Beauty and the Breast
This article was first published as "Beauty and the Breast: How Industry Sold Implants to Women", PR Watch, volume 3, number 1, First Quarter 1996. The original article was authored by John Stauber and Sheldon Rampton and is used here with permission. As with all SourceWatch articles, feel free to edit and revise.
Juries which have issued multi-million-dollar judgments against Dow Corning have based their verdicts on evidence beginning with the first known instances in which silicone was used for breast enlargement.
Following World War II, Japanese bargirls found that their G.I. customers preferred big bosoms, so they attempted to enlarge their breasts with injections of industrial-grade liquid silicone. The injections led to numerous complications. The injected liquid would migrate to other parts of the body, causing infections, formation of hard lumps called granulomas, blood clots to the lungs, cancer and death. Japanese doctors reported in medical journals that women injected with silicone showed symptoms of immune system disorders.
The technique of silicone injections travelled from Japan to the United States, where it was first adopted by topless dancers. Recognizing the problems with injections, Dow Corning developed implants in 1962 which used silicone envelopes to contain the liquid silicone gel inside. Dow and other implant makers projected that the implants were durable enough to remain intact within women's bodies for a lifetime.
Implants did cause problems, however, the most common of which is known as "capsular contracture." The body tends to treat the implant as a foreign intrusion, walling it off by forming an often-painful capsule of scar tissue that hardens, tightens around the implant, and distorts the shape of the breast. Several studies of the rate of capsular contracture have found that it occurs in over half of the women who receive breast implants.
Implant rupture, which causes silicone gel to spill into the surrounding tissue, is another complication, which increases in frequency as the implants age. Contrary to Dow's projections that implants last a lifetime, one study of implant recipients found that 35.7% of the women had experienced a rupture within the first nine years after implantation. By year 17, the rupture rate had increased to 95.7%. The rupture problem apparently increased after Dow redesigned its implants in the 1970s. The thick gel in early implants produced unnaturally firm breasts, so Dow attempted to come closer to the real thing by using a thinner gel, described by one doctor as having "the consistency of 50-weight motor oil."
Problems with the new implants began to crop up in some of the "damning memos" mentioned by Burson-Marsteller PR executive Johnna Matthews. The gel tended to bleed through the envelopes, even when there was no rupture. In an internal memo, sales executive Tom Salisbury noted that implant samples used in sales pitches to doctors "have a tendency to appear oily after being manipulated." He advised salespeople to "change demonstration samples often" and to clean them before demonstrations by washing them "with soap and water in nearest washroom" and drying with hand towels.
In 1977, another Dow marketing executive wrote a confidential memo stating that a number of doctors had raised concerns about gel bleed. "I assured them, with crossed fingers, that Dow Corning too had an active 'contracture/gel migration' study underway," he wrote. "This apparently satisfied them for the moment, but one of these days, they will be asking us for the results of our studies. . . . It is very likely just a matter of time until the orthopedic community will be aggressively asking similar questions to those we are now hearing from the plastic surgeons."
Outside the medical community, women implant recipients were complaining of unexpected implant complications. A 1976 issue of Ms. Magazine documented serious health concerns, which continued to be ignored by the mainstream media.
"We knew that silicone was no good back in the 1970s," says Harriet Trudell, who worked at the time for Nevada Governor Mike O'Callaghan. "Showgirls and cocktail waitresses in Las Vegas were coming under enormous pressure from the casinos to have their breasts enlarged. We wouldn't hear about their cases until they started having problems and came to us for help. The silicone would just rot their breasts away. It was horrible, and of course there went their livelihood."
In the '70s and '80s, however, implant makers and plastic surgeons assured women that "breast augmentation" was a simple, safe procedure. In 1982, the American Society of Plastic and Reconstructive Surgeons (ASPRS) declared that small breasts were "deformities . . . a disease which in most patients result in feelings of inadequacy, lack of self-confidence, distortion of body image, and total lack of well-being due to a lack of self-perceived femininity. The enlargement of the underdeveloped female breast is, therefore, often very necessary to ensure an improved quality of life for the patient." Breast augmentation was also a profitable procedure. Doctors paid $200 to $300 for a set of implants, and charged $4,000 for the one-hour surgery needed to put them in. By 1981, cosmetic surgery had become the fastest-growing specialty in American medicine, and doctors started aggressively marketing their services. In 1983, the ASPRS launched a "practice enhancement" campaign, issuing a flood of news releases, "patient education" brochures, videotapes and other marketing materials. Surgeons like California's Dr. Vincent Forshan bought advertisements displaying their well-endowed clients posing next to luxury cars, with headlines boasting, "Automobile by Ferrari. Body by Forshan."
By the late eighties, advertising had created "a breast-implant free-for-all," according to Franklin Rose, a Houston plastic surgeon who himself performed over 2,500 augmentations. "Twins would come in, sisters would come in, and I'd go from room to room," he said, describing his typical operating schedule.
Another Houston doctor, Gerald Johnson, recalled holding "Grand Teton Days" at least once a month. "The most surgeries we did in one day was seventeen," he said. A successful surgeon could hope to earn as much as $3 million a year, and Johnson celebrated his success by building a breast-shaped pool at his home with a nipple-shaped hot tub. By 1990, over a million women had gotten "boob jobs."
The Bubble Bursts
Until the mid-eighties, no one paid much attention as women began appearing in their doctors' offices with vague and often undiagnosable ailments. Their problems seemed unrelated to their implants: chronic fatigue, memory problems, rashes, joint pain and stiffness, night sweats, skin tightness, swollen glands, headaches, nausea. The symptoms often resembled rheumatoid arthritis, lupus or scleroderma--serious diseases reminiscent of the immune-system disorders that Japanese doctors had reported in early recipients of silicone injections.
In the 1950s and 60s, Dow Corning's parent company, Dow Chemical, had tested liquid silicone and found that it had the potential to migrate throughout the body, affecting the immune and central nervous systems. In 1974, Dow Corning researchers had injected rabbits with silicone and concluded that "organo-silicone compounds can stimulate the immune response." The results of these tests, however, were kept confidential and did not disturb the consensus of opinion within the company, which continued to believe that silicone was an inert, harmless substance.
"I started going to internists with these symptoms and problems and I went to two different internists and no one could find a problem," said implant recipient Marie Walsh. "I had no history of health problems until these polyurethane implants were done and then I developed the blatant rheumatoid arthritis symptoms and, of course, the lupus rash developed at the same time." Walsh eventually started a women's support group and began to receive phone calls from other women, "calling me from all over the United States with these problems and they're crying because they've said, 'Now I have someone just like me.' . . . We, as women, were going to Ob-Gyn's, G.P.'s, M.D.'s, not thinking these problems were related to our breast implants."