It is a story that might have sprung full-blown from the deep well of conspiracy fantasies. All the princes of darkness were there at the beginning of the Saga of Silicone. Racism. Sexism. Imperialism. Even the Military-Industrial Complex.
Silicone made its entry into the female body almost 50 years ago, because Japanese women were trying to attract American soldiers. The conquerors liked bigger breasts and so industrial strength transformer coolant was injected directly into these women.The next stop in this tragic progression was Las Vegas where some 10,000 women - mostly waitresses and showgirls - had liquid silicone injected. At the time it was nothing more than an investment in a topless career.
So, from the outset, the story held all the confusing elements of beauty and business, worth and self-worth. There was even the secret sacrifice of health for "self-improvement," a terrible price paid for beauty.
In time, too much time, the troubles with liquid silicone became clear. Then silicone, in gel form, was packed in an envelope before it was packed into a female body. But packed it was, into one million to two million American women.
Only now, after three decades of breast implants, are we learning that women were part of some vast experiment. Perhaps "experiment" is too scientific a word for the poorly researched and weakly regulated free market in silicone.
In the weeks since the FDA called for a voluntary moratorium, we've gradually discovered that implants were used in women before the studies on animals were completed. We've learned that almost none of the studies tested silicone in the breast tissue of the animals. We've learned too that some people at Dow Corning, the major silicone manufacturer, a descendent of the company that brought us napalm in Vietnam - where is Oliver Stone when you need him? - had safety concerns that were never followed up.
Despite all the confusion, the conflicts and the arguments about "junk science," the way to begin is relatively clear. We have to make a distinction between the 80 percent of women who chose implants for cosmetic reasons and the 20 percent who chose them for cancer reconstruction.
This is not a judgment about worthy and unworthy patients, about vanity and need. But it's a judgment based on an ethical standard that balances risks and benefits.
We don't know how many women might refuse cancer surgery or postpone treatment out of terror of mutilation. But there are some. So for women with breast cancer, the options of reconstructive surgery, saline implants and silicone carry a different balance. The benefits for some may outweigh the risks.