‘I Did It Just for Me’ : Three women talk about their breast implants--why they had them, how they’ve learned to live with them and what they plan to do in the wake of this week’s FDA call for a moratorium on the sale and use of silicone gel breast implants.
Rosemary Hale is “very angry.”
Only last Thursday, she and her plastic surgeon discussed a date to replace the silicone gel implants in her problem-plagued breasts.
Now, she says, she’s been placed in limbo by the FDA moratorium.
“I’ve lost my freedom of choice,” says Hale, 41, an Orange County sales representative. Her breasts shrank after childbirth and breast feeding, so she had implants inserted in 1986--”just for me. I felt good about it.”
She still feels good about it even though she’s facing the sixth operation on her breasts.
“I didn’t feel any panic,” Hale says about potential evidence linking silicone leakage to autoimmune disorders, arthritis and cancer. She reasons that, although cigarette smoking has been linked to cancer, “cigarettes have not been banned.”
A day after Hale’s implants were inserted, a hematoma had to be removed. But for the next 4 1/2 years, she had no problems and was delighted with her new breasts. However, last January, a mammogram revealed a cyst in her left breast and in March four cysts--all benign--were removed. The breast tissue did not heal properly. During corrective surgery in November, more cysts were removed. Last month, another hematoma was removed.
“Even after all this, I would support the whole concept of the breast implant,” she says, “and I’m looking at surgery No. 4 in less than a year.”
Hale does not connect her fibrocystic disease to the implants and has “no regrets” about having implants. “I have a lot of confidence in Dr. (Garry) Brody. The bottom line is, there are isolated cases (of health problems). They’re real and they’re valid, but several cases aren’t going to affect the millions of women who have them who have no problems.
“I would never contemplate having the implants removed permanently.”
Hale had looked forward to getting new gel implants, an advanced design with textured coating to help prevent scar tissue. Meanwhile, her left implant has shifted out of position.
Hale says she’s had so much breast tissue removed that she is not a good candidate for saline implants, which are unaffected by this week’s moratorium.
Now, she says, “I am forced to wait 45 days to see what happens. What are my choices? I’m between a rock and a hard spot. I’m frustrated.”
She adds, “I would like to write letters to (FDA Commissioner) David Kessler, write to my congressman . . . . My reconstructive surgery is being placed on hold. I’m in a dilemma.”
Brody, Hale’s surgeon, is secretary of the American Society of Plastic and Reconstructive Surgeons and past president of the state society. He says some of his other patients are having second thoughts about getting implants.
But, “I’ve had just as many patients say: ‘Get me in under the deadline,’ ” anticipating a ban. “We had a rush in December. I’ve also had patients who’ve bought themselves an extra pair of implants, just in case.”
Barbara does not consider herself a risk-taker. After the second of her four children was stillborn, she quit smoking, cold turkey.
But, in August, 1989, she had silicone gel implants. “I’d always enjoyed having large breasts,” she says. “I was built to have them. Somehow along the line they were lost in childbearing. They just sort of disappeared.”
The 51-year-old Westside property manager consulted with Dr. George Semel of Beverly Hills. He had given a silicone implant to her daughter, whose breasts had not developed evenly when she reached puberty--”She had one that was almost a D and one was an A.”
Now, mother and daughter have silicone implants. Barbara, who asked that her real name not be used, says she’s not worried about the FDA moratorium. “It’s not time to panic until it’s time to panic. I think this is very early to get excited.”
Her daughter, now 23, has had her implant for seven years and had to have it replaced once because of encapsulation and hardening. Barbara, too, has had some problems with hardening caused by formation of scar tissue.
Before surgery, Barbara and Semel discussed hardening, leakage and other potential problems. Again, no risk-taker, she even tried out an implant sac beforehand. “I took that thing and stomped on it. My husband did the same thing,” she says, laughing. “It went through cruel treatment.”
The surgery, performed in Semel’s office, produced little pain, she says, though she experienced tenderness for several weeks and some bruising. The implants were inserted through the nipple to eliminate scarring.
Her new breasts “aren’t the first thing you notice when I walk in the room,” she says. “I did it with taste. Nobody noticed anything. It was sort of good and bad. I swore my children to secrecy, otherwise they’re out of the will.”
When her internist complimented her on her new breasts, Barbara says, she told him, “The fact of the matter is I have 18-year-old breasts and 45-year-old elbows.”
