sought breast implants for augmentation, and about half of those who had the surgery for reconstructive purposes have reported having "re-operations" ((3)). Despite all of this, many women say that they were not given adequate information about the risks associated with breast implants before undergoing the surgery ((4)).

The recent push for approval of silicone implants is particularly problematic. Doctors and patients often prefer the silicone implants because they more closely mimic the look and feel of breast tissue ((1)). Although there is little evidence supporting the claims made against silicone breast implants in the 1980's (which said that they contributed to autoimmune and connective tissue disorders), it can be said that silicone implants cause more problems than saline implants. When a saline implant ruptures, it deflates almost immediately, creating visible evidence of the problem ((1)). Silicone implants may show symptoms of rupturing, but many women have a "silent rupture" in which the scar tissue around the implant holds in the saline gel. Since these women have no symptoms, the only way to identify the rupture is through MRI ((5)). What makes this particularly alarming is that the long term effects of having the silicone gel sitting indirect contact with scar and breast tissue is unknown, which is one of the reasons that the chairman of the FDA advisory panel, which voted in favor of approving silicone implants, asked that the FDA ignore the panel's advice ((6)). Long term safety of silicone implants has simply not been demonstrated by any studies presented to the FDA, yet many in the plastic surgery community continue to push for their approval.

Aside from the physical risks of breast augmentation, there is the psychological aspect. Studies have shown that the connection that some once claimed existed between breast implants and suicide is not a valid one. What is now considered to more likely is that certain subgroups of women who seek breast implants are often in demographic groups that put them at a higher risk for suicide, but that this has nothing to do with the surgery itself ((7)). One doctor even goes so far as to claim that breast implants actually reduce the risk of suicide among women in these groups by improving their self image ((7)).

This theory brings to light what I consider to be the most troubling aspect of breast augmentation. It appears as though many people, including the doctors performing the surgery, see implants as a quick fix for women's body image. There has been a 600% increase in the number of breast augmentation surgeries performed in the last decade, with 32,000 performed in 1992 and 225,000 performed in 2002 ((8)). In between 2001 and 2002 the number of women ages 18 and younger getting the surgery increased by 19% ((9)). That the procedure is becoming more common among women in general suggests a disturbing trend; the idea seems to be that because you can do something about your small breasts you should do something about your small breasts. The increase in the number of younger women getting the procedure implies that society in general is becoming more accepting of the idea that a teenager who is unhappy with her body (which is fairly normal) needs to seek surgery to correct the problem, instead of developing a more healthy relationship with her body as it is before deciding on such a drastic procedure, the dangers of which she probably does not fully grasp.

I am not "against" breast augmentation or plastic surgery in general. Plastic surgery provides a valuable service to those who have been scarred in accidents, and to women who have lost their breasts to cancer. Even in cases where the procedure is non-restorative, breast augmentation can be beneficial for women who fully understand the procedure and acknowledge that it is more than likely not going to be a quick fix to their problems. The trend in popular culture, however, leans towards encouraging women to "explore the possibility of sculpting a new you" ((10)), as though surgery will somehow change and improve a woman's life. By encouraging this mentality, popular culture is able to avoid facing the problematic beauty ideals it constructs for all of its members, not just women. The idea that there is no reason to reevaluate the standards set by society because everyone can go under the knife to conform to the standards is a frightening one.

References

1)Saline Vs. Silicone Implants, Discusses differences in aesthetic qualities of implant types, as well as risk variances.

2)Potential Breast Implant Complications, Informs the reader of the various risks associated with breast implants and breast augmentation surgery.

3)Silicone Breast Implants Would Be Carefully Monitored, Lists some of the restrictions that would be imposed on silicone implants upon reapproval

4)Silicone Breast Implants Do Not Cause Chronic Disease, But Other Complications Are of Concern, Discusses the myths and truths about breast implant complications.

5)Silicone Breast Implants – Most Common Risks

6)FDA Advisor: Ignore Breast Implant Vote, Details the concerns that the FDA advisory board chair has about silicon implants.

7)Suicide Risk May Be Lower Than Expected, from the American Society For Aesthetic Plastic Surgery.

8)Silicone Breast Implants Redux

9)Silicone Breast Implants Could Make a Comeback After FDA Hearings, Talks about the rise in the number of breast augmentation surgeries.

10)Breast Enhancement For the Modern Woman, Article written by a plastic surgery


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