Time - Man of the Year/Time_Man_of_the_Year_Compact_Publishing_3YX-Disc-1_Compact_Publishing_1993.iso/moy/021792/0217640.000

Text File | 1992-08-28 | 6KB | 123 lines

                                                                                ESSAY, Page 88

Stamping Out A Dread Scourge


By Barbara Ehrenreich


    In the spirit of a public health campaign, the American
Society of Plastic and Reconstructive Surgeons (ASPRS) has
launched a p.r. drive to "tell the other side of the
[breast-implant] story." Public health? Slicing women's chests
open so that they can be stuffed with a close chemical relative
of Silly Putty? Yes, indeed, because the plastic surgeons
understand what the FDA is so reluctant to acknowledge: small
breasts are not just a harmless challenge to the bikini wearer
or would-be topless entertainer. They are a disease, a
disfiguring illness for which the technical term is micromastia.

    As the ASPRS tried to explain to the FDA almost 10 years
ago, "There is a substantial and enlarging body of medical
information and opinion to the effect that these deformities
[small breasts] are really a disease." Not a fatal disease,
perhaps, to judge from the number of sufferers who are still
hobbling around untreated, but a disease nonetheless, like the
flu or TB. And anyone tempted to fault the medical establishment
for inaction on breast cancer or AIDS should consider its quiet
but no less heroic progress against the scourge of micromastia:
in the past 30 years, 1.6 million victims have been identified
and cured. Who says our health system doesn't work?

    Once we understand that small breasts are a "disease,"
it's easier to see why Dow Corning and others rushed so
breathlessly to get their implants onto the market. Why diddle
around with slow, costly tests while an epidemic is raging out
there? And everyone's life is touched by the tragedy of
micromastia because everyone has a friend, sister, co-worker or
wife who falls pitifully short in the mammary department. In the
past, small groups of health-conscious males, typically gathered
at construction sites, would offer free diagnoses to women
passersby, but there was little that could be done until the
advent of the insertable Silly Putty breast.

    Admittedly, micromastia is in some ways an atypical
disease. It is painless, which is why many victims put off
treatment for years, and it in no way diminishes breast
function, if that is still defined as lactation. The implants,
on the other hand, can interfere with lactation, and they make
mammograms less able to find cancer (not to mention the
potential for a disfiguring or life-threatening side effect like
lupus or scleroderma). But so what if micromastia has no
functional impact? Why can't a disease be manifested solely by
size?

    Consider the rigorously scientific methods employed by the
medical profession in its efforts to curb the epidemic. Not just
anyone could get breast implants. No, the doctor had to study
the afflicted area first to decide whether they were truly
needed. For example, a friend of mine, an inquiring journalist
of average proportions, called a New York City-area plastic
surgeon to ask about implants and was told to come in for an
exam. One quick, searching look and he told her yes, she needed
them, badly.

    In fact, according to the rumor mill, Jessica Hahn may
have needed them too, as may have Melanie Griffith, Jane Fonda,
Brigitte Nielsen and even, gasp, Dolly Parton. Why take chances?
The doctors know there are not only obvious forms of
micromastia, discernible to the man on the street, but
insidious, hidden forms -- very well hidden indeed.

    So we can see why the plastic surgeons were willing to
cough up hundreds of dollars each to finance the ASPRS's
campaign to show the bright side of the breast-implant story.
Though nearly 2 million micromastia victims have been cured,
millions more remain untreated, as shown by the continued
existence of the plague's dread symbol -- the A-cup bra. There
have been many earnest attempts to reach the untreated: public
health-oriented magazines like Playboy, for example, repeatedly
print photos illustrating normal breast size for the woman in
doubt. Tragically, though, many women still live in denial,
concealing their condition under mannish blazers and suit
jackets, forgoing the many topless forms of employment.

    Now a cynic might see the silicone-implant business as
another malfeasance on the scale of the Dalkon Shield (which had
a tendency to cause devastating infections), DES (which could
cause cancer in the user's offspring) or the high-estrogen
birth-control pill (which was also rushed to market after hasty
and dubious testing). A cynic might point to the medical
profession's long habit of exploiting the female body for profit
-- from the 19th century custom of removing the ovaries as a
cure for "hysteria" to our more recent traditions of unnecessary
hysterectomies and caesareans. A cynic might conclude that the
real purpose of the $500 million-a-year implant business is the
implantation of fat in the bellies and rumps of underemployed
plastic surgeons.

    But our cynic would be missing the point of modern medical
science. We may not have a cure for every disease, alas, but
there's no reason we can't have a disease for every cure. With
silicone implants, small breasts became micromastia. With
injectable growth hormone, short kids become treatable dwarfs.
Plastic surgeons can now cure sagging jowls and chins, droopy
eyelids and insufficiently imposing male chests and calves. So
we can expect to hear soon about the menace of new diseases such
as saggy-jowlitis and hypopectoralis.

    It will be hard, though, to come up with anything quite so
convincing as micromastia. As the plastic surgeons must have
realized, American culture is almost uniquely obsessed with
large, nurturing bosoms. And with the silicone scandal upon us,
we can begin to see why: in a society so unnurturing that even
health care can sadistically be perverted for profit, people are
bound to have a desperate, almost pathological need for the
breast.