Thursday, April 10, 2008

Silicone-istas going batty over Newsweek breast implant story

If it wasn't so predictable it would be funny.

Newsweek magazine ran a vanilla story about breast implants called "Chest Right" which was an overview safety/educational guide for laypeople on some issues re. breast augmentation surgery. It's a very conservative piece and touches on a few important factors like choosing a qualified surgeon, complications, follow up, silicone vs. saline devices, etc.... It quotes the presidents of the two major Plastic Surgery organizations and one of the more well-known female Plastic Surgeons, all of whom are reputable and all of whom have extensive track records of championing patient safety issues. In summary, a very mainstream and respectful treatment of the issue.

Skip to the reader comments however, and you see breathless condemnation of the story by a number of the crusaders that populate the handful of web bulletin boards promoting the idea that a giant medical-industrial conspiracy exists to hide the truth from unsuspecting women about links of implants to every known medical condition and psychiatric disorder known to man. Readers of Plastic Surgery 101 know that there is pretty overwhelming international consensus that breast implants have been vindicated over and over in this regard in the medical literature (read here).

Now implants have their own issues, namely capsular contracture and surveillance for rupture, but we appear poised to make signifigant progress on these issues with the 5th generation form stable silicone implants seemingly poised for approval. Both the major manufacturers, Allergan & Mentor, have arranged for inservices this spring for their product reps on these devices. To me this suggests they've already heard thru the back channels that FDA approval is imminent and are getting ready for a new marketing push. You'd think with the improved performance data on these devices, the people upset over existing implants would be encouraging the FDA to act. On the contrary they're determined to push the FDA to rescind access to all breast implant devices (silicone and saline).


Snafu Suz said...

On the contrary they're determined to push the FDA to rescind access to all breast implant devices (silicone and saline).

Seriously? They want to eliminate access to ALL implants??? Clearly they have not had breast cancer and had to live without breasts all together. Sure, there's the option of tissue transfer surgeries for reconstruction, but I for one don't want to have to hack up other parts of my body to form a couple of breasts for myself. I already have enough huge scars from my mastectomy, thankyouverymuch.

Tissue transfer surgeries definitely have their merit and their place (for women who have had radiation, problems with capsular contracture with implants, don't feel comfortable with implants, etc) but the MAJORITY of recontruction patients choose implants if they can. Why? Because they are less invasive, do not cause additional scarring, they generally look better, have a shorter recovery time, etc, etc, etc. Take away this choice and we breast cancer survivors are forced to endure even more hardship than we already have, either going without breasts all together or having to go through even more trauma to our bodies with tissue transfer recon.

This is not to mention that women who want an augmentation simply wouldn't be able to anymore because they don't do tissue transfer for augmentations (as far as I understand it - please correct me if I'm wrong on that).

As you know Dr. Oliver I am a breast cancer survivor and a fellow blogger. I got slammed on my blog for saying silicone is safe and actually had one person have the audacity to tell me that the "bravest" thing I could do is go without recon all together. Whatever. Clearly that person still has their boobs.

I wish the silicone crusaders would back off and let the rest of us make our own choices. I have new silicone breasts and I am happy, whole again, and still healthy! If I get lupus the naysayers can say "I told you so", but I'm pretty darn sure hell will freeze over before I get an auto-immune disease from my implants.

Cancer and the silicone-istas can kiss my patooty!

Dr. Rob Oliver said...

Thanks for the note Suz! I have a post I'm working on where I refer to you. Stayed tuned!

As to the anti-implant activists... I don't want to come off super-dismissive to their concerns. However, the ignorance and dismissal of evidence based medical practice on this topic that floats around those circles undercuts their credibility.

There are 3 big issues with implants to me that all sides in this issue should be looking at

1. reoperation rates from technical errors and oversized implants

2. capsular contracture

3. rupture rates of earlier generation implants.

Surgeon and patient education can improve signifigantly on #1, while next generation implants appear to greatly address issues 2 & 3 in most patients.

Private Beach said...

Leaving aside breast cancer survivors, just because breast implants are safe doesn't necessarily mean they're desirable. The Sun newspaper in England had a recent article about a 12-year-old who already wants to follow in her mother's footsteps by getting a breast enlargement. You are right to castigate those whose arguments against implants deny the science; but there are serious issues which need to be addressed about the social pressures on healthy young women with small breasts to conform to an unrealistic "ideal" body shape.

Dr. Rob Oliver said...

I'm not so sure that breast implants have some unique characteristic of body modification that you've got to single them out as problematic from a philosophic POV.

People modify their appearence in many ways that are "unrealistic" from hair dye, nail polish, tattoos, body piercing, wonder-bras, fashionable clothes, etc.... I wrote a blog post last year about how when compared to historical standards around the world, what passes for extreme body modification now is rather tame.