Note from Health Lover, Ilena Rosenthal: I concur with Dr. Zuckerman's
comments. I have heard of Plastic Surgeon's getting around the
restrictions by first implanting saline implants, and then 'replacing'
them months later with silicone gel, a loophole in the rules.
www.breastimplantawareness.blogspot.com

EXCERPT: "I had a young woman tell me her plastic surgeon called an
acne scar a deformity so she could get a silicone implant," said Diana
Zuckerman, president of the National Research Center for Women &
Families.        www.BreastImplantInfo.org

http://www.palmbeachpost.com/localnews/content/local_news/epaper/2008/03/29/m1a_
perfection_0330.html

Quest for perfection leads more teen girls to surgeons' scalpels

By JANE MUSGRAVE

Palm Beach Post Staff Writer

Saturday, March 29, 2008

They get them because they don't like the way they look in a bikini.
They get them because all their friends are getting them. Sometimes it
becomes a mother-daughter outing - with both getting them at the same
time.

"It was really odd. I turned around one day and said, 'Oh, my God.
Everyone has fake boobs,' " 19-year-old Jupiter resident Jessica Angst
said, ticking off the names of young friends and family members who,
like her, have had breast implants. "Everyone I know has had surgery."
Young women talk about their decicision to get implants

Well, everybody is a stretch.

But there is no doubt that the number of women getting breast implants
has soared in recent years. And as Angst noted, more of the women
showing up in plastic surgeons' offices wanting bigger breasts are
barely more than girls.

"The absolute number of teenagers getting breast augmentation has
probably increased 15 to 20 percent in the last several years," said
Dr. Lawrence Korpeck, a Boca Raton plastic surgeon.

Nationally, the increase is even more dramatic.

The phenomenon exploded into the national consciousness last week when
an 18-year-old West Boca High School cheerleader died of an apparent
fatal reaction to anesthesia while undergoing surgery to correct
inverted nipples and make her breasts more symmetrical.

Stephanie Kuleba's grief-stricken family has not spoken about her
motivation for seeking what is regarded as extremely low-risk surgery.
However, the family's attorney has made it clear that it was
corrective, not cosmetic.

Nevertheless, her death ignited the passions of those who decry
society's emphasis on looks. While noting that it is a global issue,
some insist the attitudes seem to thrive in suburbia, often lampooned
as ground zero for our image-obsessed culture.

"It's money," said Lois West, a sociology professor at Florida
Atlantic University. "The girls that have plastic surgery are the
girls whose families have money. Girls who don't live in the moneyed
world don't even think about plastic surgery."

However, with plastic surgeons coming up with convenient monthly
payment plans and some offering men the chance to "sponsor" women who
want breast surgery in exchange for exclusive photos and online chats,
the roughly $6,500 operation can be affordable, even for high
schoolers with part-time jobs.

The bigger questions for some: Why would attractive young girls endure
the pain of surgery to trade an A cup for a C? Why would their parents
allow it? And is it safe?

A Boca Raton lawyer, who blames serious health problems she suffered
on implants that she ultimately had removed, said she has given up
hope of convincing federal regulators that implants are unsafe.
Instead, she now argues that breast augmentation is unnecessary
surgery. And, like any surgery, problems, sometimes fatal ones, can
result.

"Why are we as a society convinced that large breasts are so important
that we are actively encouraging our children to have unnecessary
surgery? Why would we do that?" asked Jean, who requested that her
last name not be used because she does not want people to know she had
implants.

Exceptions offer loophole

Even the U.S. Food and Drug Administration doesn't think breast
implants are safe for young women.

When it lifted a 14-year ban on silicone implants in 2006, the agency
also restricted their use. Silicone implants are not permitted for
women under the age of 22. Saline implants, which are considered safer
than silicone, are not recommended for women under 18 except for bona
fide medical reasons.

But FDA does not regulate their use, said Karen Riley, an agency
spokeswoman.

"FDA regulates the product and the marketing and manufacture of that
product," Riley said. "It does not regulate doctors."

While both the American Society of Plastic Surgeons and the American
Society for Aesthetic Plastic Surgery endorsed the FDA's
recommendations, there are no penalties for ignoring them.

Besides, critics say, the "bona fide medical" exception opens a wide
loophole.

"I had a young woman tell me her plastic surgeon called an acne scar a
deformity so she could get a silicone implant," said Diana Zuckerman,
president of the National Research Center for Women & Families.

As head of the nonprofit Washington-based organization, Zuckerman said
she has heard horror stories from women about health problems they
suffered sometimes years after surgery.

She questions whether a young woman, even at 18, can grasp the
possible long-term consequences of breast augmentation surgery.

"There's a whole set of research that shows their brains have not
quite developed the understanding of risk," Zuckerman said. "It's the
same reasons they drive fast."

Adds Boca Raton psychologist and sex therapist Wendy Fader: "Everyone
has things they don't like about themselves. But most of us, as we
age, learn to deal with it. Teens are just trying to figure out who
they are."

