Aug. 1, 2004, 12:59AM

Breast Enlargement Brouhaha
This surgery strictly non-reg
By DIANA ZUCKERMAN

http://www.chron.com/cs/CDA/ssistory.mpl/editorial/outlook/2712058

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 justification
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 more than 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 New
Yorker article: "The benefit of offering elective cosmetic surgery to
soldiers is more for the surgeon than for the patient," according to a
New Yorker 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, N.J. Her reconstruction was done at Fitzsimmons Army Medical
Center in Colorado, and when she had problems, subsequent surgeries
were done 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,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, and although
she does not smoke she has been coughing up blobs of silicone, and 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 it sued implant manufacturers
and recently settled for $12 million 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 be the cause of millions of long-term health problems.

Zuckerman is president of the National Center for Policy Research for
Women & Families, a Washington research center.

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For Dr. Zuckerman's website, please visit:

www.BreastImplantInfo.org

For information on the ongoing controversy:

www.BreastImplantAwareness.org