She admits: “For me, it was a frivolous thing. I could afford it. It cost me $3,500. I didn’t do it to get a guy or have a husband who’d lost interest in me regain interest. It’s not a thing where every time he sees me he says: ‘Oh, boy!’ In the beginning, he laughed and got a kick out of them.”
To combat hardening, patients are advised to massage their breasts regularly and rigorously. “At first, I must tell you, I was afraid of them,” Barbara says. “I thought they were going to break.”
But when hardening developed, she underwent ultrasound, in an unsuccessful effort to break the scar tissue. Then, one day, she remembers, “the doctor tried to break it himself.” He massaged until he got red in the face. “He was in one of those chairs with the wheels on it and he sailed across the room. We both had a good laugh.
“If I had to take them out, it wouldn’t bother my husband one bit,” she says. When he heard the FDA announcement, “he looked at me and said: ‘What are you going to do?’ I said: ‘Nothing.’ He said: ‘Oh,’ and then he went back to reading.”
Semel, her plastic surgeon, says he has spent a lot of time on the telephone since Monday’s announcement. One call was from “one of my inflatable ladies (one with a saline implant) from 1977 who didn’t remember which kind she had.”
He has reassured patients with silicone implants that, to the best of his knowledge, they are safe. Semel does 50 to 75 a year, he says, and breakage is rare. “We had one lady who was stepped on by a horse and we had a lady who was in a car accident.”
He knows of no cancellations of planned implants. Until the silicone issue is resolved, Semel says, he will use saline inflatables--”I always liked them. It was the public that didn’t like the need for replacement” because of deflation.
There are other options, such as prostheses. But, Semel says, those have a habit of riding up or down and are often too light or too heavy. “If you reach for the pepper at the dinner table, that thing’s going to move.”
Barbara has annual mammograms. About a week before inserting her implants, Semel removed a benign cyst from one breast. She has had no further problems.
Two years ago, only six months after Barbara had her implants, breast cancer was diagnosed in another daughter, now 30. Last May, she had a recurrence. She has undergone a lumpectomy, chemotherapy and radiation.
Despite her family’s experiences, Barbara says, “I don’t think there are enough statistics for me to panic. I think implants are a godsend for women who really need them, who have undergone breast surgery.”
Barbara would do it again, without hesitation. She says, “I didn’t realize all the attention that one gets when she has a nicer bust. It’s quite amazing. Men are such jackasses. They will dance around you if you fill out a sweater.”
Six years ago, when she was 36, Beth Yale was found to have cancer of the left breast. Seeking psychological help, she contacted Vital Options, a support group for young adults with life-threatening illnesses. Today, she is an officer of the organization.
Her nightmare began when, having seen a TV spot promoting mammography, she went with a couple of girlfriends to have X-rays. “I was notified the next day that there was a problem.”
A mastectomy and radiation were recommended and, Yale recalls, “I was given the option of doing immediate reconstruction or a procedure that at that time was not as widely used as today, an abdominal flap (in which abdominal tissue is removed and inserted in the breast). That seemed like another quite serious operation,” so she opted for a silicone implant.
A gel breast is not like a real one, she has found, but “psychologically, it’s made a huge difference in my feeling of recovery.
“First of all, when you’re feeling warm, your silicone breast could be feeling very cold. It just stays at its own temperature. Also, it’s very much more erect than your own tissue. It’s a definite form. Your own tissue, as years go by, starts to collapse and get softer.”
Even so, Yale says, her silicone breast “certainly isn’t something I think of on a daily basis.” She has not experienced any hardening.
The FDA announcement “sort of makes me angry,” she says. “To me, this is a very drastic step. No physician is going to dare (do silicone implants) for fear of malpractice.
“It makes me angry that the FDA would go ahead and say nobody can use it, unless there’s some sort of underlying information that they have been holding back all these years.
“Where were they before? How much do they know now that they didn’t know 20 years ago? I’m a little wary of what exactly is going to be the outcome.”
Nevertheless, Yale says, “I would not have mine removed unless it was leaking.” If the option was having no breast at all, she adds, “I would not be able to be healthy in my mind and be happy with myself.”
The implant dilemma is a “two-sided coin,” she says. If implants were not “100% safe” they should not have been available to anyone.
Right now, however, she says she feels sorry for women with breast cancer who have to make choices about reconstruction. “I feel they’re being cheated in a way because they’re not being given this option.
“At the initial diagnosis you’re so devastated. When you finally make the determination you’re going to remove the breast, that’s a trauma. To not have something on the positive side, something to look forward to--it’s difficult to imagine what they’ll go through.”
