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Which Are Poisonous,
The Implants Or The Allegations


William Taylor, M.D., F.A.C.S.


William Taylor, M.D., F.A.C.S.

Add to the list of controversial topics to be discussed only at one's peril -- religion and politics -- a third: silicone breast implants. The print, television, radio and now the electronic media are constantly in search of sensational topics. Sometimes, in lieu of finding one, they create one by sensationalizing an everyday occurrence or a mundane subject.

We live in an era in which even weather newscasts are presented like mystery theatre; full of suspense, drama and of course the requisite villain -- replete with names such as Hurricane Mitch! So it's no surprise when a "touchy" subject such as surgical breast enhancement attracts the attention of the media, and of all of us who read, watch and listen to the news.

But when is news news, and when is it trash talk? That's for each of us to decide on our own. At SCCSN, we believe it is our job to present facts and professional opinions so that you, the reader and prospective client, can make an informed decision.

As a prominent, longtime plastic surgeon who is highly respected by patients and colleagues alike, William Taylor, M.D., F.A.C.S. here responds to recent media allegations concerning a subject about which he knows a great deal: silicone breast implants.

Recently, a popular alternative medicine periodical presented a feature article claiming to prove that ‘silicone breast implants are toxic’, using the words, "Poisoned Breasts." The article (more accurately a "hit piece") is itself a toxic cocktail of misrepresentations, artfully distorted interpretations, outright lies, and a general mish-mash masquerading as valid medical information. It is obviously not a scientific piece, but a collection of self-serving attacks in support of a group of tort lawyers. It is a description of the misery they have inflicted upon the manufacturers, their thousands of jobless workers the installers, and the susceptible women (that is, susceptible to the fear mongering) who have had or consider having breast implants.

1. This article begins with the description of 450,000 siliconized women’s class action lawsuits. "CLASS ACTION" LAWSUITS DO NOT CONSTITUTE SCIENTIFIC PROOF OF ANYTHING. A very significant percentage of the information in the article has nothing whatever to do with silicone implants, but with government controls, rules, regulations, and the status of the legal situation of lawsuits filed on behalf of these litigants. They are employing the unique American tort system to mount a risk-free legalized plunder of American industry and medicine.

2. A collection of over 50 anecdotal and briefs "extracted out of context" statements attempts to support the validity of their claims. There are no citations of the findings, results, and conclusions of at least 15 major, tightly controlled, recent scientific studies, nor of major British and European plastic surgery congresses, all of which fail to connect silicone breast implants with any toxic conditions in the body. The arguments mostly employ a faulty logic described by the Romans 2,000 years ago, e.g. "post hoc, ergo propter hoc" which translates as "after this, therefore, because of this." The "reasoning" claims that if factor "A" occurred first, a subsequent condition, "B" must have been caused by Action "A", because "A occurred first and B appeared afterward." Using this method, one could "prove" that milk is the cause of all of mankind’s difficulties. After all, every one of us consumed milk from the time we were born, so with this logic, it must be that milk causes all human health and physical problems. Why so? Well, because the milk came first, therefore, whatever happened afterward must have been caused by that milk. Although this "post-hoc" is false argument, and they know it, it is one of the trial lawyers’ favorites.

The statement that silicone was injected into the body for breast enlargement in Japan in the 1940’s is as false as the charges that "silicone injections produce immunologically toxic effects...poisoning...early development of cancer...." "In 1961, the year the first implants were released...", is a predicate without foundation in fact. Actually, there were no silicone breast implants in 1961. The first one was under development, but not yet produced. The silicone breast implant story actually began in the fall of 1960 at the annual scientific meeting of the American Society of Plastic and Reconstructive Surgeons, where Dr. Thomas Cronin of Houston learned of the silicone substance "Silastic." It seemed that a silicon polymer, "dimethylpolysiloxane" could be structured so as to be a very thin (or thick) liquid, a jelly, a soft solid, or a very hard solid, depending upon the degree of cross-linking. From this knowledge, he pictured a breast shaped implant with a thin Silastic outer shell, and a soft jelly-like silicone Silastic filler. (Silicone was already in use in a few special surgical devices, where it was valued for its inertness, a very important, and critical quality.)

During the next 15 months a great deal of activity took place between Houston and Dow Corning in Midland, Michigan, resulting in the very first practical breast implant. The initial implants had "welded" seams around the rim, the shell was comparatively thick, and the back was covered with dacron mesh to promote adherence of the implant to the chest wall. How do I know all of this? I was there, I had a small part in the actual development of the first implants, and I was present at the first surgery, when they were inserted into a patient at Houston’s Jefferson Davis hospital in the second week of February 1962.

For the next 20 months Dow-Corning produced these implants on a "trial-experimental" basis, offering them to the few who knew they existed, myself included. Relatively crude devices compared to those which we have at present, their development was typical of any "learning curve," from which there are simply no exceptions.

In October 1963 at the International Plastic Surgery Convention in Washington D.C., Dr. Cronin dropped a breast implant blockbuster on the plastic surgical world by presenting these new implants. There were no other practical implants until that time. However, within a few years, the French had developed their own silicone breast implants, including the first saline inflatable models. During that same period of time, some doctors were injecting silicone into women’s breasts, a procedure advocated by some prominent Oriental plastic surgeons, such as Dr. Seichi Ohmori. While the idea had a certain appeal, organized plastic surgery in the United States never accepted nor approved of injections of free silicone into human breasts. Admittedly, some of this was done by a few practitioners, most notable non-plastic surgeons in Nevada. This generated a relative epidemic of problems, which persisted until Nevada plastic surgeons persuaded the legislature to ban such injections.

Contrary to the statements in this article, silicone breast implants are not, and never have been "toxic" (Webster’s toxic: adjective (Greek toxicon) 1. poisonous). It is marvelously interesting that there exist over 100 different silicone, or silicone covered devices which are implanted within the human body for medical/surgical purposes. If the claims of toxicity were true, these implanted devices should be causing an epidemic of poisonous complication in all these patients, not just the breast implants. Where is this epidemic? Where indeed? It does not exist!

Significantly, the only country in the world where silicone implants have been so assailed is the United States (and Canada, which copies much of what we do). Please note that this is situation made possible only with the U.S. legal system, also unique in the world. This is where even the winning defendant still loses, because the defense costs come from his own pocket one way or another, while a losing suer or plaintiff walks off having lost nothing. The lawyer has a low risk opportunity to plunder any unwitting victim with enough assets to tempt a plaintiff, who may think it worthwhile to gamble on "winning the lottery." It costs him little or nothing, especially when considering the possible gain. This is the prime reason the breast implant manufacturers caved in/went bankrupt/moved overseas; even if they won every individual case, the legal expenses would still have bankrupted them. This is "legal blackmail" in action. The bottom line is that this article was not an impartial scientific study, but a dramatic hit piece designed to promote the tort lawyers’ cause, and to appeal to the emotions of the general public.

Just two days before the final revised copy of this article was submitted, the San Diego Union-Tribune (November 14, 1998) published an excellent editorial summarizing the entire breast implant controversy. I strongly recommend it as an impartial evaluation and report.

 
 
 

 

 

 

 

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