The cultural side of implant debate

April 18, 2005|By Ellen Goodman

BOSTON - This has got to break the record for the fastest transition from science to sitcom.

The hearings on silicone implants for cosmetic surgery closed with a split decision Wednesday. An advisory panel rejected one brand, approved another and dropped the whole issue into the lap of the Food and Drug Administration. For three days, dozens of women had testified that silicone implants had either ruined their lives or restored their self-worth. At one point, a woman with implants nearly got into a fight with a group of women wearing T-shirts that read: "100 Percent Natural."

Then a couple of hours after the hearings ended, the scene shifted from the FDA to the Fox network. There was Pamela Anderson, famous implantee, in a new comedy show that is unsubtly named Stacked. Our gal Pamela entered the bookstore called "The Stacks" - double entendres abound - in search of something from the self-help shelf. But her surgically endowed body immediately led all the male characters to behave like - how else can I say this? - boobs.

There you have it. A scientific mixed message trumped by a cultural message.

The debate about silicone breast implants has gone on for well over a decade. The discussion has turned on health and safety, ruptures and leakage, granulomas and scar tissue. But through it all, I have been left wondering, where is the panel to discuss the ruptures and scar tissue in the culture?

Yes, I know the FDA doesn't have the mandate to judge cultural values. Its job is to calculate safety. But cosmetic breast implants exist in that gray zone where medicine meets beauty. In the past year, some 250,000 healthy women have undergone operations to enlarge their breasts with saline implants. Many will tell you that it also enlarged their image. But what do you call surgery that repairs what the culture rips apart?

The history of silicone reads like a feminist conspiracy theory. After World War II, young Japanese women had transformer coolant injected into their breasts to please American GIs. In the 1960s, Las Vegas showgirls had liquid silicone shots to pump up their professional rM-isumM-is. When silicone was put in gel packs in the 1970s and 1980s, it was marketed as a treatment for small breasts, which the American Society of Plastic and Reconstructive Surgeons diagnosed as "deformities" and "really a disease."

Fast-forward in the search for a cure for a cultural disease to the Chorus Line star who sang about a career made on the operating table, not the casting couch. Fast-forward to Extreme Makeover, where breasts are often thrown in as an added extra, like a second pair of shoes. Fast-forward to an era when parents buy their daughters bigger breasts for their birthdays.

Few women want the cartoonish figure of a Pamela Anderson, but we live in a world of superstars and supermodels who are impossibly skinny with improbably perky breasts.

Studies may have found no evidence that the silicones used in implants are toxic to humans. But the difficulty faced by the FDA is balancing the risks against the benefits. How do you calculate the benefits of larger breasts?

At the hearings, the manufacturers defended silicone as a choice. A woman doctor said that if "drugs for erectile dysfunction are sold to enhance the self-esteem of men," surely silicone implants can be sold to enhance the self-esteem of women. Never mind the implication that small breasts are a female form of impotence. We have to ask, what societal weight is there on the "choice" of appearance over sensation, sex appeal ahead of breast-feeding, form before function?

I know there's a continuum, from hair color to face lift, from braces to breasts. I also know that the government can only apply safety standards. And it's by no means certain that the FDA will accept the mixed verdicts of the panel. But in the time I have watched the debate about breast implants, I have also watched the beauty ideal for women grow narrower and the expectation that we will meet it grow wider.

Today the FDA studies the science, but we're stuck here in the sitcom. It's still the culture that is stacked against us.

Ellen Goodman is a columnist for The Boston Globe. Her column appears Mondays and Thursdays in The Sun.

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