Be All You Can Be — In A C Cup

Diana Zuckerman, PhD, National Center for Health Research, Houston Chronicle, Tulsa World and other Knight Ridder newspapers: August 1, 2004

The news that the Department of Defense is providing free breast augmentation to women in the military and wives of our fighting men has raised more than a few eyebrows.

Extreme Makeover and similar TV programs tout breast augmentation as a way to improve women’s self-esteem. But when that same claim is used to justify offering plastic surgery for women in the military, eyes roll. Many of us can’t help but wonder if there aren’t better ways to build self-confidence among women fighting for our country.

I know it’s difficult to find enough recruits right now, but do we want to attract women planning for a free augmentation surgery during R & R?

At a time when we worry that some of our soldiers don’t have the armored vests they need, and many Americans have no health insurance, the thought of using taxpayers’ money for liposuction and implants for either our recruits or their wives is hard to accept. Surely there are better incentives and rewards for our military men and women.

But the cost and the principle are not the only issues. After all, breast implants are also used for reconstruction for breast cancer patients who lose a breast to mastectomy surgery. Don’t those women deserve free medical care if they or their husbands are serving our country? Or is breast implant surgery not safe enough — especially if done by doctors with limited breast implant experience, as would almost always be true of military doctors?

Kathy Nye is a friend of mine who underwent a double mastectomy at the age of 22, performed by military doctors at the Portsmouth Naval Hospital in Virginia because her husband was in the Navy. She was told she needed to have both breasts removed because she had a pre-cancerous condition, and that silicone gel breast implants would make her as good as new. There was no publicly available risk information about silicone implants at the time, but one doctor at the military hospital warned her before her biopsy that she should get her clothes on and leave, because the doctors were using her. She never forgot his warning, but she did not heed it. She had her surgery, and the implants caused immediate problems — fatigue, joint pain, and muscle pain. Implants that she was told would last a lifetime were replaced four times, eventually destroying some of her breast tissue and popping through the skin. With over 20 operations related to her implants, she finally had her implants removed and not replaced.

Was she a guinea pig? At the time she thought the doctors were trying to help her, but she remembers the Navy doctors asking if she knew any women who wanted implants for any reason. They clearly wanted to practice the surgery, just as an army plastic surgeon said in a recent New Yorker article: “The benefit of offering elective cosmetic surgery to soldiers is more for the surgeon than for the patient,” according to the interview with Dr. Bob Lyons, the chief of plastic surgery at Brooke Army Medical Center in San Antonio. And, even though breast reconstruction is to help repair the damage of breast cancer, it is still considered elective surgery.

Eileen Swanson got her saline breast implants after a mastectomy at Fort Dix, NJ. Her reconstruction was done at Fitzsimons Army Medical Center in Colorado, and when she had problems she had additional surgeries at nearby Fort Carson. When she became extremely ill with autoimmune diseases, the doctors refused to believe the implants might be to blame. She finally convinced doctors at Fitzsimmons to remove the implants without replacing them. Still, she doesn’t blame the military doctors. “They weren’t open-minded about the potential cause of my problems but I really believe they thought they were providing the best medical care possible” Eileen tells me. Fortunately, she made up her own mind, and her health improved after her implants were removed.

Carolyn Wolf had her breasts removed in 1971 because they were lumpy. The condition, called fibrocystic disease, was considered a pre-cancerous condition, although it is now acknowledged that it is not a disease and most women with that condition will not get breast cancer. She was referred to the plastic surgery clinic at Walter Reed Army Hospital in Washington, DC, where she was told that there was no way that a doctor could ever find breast cancer because her breasts were so lumpy. She didn’t want implants, and felt that she was making a good adjustment to the mastectomies when one of the doctors told her “You don’t have to go through life like this –we can make you look normal.” “I suppose that was the straw that broke the camel’s back ” Carolyn tells me– “I had implant surgery shortly after that.” Last year, she testified before the FDA that her implants ruptured more than 20 years after her surgery, spilling silicone throughout her body. An MRI of her brain reveals more than 20 lesions, she has been coughing up blobs of silicone, and although she does not smoke a lung x-ray shows chronic obstructive pulmonary disease.

For these women, the military doctors did them no favor by offering free reconstructive surgery — in fact, all are still suffering from health problems related to their implants. The surgical complications they experienced may have been exacerbated by their inexperienced doctors, but the most serious health problems were apparently from the product, not the doctors. Our government knows this — that’s why they sued implant manufacturers for tens of millions of dollars to reimburse Medicare for health costs caused by implant problems.

The decision to offer breast implant surgery for military women and military wives sounds funny, but it’s not a joke. Just ask the women who are still paying for their free surgery — through years of health problems and doctors bills.

As taxpayers, we want to provide the best possible benefits to those who risk their lives on our behalf. That should not include implants that our own government has determined to cause expensive long-term health problems.

All articles are reviewed and approved by Diana Zuckerman, PhD, and other senior staff.