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Are breast implants a form of mutilation?

Why would a woman pay a considerable sum of money to have a surgeon cut open her body and implant globs of plastic filled with chemicals?

When you get right down to it, isn't it just another form of female genital mutilation?

Those are a couple of the questions asked by Marianne Mollman of Amnesty International in a provocative new essay published by The Huffington Post.

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Sure, conditions are far more sanitary at Western plastic-surgery clinics where women's breasts are sliced and "enhanced" than in dirt-poor villages in the developing world where girls and young women have their clitorises and labia excised ritualistically.

Yes, the breast augmentation is done voluntarily, but then so too is much female genital mutilation. But both practices are driven by ingrained notions of a woman's place in society, the quest for an ideal of beauty/sexuality and social/religious norms.

Isn't the outcome ultimately the same, Ms. Mollman asks: surgery with no discernible health benefits (and many potential health risks), a negative impact on a woman's sexual health, and permanent scars, physical and psychological?

Obviously, the mutilation of girls and women with rusty razors is a far greater horror, a human-rights violation on a grand scale.

But the rhetorical comparisons do serve a useful purpose. They should lead us to wonder why Western society is so enamoured of large breasts. The comparisons should serve too to remind us that breast augmentation surgery is not as banal as we tend to make it out to be.

That point is driven home by the current scandal unfolding from Australia to Uruguay. (It does not directly affect the Canada or U.S.) The French company Poly Implant Prothèse sold about 400,000 implants between 1991 and 2011, when it declared financial bankruptcy. But the current problem had its roots much earlier. The company allegedly, in a bid to cut costs, removed one protective layer from the product and used industrial-grade silicone (used in mattresses) in its implants instead of medical-grade silicone. Just as concerning as the company's actions was the failure of regulators to catch the gross, decades-long violations.

There are fears that, due to the cutting of corners, the PIP implants are more likely to leak and, hence, raise a woman's risk of cancer.

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Countries and individuals are now scrambling to figure out what to do. Is it best to remove the implants or leave them in place? If they are to be removed, who will pay – the private clinics that implanted them, the state, or women themselves?

Breast augmentation has a long, sordid history. In her book Inventing Beauty, Teresa Riordan notes that women have used a seemingly endless variety of contraptions to enhance their bosoms since the 18th century: bustiers, falsies, wire devices, suction machines, creams, injections of paraffin wax, animal fat and so on.

In the early 1960s, technological advances led to a switch from glass bottles to plastic bags for the storage of blood for transfusion. One day, a physician carrying a bag of blood noted that it felt like fondling a breast. His colleague, Thomas Cronin, had a classic Eureka moment. He created the first breast implants.

The product took off, interest fuelled by buxom Hollywood stars, and the relaxing of sexual mores that made publications like Playboy and "entertainment" venues like strip clubs more popular.

Breast implants were not regulated until 1976, when researchers began to worry about risks of cancer. In 1980, CBC-TV ran one of the first exposés. Later, Montreal Gazette reporter Nicholas Regush exposed the Même breast implants scandal, showing that polyurethane foam degraded in women's bodies, causing health problems, and that Health Canada failed to act on the danger.

Similar issues arose around the world. In 1992 the U.S. Centers for Disease Control and Prevention essentially banned the cosmetic use of implants. (They could still be used for reconstructive surgery for breast cancer survivors and for men undergoing sex changes.) The hiatus lasted until 1999 when the Institute of Medicine released an exhaustive report concluding implants did not cause any systemic disease. However, the report noted that the surgery can lead to serious infections, to loss of nipple sensation and to capsular contraction, which can leave the enhanced breast rock-hard.

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The moratorium was lifted contingent on manufacturers doing large, postmarket research studies that track the health outcomes of at least 40,000 women over a decade or more. We still don't have the results but, despite the scandals and the health concerns, implants are selling more than ever.

Today, an estimated 10 million women worldwide have breast implants, and it is one of the most common cosmetic surgeries procedure on Earth.

In other words, breast implants have become normalized: It has become, in our consumerist society, natural to look unnatural.

Should our outrage be limited to the fact that a manufacturer used mattress-grade silicone rather than so-called medical-grade silicone? Shouldn't we be more concerned about the fundamental acceptability – and ethics – of sewing plastic bags into women's breasts to "enhance" them, regardless of the material used being silicone, saline or foam?

Should we glibly accept the mutilation (or self-mutilation if you prefer) as normal? And, if so, are we not tacitly accepting the mutilation of women's genitals more generally?

Barbarism remains barbarism, even when it is regulated, and even when it is sugar-coated (or plastic-coated and sterilized).

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About the Author
Public health reporter

André Picard is a health reporter and columnist at The Globe and Mail, where he has been a staff writer since 1987. He is also the author of three bestselling books.André has received much acclaim for his writing. More

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