Their bodies are changing. Their view of the outside world and their
role in it is evolving. Psychologically, they are on a journey from
the instant gratification of childhood to the more reasoned approach
of adults.

"They're more susceptible to the quick fix," Fader said.

Indeed, FDA's restrictions are based on concerns that teenagers may
not be able to make such a life-altering decision.

"FDA restricts the marketing of breast implants for augmentation to
women of a minimum age because young women's breasts continue to
develop through their late teens and early 20s and because there is a
concern that young women may not be mature enough to make an informed
decision about the potential risks," Riley said.

Improving self-esteem

Plastic surgeons say they talk to young girls at length to make sure
they want breast implants for the right reasons, are not being
pressured by boyfriends or parents and are mature enough to understand
the consequences.

"Am I looking at a 16-year-old who thinks like a 20-year-old or am I
looking at a 16-year-old who thinks like an 11-year-old?" Dr. Foad
Nahai says he asks himself as he's interviewing a teen interested in
breast implants.

An Atlanta physician who is president of the American Society for
Aesthetic Plastic Surgery, Nahai said during his 30-year career he has
refused to perform breast augmentation surgery if he believes the girl
is being pressured, has an unrealistic view of how a bigger chest will
change her life or is simply too young.

"I don't subscribe to the belief that a 16-year-old gets surgery as a
Sweet 16 present," he said.

Dr. Daniel Man, a Boca Raton plastic surgeon, says he won't
accommodate young women who want to look like Pamela Anderson or Dolly
Parton.

"Many times I refuse to do it. Like women with unusual expectations --
they're a B, and she wants to go to a double D," Man said.

Judging whether a girl is mature enough is dicey, doctors admit. But
it's the type of determination that physicians are trained to make.

"Can you justify a procedure on a young girl? Well, who can say?"
Korpeck said. "Who's to judge you on what you buy to make you feel
better? A good reason to do it is to improve one's self-esteem."

Neither Fader nor Zuckerman is convinced.

Both psychologists said plastic surgeons are not trained to determine
what is driving a patient's decision. Further, if a person really
doesn't feel good about herself, bigger breasts are not going to help.

"People who get plastic surgery don't feel better about themselves;
they feel better about the part that was changed," Zuckerman said. "If
you want to feel better about yourself, go see a therapist."

Angst said she doesn't need a shrink, thank you very much.

Having seen her older sister and her mother get breast implants, the
bubbly, outspoken blond woman knew exactly what she was getting into
when she went under the knife almost two years ago at 18.

Further, Angst went on the Internet and read stories posted by women
who blame implants for dire health problems. Since implants have an
estimated life of 15 to 25 years, she said she knows it is likely she
will have to have the surgery again.

She learned that saline implants are safer than silicone, so she opted
for saline, even though silicone offers a more natural look and feel.

While she was nervous about having elective surgery and described the
weeklong recovery as extremely painful, she has no regrets.

"They're fabulous. I love them," Angst said.

Her younger sister Kayla, who had surgery in the summer shortly before
beginning her senior year of high school, is equally pleased with her
larger chest.

They say the surgery did not change their personalities. But, they
add, it makes shopping for clothes easier, and they feel better about
themselves.

Still, they think girls -- like their two younger sisters -- should
wait until they're at least 18.

"When I was 16, I thought I knew everything," Jessica Angst said.

Like others, they say they were shocked and saddened by Kuleba's
death. But, they say, it does not reflect on the safety of the
surgery. The teen simply had a bad reaction to anesthesia, they
believe.

"It could have happened when she was having her wisdom teeth out,"
Jessica Angst said.

As for women who report severe health problems, Jessica Angst says it
is likely they had unrealistic expectations about the surgery and then
blame the implants for a host of unrelated ills.

Women who have devoted their lives to trying to convince others that
the surgery is not safe are accustomed to such reactions.

Gretchen Cannon blames her implants for debilitating health problems
she suffered almost immediately after she had silicone implants to get
back the breasts she lost when intense exercising transformed her from
a 34C to AA.

She couldn't concentrate at work. She had no short-term memory. She
was constantly tired. Her vision was blurry. She started exhibiting
symptoms of lupus and multiple sclerosis.

Nearly a year and three operations later, the 27-year-old California
woman said she is almost back to full strength. Ironically, although
the implants are out, Cannon's breasts have returned to their
pre-exercise size.

She has created a Web site -- myimplantstory.com -- to warn other
women about breast implants.

Still, Cannon knows many women will dismiss her claims as baseless or
some aberration.

The societal pressures to have a perfect body are great. The Angst
sisters say it is particularly pronounced in South Florida. Had they
grown up somewhere else, they said, they probably would not have had
breast implants.

Jessica Angst recalled a vacation in Kentucky when a young man asked
her whether it was true that all girls in Florida have fake breasts.

"Well, yeah," she said. "It is true."