More young women choosing implants

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News Despite risks, more young women choosing breast augmentation September 10, 2001

TRENTON, New Jersey (AP) - Paige Lippe made up her mind in high school that she was going to have breast augmentation after her 18th birthday. Although she intended to have the procedure with or without the financial support of her parents, she talked it over with them and with a doctor before getting it done during her freshman year in college. Lippe said she had a pear shape and was self-conscious about her body at school. She wore padded bras as a solution, but felt it was “false advertising” and said it made her feel uncomfortable.

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She chose one of the smallest implants available, and went from an “A” cup to a “B” cup. “I felt very insecure putting on a bathing suit,” said Lippe, who turns 23 this month. “I wanted to be able to look into a mirror and feel I had a feminine body.” Despite warnings the implants can break, leak, cause painful scar tissue or infection, an increasing number of young women like Lippe are opting for breast augmentation. The number of women ages 19-34 who sought breast augmentation increased from about 19,500 in 1992 to more than 108,000 in 2000, according to the American Society of Plastic Surgeons. And the popularity of breast enhancement is rebounding from the controversy that arose over implants in the early 1990s. Thousands of women claimed implants gave them diseases ranging from arthritis to cancer. After repeated studies, the Institute of Medicine declared in 1999 that silicone gel and saline breast implants do not cause major illnesses. Dr. Lyle Leipziger, chief of plastic and reconstructive surgery for North Shore University Hospital and Long Island Jewish Medical Center, said he has seen an increase over the last couple years in the number of women between 18 and 25 who are seeking breast augmentation. Most women who want to increase their breast size are trying to achieve through implants a look they would normally get through the use of padded bras, Leipziger said. They are “realistic” in what they want to accomplish with the surgery, he added, and most are looking to increase their breast size to the full “B” cup to small “C” cup range. “Most of the women coming in have just wanted to feel better about themselves,” Leipziger said. Dr. of The Center for Plastic & Reconstructive Surgery in Paramus, New Jersey, said the patients he sees often have problems with their self-esteem or body image because of their small breast size. During the consultation, he said he is careful to ensure patients are having the surgery for themselves - not to please a boyfriend or spouse. Critics charge that the popularity of breast augmentation has been fueled by the barrage of advertising by doctors, professional groups and implant manufacturers that often downplay the risks. There are even ads for pills that claim to enlarge breast size. WellQuest International Inc., maker of Bloussant Breast Enhancing tablets, has ads in the fall edition of Teen Vogue and the September issue of Seventeen magazine. The full-page ad in Teen Vogue runs in the front half of the magazine - sandwiched between an anti-smoking ad and an ad for sneakers. WellQuest features a young, tanned woman in a one-piece swimsuit and promises readers that Bloussant is a “fast acting ... less invasive alternative to cosmetic surgery.” The company also includes testimonials from satisfied customers. Calls to WellQuest offices in New York City were not returned. Deborah Sullivan, an associate professor of sociology at Arizona State University who recently published a book on cosmetic surgery, said advertisers are exploiting a lack of confidence in young and impressionable women. “Advertising has to tap into something and there's nothing you can depend on more than the needless insecurity of women and their bodies,” she said. “The market's gigantic.” Dr. Sidney Wolfe of consumer advocate Public Citizen said the implant advertising is telling young women that “the only thing wrong with your life is your breasts aren't big enough.” “There's a great overemphasis on the benefits and a great under-emphasis on risks - such as they rupture,” Wolfe said. “It's just shameless.” When some of the side effects to the surgery are mentioned, Sullivan said they are downplayed, merely mentioning that patients can expect some discomfort. Ads neglect to mention that the implants do not last a lifetime, she said, or that after the surgery patients may feel they've been run over by a truck. Earlier this year, the Food and Drug Administration, which monitors advertising for medical devices, contacted the two approved manufacturers of saline implants with concerns about their advertising campaigns, according to Sharon Snider, an FDA spokeswoman. The companies are Mentor Corp. and McGhan Medical Corp., both of Santa Barbara, California. The FDA will not reveal its concerns, but said manufacturers generally are required to disclose all side effects and the ads must clearly state the approved use of the products. Mentor refused to comment on the FDA letter or its advertising campaign. DesChenes, a spokeswoman for McGhan, said the company stopped its direct-to-consumer advertising campaign around May, although it was not because of the FDA concerns. But, she added, the company has modified its advertising on occasion in response to FDA comments. “We, as a responsible manufacturer, support the FDA's position and label our breast implants and related material accordingly,” DesChenes said. Dr. Wells, vice president of the American Society of Plastic Surgeons, said there is probably some truth to claims that advertising is increasing the number of women who seek breast augmentation. In 1999, the society committed to spending $2 million on its own three-year campaign. But he said the ads did not mention specific procedures and also targeted men. They were aimed, Wells said, at creating recognition of the society's logo and to distinguish its member doctors from physicians of other specialties who also do plastic surgery. Lippe said she was well-informed about the risks and believes that while many people seek different kinds of surgical implants, a disproportionate amount of attention is given to breast implants. She is happy with her decision and has felt much better about herself after the surgery. However, she said, she had some regrets after having a bad reaction to the painkillers.