The Pressures of Perfection

By Katherine Beagle

I call myself a feminist. I am preparing to graduate with a B.A. in Women’s Studies from the University of California, Riverside (UCR). I believe that a woman’s value should not be measured in terms of her attractiveness, sexuality, or reproductive capabilities. Nonetheless, I have wanted breast implants since I was a sophomore in college. I have simultaneously fought for women’s equality and desired breast augmentation.

Like most young women, I feel the pressure to be perfect and, in our society, that means having large breasts. I see the models, actors, and dozens of women on the street with nice, curvy bodies, and I want the same. Throughout my four years in college I have listened to feminist professors lecture about women’s objectification and exploited sexuality. I have read articles and written papers about women’s struggles to gain equality. All the same, I fully intended to purchase a pair of perfect boobs before entering law school.

During my last year as an undergraduate, I interned for 10 weeks at the National Women’s Health Network, where I researched breast implants for a special project. When I started reading about the risks involved with breast implants, I became tentative about my own intentions to go under the knife.

My initial plan had been to finance the procedure with a loan and pay it off within a couple of years. I discovered, however, that additional surgeries are often needed due to complications that include infection, rupture, extrusion, or capsular contraction (painful hardening of the breasts). I hadn’t anticipated anything going wrong with my implants, but the numbers speak for themselves. About 250,000 women have breast implant surgery for augmentation each year. And studies have shown that 20-26 percent of augmentation patients receiving saline-filled implants needed additional surgery within five years of the initial procedure1. Health risks aside, I asked myself if it was worth risking having to pay for an additional surgery if I have a complication? Was I willing to jeopardize my education should I have to choose between law school tuition and medical bills? These were only the beginning of my worries.

The FDA imposed restrictions on the availability of silicone-gel-filled breast implants in 1992, but it allowed continued general use of saline-filled implants (consisting of a silicone envelope with a saline filling). (Silicone-gel-filled implants continued to be available to some women through reconstructive surgery and clinical trials.) Manufacturers and plastic surgeons are trying to get silicone-gel filled implants approved for general use as well and the FDA just sent ‘approvable’ letters to two silicone implant manufacturers; silicone gel-filled implants are likely to return to be widely available soon.

On April 11-13, 2005, I attended the FDA Advisory Panel meeting on silicone-gel-filled implants (see the July/August Women’s Health Activist). During the panel meeting, I met numerous women who testified that their silicone-gel-filled breast implants ruined their lives. These women suffered from various symptoms including arthritic pains, extreme fatigue, high levels of platinum in their and their children’s bodies, and other health problems. Other women testified that they loved their silicone gel-filled implants and had experienced no problems with them.

At this point, I had developed some serious doubts about putting a foreign object in my body when long-term studies have yet to be conducted, and have yet to prove silicone-gel-filled breast implants to be safe. I assumed that they were safe because implants have been around for decades, and hundreds of thousands of women get them each year. I also had assumed that if the FDA approved implants, they must be safe, right?

Not necessarily. FDA approval means that the implants are ‘reasonably safe’. After the panel meeting, I began to ask questions such as: How long do they last? What happens when silicone leaks into the body? Who will have to pay if I need multiple surgeries because of complications? How could implants affect my ability to breastfeed? Will my insurance company cover me if I have problems with the implants? It is important to ask questions and be aware of the risks and consequences involved with the procedure.

The answers I found were hardly comforting. I learned that all implants break at some point – it’s just a matter of time. Newer, silicone-gel-filled implants have not been around long enough to know precisely how long they will last. When a saline-filled implant breaks, the saline leaks into the body and is absorbed. That is usually safe, unless the saline is non-sterile, or contaminated with a fungus or bacteria. When a silicone-gel-filled implant breaks, the silicone might move around the body and get stuck, making it impossible to remove. Evidence seems to suggest that implants can interfere with breast-feeding and with milk production; one study found that 39 percent of new mothers with saline-filled implants had trouble breast-feeding2.

This is not a storybook ending; I have not completely ruled out the idea of getting implants. What I do know now is that I would like to see more conclusive long-term studies that show whether implants are safe or not before I make a final decision.

I also would like women to recognize that many people (even feminists) feel the pressure to be perfect and that, when we comply with prevalent norms of beauty, we risk measuring our own value in terms of attractiveness and sexuality rather than by deeper qualities. Ultimately, I want women in our society to have worth without having to nip, cut, tuck, or enhance any parts of our bodies. The National Women’s Health Network works to inform women about health issues so that we can make informed decisions about our own health, and can assist other women in doing the same. And so I stand here, still undecided about implants, but definitely more educated on the subject.

References

1.  FDA Breast Implant Consumer Handbook – 2004. See http://www.fda.gov/cdrh/breastimplants/indexbip.html
2. Strom, S.S., Baldwin, B.J., Sigurdson, A.J., Schusterman, M.A., ‘Cosmetic Saline Breast Implants: A Survey of Satisfaction, Breast-Feeding Experience.’ Cancer Screening, and Health, Plastic and Reconstructive Surgery. 100:1553-1557. 1997. See: http://www.commandtrust.org/children.shtml

Katherine Beagle recently received her Bachelor’s Degrees in Political Science and Women’s Studies from the University of California, Riverside. She plans to attend law school and looks forward to making women’s health advocacy part of her career. Katherine’s time as an intern at the NWHN in Spring 2005 was a great determinant in deciding her field of study.