Women's Bodies, Women's Wisdom (84 page)

Since then, several additional studies have been done on long-term mortality among women with silicone implants. A 2001 study by the National Cancer Institute found that women with breast augmentation were more likely to die of brain cancer or lung cancer compared to other plastic surgery patients. In fact, the results showed a doubling of brain cancer and a tripling of lung cancer, emphysema, and pneumonia in women with implants. There was also a fourfold increase in the risk of suicide among implant patients.
¹¹¹
A 2007 review conducted by the University of Pennsylvania Medical Center of six different studies found that women with cosmetic breast implants had approximately twice the expected rate of suicide.
¹¹²
Researchers in one such study from Sweden felt this increased risk was likely not related to any effect of implants; rather, there is a link between the desire for plastic surgery and psychiatric disorders,
¹¹³
a risk that is well documented.
¹¹⁴

It’s intriguing that both brain cancer and suicide risk appear to be higher in women with breast implants. Those are both sixth-chakra issues— involving perception, thought, and morality. In other words, it is not the implants themselves that are causing the problem. It is how each woman is thinking about and perceiving herself and her worth that either sets the stage for health or illness concerning implants.

Having seen dozens of women over the years who have done very well with their breast implants (and some who haven’t), I’m convinced that the women who are most likely to do well are the ones who generally already feel good about themselves and their worth but are getting the implants to enhance how they look in clothes or because of their professions, such as modeling or acting. (See stories, below.) They are not getting implants to get or keep a man or because they don’t feel feminine enough.

It doesn’t take a sociologist to figure out why women would want to look like the images that have been burned into our brains since childhood by everything from
Playboy
to MTV. (By the time my daughters were eleven and thirteen, they had been concerned with their body shape and weight for several years.) The pressures on girls to match the cultural ideal is far greater now than in the past.

But when I first watched a breast augmentation and saw the amount of tissue damage done by lifting the chest wall off the underlying tissue, I instinctively held my own breasts protectively. I realized that I could never elect to have this procedure, as it is currently performed, done for cosmetic reasons. For one thing, implants can decrease or eliminate nipple sensation, which is part of a woman’s sexual pleasure. The implants can become very hard (though that is less common with the materials used now), and they can cause the breast tissue to develop fibrous capsules around them. (To prevent this, take omega-3 fats as supplements, 1,000–5,000 mg/day; see
chapter 17
, on nutrition.) In some cases they make it difficult (though not impossible) to nurse a child.

There are other risks associated with implants that all women who plan to get them should keep in mind. Data show that about 40 percent of augmentation patients and 70 percent of mastectomy reconstruction patients have at least one serious complication within three years after getting their implants. Within the first three to five years after surgery, 12.5 to 25 percent of breast augmentation patients can expect to have additional surgery, and within ten to twelve years, most women will need at least one additional surgery. The reason is that by then, at least one implant is likely to have ruptured. Like most new products, the majority of implants are often fine for the first few years. Then, like with anything (such as a car), problems can happen over time. The older they get, the more likely they are to rupture. The ruptures are not always obvious.

All breast implants have the same basic design. They are made up of a silicone envelope with a filling of some sort, usually saline or silicone gel. Silicone implants have a more normal feel than saline, and a big advantage of the newer ones is that it’s impossible for them to leak. The silicone is in a matrix, sort of like a gummy bear candy, so it ad heres to the shell that encases it. Even if the implant develops a hole or a tear, called a rupture, the silicone stays put and can’t migrate into the body and cause tissue reaction. This is thought to be why the newer sili cone implants are less likely to develop hard encapsulations around them.
¹¹⁵
(Before getting breast implants, check out the information at
www.breastimplantinfo.org
.)

Mammograms can potentially cause an implant to break, especially with older implants or with a technician who is not trained to work with breast implants. (Make sure the mammogram technician knows you have implants and is qualified to do the procedure.)
¹¹⁶
Women who have had implants after a mastectomy do not need mammograms of the reconstructed breast. MRIs are useful for imaging both the breast and the implant when mammograms are not helpful or are intolerable.

At the end of the day, I would never judge women who have had implants or who want them, any more than I would judge women who have had their nose size and shape cosmetically altered. Breast implants and the newer breast reconstruction methods can give women who have lost a breast to cancer a body image that ap proaches wholeness. This surgery can be key to a woman’s healing. Sharon Webb, M.D., Ph.D., a plastic surgeon who specializes in breast reconstruction following breast cancer surgery, says that she often receives letters from her patients and their family members telling her how grateful they are for her work and how much the surgical breast reconstruction has contributed to their overall sense of well-being.

None of us is immune to our cultural inheritance and its impact on how we approach our breasts, and we need to exercise compassion for our own and other women’s choices. Each woman has to decide for herself what feels best for her body and why. Here are a few stories concerning cosmetic breast surgery and its consequences.

Women’s Stories

Janice: Family Pressure

Janice came to see me ostensibly for a routine annual physical exam. She had been there on two previous occasions for diaphragm fittings. A working woman, she was slim and attractive. When I entered the exam room, she said that she had some other issues she wanted to discuss after her exam, so afterward she came into my office.

Janice told me that she had had a breast enlargement procedure a few years before and that everything seemed fine. (My exam had con firmed that.) In my office, however, her eyes filled with tears, and she said she was afraid she would cry because she had something to ask me that she had never before asked a doctor. I suggested that she stay with her emotions because whenever we’re moved in this way, we are on to something very important. She continued, “I first went to see a gyne cologist when I was sixteen. I was having terrible menstrual cramps, and I wanted to see if anything was wrong with me. He wouldn’t let my mother remain in the room with me when he examined me. His exam was very painful and I asked him to stop, but he wouldn’t. Then when he saw my breasts, he laughed and said, ‘Maybe if you marry and your husband fondles you enough, they’ll grow.’ ” He prescribed birth control pills for her cramps, and she left the office feeling humiliated.

Janice went on to describe her early breast development. She said that at first her nipples had grown and started to stand out. It felt, she said, as if she had a walnut-size mass under each nipple. The tissue grew to about the size of an avocado pit and stopped. What she was describing was normal breast budding, with normal glandular tissue underneath the nipple. This had happened around the time she got her first period. I told her that it all sounded very normal to me. She cried again. Her breasts were naturally small, but her mother, her brother, and a sister had always referred to her as “deformed.”

One day while clothes shopping with her mother, her mother com mented on Janice’s “deformity” and told her that if she ever wanted anything done about it, she’d be willing to pay for it. (I frequently hear stories of mothers telling their daughters that their breasts are not big enough. Sometimes they suggest that their daughters wear padded bras or stuff their bras with tissue.) Janice surprised her mother and said that she did in fact want something done. Soon after, she had an aug mentation mammoplasty, or breast enlargement procedure, with silicone implants.

I asked Janice how she felt about her breasts now. She replied that she had mixed feelings because of the circumstances under which she had had the surgery. Since she was also having acupuncture treatments and was more interested in natural healing than she had been in the past, she was afraid that she’d messed herself up by doing something so “unnatural.”

My reply was to share with Janice that many women have elected to have their breasts enlarged and have been very happy with the procedure. The women who are happiest with it are those who have given it a lot of thought beforehand and are doing it to please themselves and not anyone else. These women usually have good results and no complications. When someone feels positive about a decision such as this, I believe that her immune system function is enhanced and that the com plication rate is apt to be lower. I wanted Janice to know that I didn’t think that having the breast surgery had damaged her health in any un alterable way.

Most important, I affirmed that she was normal, not “deformed,” and that she had always been normal. She simply had small breasts, like all the women on her father’s side of the family. Unfortunately, she had grown up in a family that was emotionally abusive about her body at a time when she was very vulnerable. Her visit to the gynecologist had reinforced that pathology.

Now, at the age of thirty-three, Janice was finally ready to bring up this history about her body. Before she left, she said to me, “You have no idea how important it is for me to hear this stuff from a doctor.” I suggested that she spend the rest of the day staying with her tears and any other emotions that came up. I asked her to express them through sound. All of the tears and all of the emotions that we stifle stay in our physical bodies as unfinished business and are waiting for us to attend to them. Janice now had the opportunity to finish a significant amount of healing. She was ready to heal on all levels her relationship with her breasts.

Sarah: Implants to Please Her Husband

Sarah was about fifty-five when I first saw her. She had raised several children and had been married for twenty-five years to an alcoholic but was now divorced. As is so often the case with people like Sarah, her father had also been an alcoholic. Fifteen years before, Sarah’s husband had become impotent. He had blamed her for his condition, telling her that her body just wasn’t the way it needed to be for him to be able to get an erection.

Like so many women who are in dominator relationships, Sarah believed him and took on his problem as her own. Her husband said that maybe he wouldn’t be impotent if her breasts were bigger. She dutifully went to New York and had breast implants placed. She hated them from the first, and her husband’s impotence remained—except that now he told her something must be wrong with her vagina. Their relationship continued to deteriorate, and his drinking worsened.

Several years later Sarah’s husband left her. (He is now with a younger woman, for whom we can all feel sorry.) Sarah went into code pendence recovery and realized that she was
not
the cause of her husband’s impotence and never had been. But now she is stuck with silicone implants that she hates. She said that when it’s cold outside, her breasts don’t get warm because it takes so long for the implants to warm up. She had apparently looked into having them removed but was told that it would cost her thousands of dollars, which her insurance wouldn’t cover. Every day she is reminded of the price she’s paid with her body. (Sometimes insurance will cover implant removal. And many plastic surgeons will remove them for a minor fee.)

Kim: Implants to Please Herself

Kim is a vivacious woman in her late thirties. She works in the fashion industry now, but she was a teacher for years. When she was a teenager, she had large hips and very small breasts. She was never able to buy a suit because she could never find a top and a bottom that both fit. For years she was unhappy with her figure, even though she was a multitalented woman. She exercised and followed diets to correct as much of the imbalance as she could, and she elected to have her breasts enlarged after giving it years of thought. The procedure went beautifully and was healing for her because she chose this procedure under optimal circumstances: She did it for herself. She already had high self-esteem, and her expectations for the procedure were appropriate. When the media hype about the dangers of implants broke out shortly after her surgery, she remained unconcerned. She has never had a problem. I spoke with her recently, nearly ten years after her surgery, and she said she still loves her implants and is certain she’ll have no trouble with them.

Beth: Caught in the Middle

Beth was a patient of mine for years. She had two pregnancies and nursed both children. Her husband left her after her second child was born, and she was raising her children by herself. She was independent and strong. Several years ago, she had a breast augmentation. After childbirth and nursing, her breasts seemed to be flaccid. She couldn’t find a bra to fit, and she was uncomfortable with her appearance. She had always had a very attractive body. (I realize that this concept is loaded: Attractive to whom? Why? For what purpose?) In any case, though she had a very low income, she managed to get the money together to have her breasts enlarged. The outcome was excellent, and she was very pleased with the results. An anthropologist might say that her “so cial” body was improved by this surgery. (She’s currently at work on overcoming her uncanny ability to attract men who aren’t supportive of her.)