Breasts

by Florence Williams

  Consider the case of poor Elisabeth Trevers: Gordon Letterman and Maxine Schurter, “Will Durston’s Mammaplasty,” Plastic and Reconstructive Surgery, vol. 53, no. 1 (1974), quoted in Nora Jacobsen, Cleavage: Technology, Controversy, and the Ironies of the Man-Made Breast (New Brunswick, N.J.: Rutgers University Press, 2000), p. 50.

  Vincenz Czerny: The first boob job was technically a reconstruction. See Theodore W. Uroskie Jr. and Lawrence B. Colen, “History of Breast Reconstruction,” Seminars in Plastic Surgery, vol. 18, no. 2 (May 2004), pp. 65-69.

  glass balls, ivory, wood chips: For information on the early-twentiethcentury implant materials used, see Haiken, Venus Envy; also Bernard M. Patten, former chief of neuromuscular disease, Baylor College of Medicine, author interview, February 2011.

  disadvantages of paraffin: Jacobsen, Cleavage, pp. 52-54.

  Women have painted their faces: Julie M. Spanbauer, “Breast Implants as Beauty Ritual: Woman’s Sceptre and Prison,” Yale Journal of Law and Feminism, vol. 9, no. 157 (1997).

  Ivalon: S. Murthy Tadavarthy, James H. Moller, and Kurt Amplatz, “Polyvinylalcohol (Ivalon)—A New Embolic Material,” American Journal of Roentgenology, vol. 125, no. 3 (November 1975), pp. 609-616.

  “The material’s one drawback”: Plastic surgeon Milton Edgerton, paraphrased in Jet Magazine, December 12, 1957, available at http://www.flickr.com/photos/vieilles_annonces/3778246964/ (accessed October 2011).

  Dow Corning: For the history of Dow Corning, see Haiken, Venus Envy, pp. 246-247. Also see this colorful document from the Dow website: www.dowcorning.com/content/publishedlit/01-4027-01.pdf (accessed October 2011).

  the breasts of Japanese prostitutes, who were being injected with it: M. Sharon Webb, “Cleopatra’s Needle: The History and Legacy of Silicone Injections,” Harvard Law School paper, January 1997, available at http://leda.law.harvard.edu/leda/data/197/mwebb.pdf; and Haiken, Venus Envy, p. 246.

  Back in Houston, plastic surgeon Thomas Cronin: As recounted by Thomas Biggs, retired plastic surgeon, Houston, Texas, author interview, January 2011. Biggs also recounted the story of Cronin’s ambition and the first surgery, including parts about Esmerelda. He was a resident of Cronin’s at the time.

  On the back of the bag, they added several patches of Dacron: Jacobsen, Cleavage, pp. 78-79.

  Some authors say they tested it in six dogs: John Byrne, Informed Consent (New York: McGraw-Hill, 1997), pp. 47-50.

  Surgery to remove implants, known as explantation: For a discussion of what’s found at the explant site, see R. Vaamonde et al., “Silicone Granulomatous Lymphadenopathy and Siliconomas of the Breast,” Histology and Histopathology, vol. 4 (October 1997), pp. 1003-1011.

  “Many women with limited development of the breast”: Gerow, quoted in Jacobsen, Cleavage, pp. 78-79.

  One surgeon’s autobiography: Robert Alan Franklyn, Beauty Surgeon (Long Beach, Calif.: Whitehorn, 1960).

  “there is a substantial and enlarging body”: The American Society of Plastic and Reconstructive Surgery’s statement to the Food and Drug Administration, in 1982, is a well-known quote. I love the not-quite-subliminal use of the word enlarging. See the quote referenced with biting commentary from Barbara Ehrenreich, “Stamping Out a Dread Scourge,” Time, February 17, 1992, available at http://www.time.com/time/magazine/article/0,9171,974902,00.html.

  The largest was called “the Burlesque”: Jacobsen, Cleavage, p. 79.

  Gerow reputedly liked big breasts: Bernard Patten, author interview, January 2011.

  One Houston doctor boasted: For an excellent article on Houston in its boob-job glory days, see Mimi Swartz, “Silicone City,” Texas Monthly, vol. 23, no. 8 (1995), pp. 64-78.

  By 1985, one hundred thousand women: Newsweek noted in 1985 that nearly one hundred thousand breast augmentations had been performed over the past year “for a total addition to the nation’s mammary capacity of some 13,000 gallons (of silicone gel),” as quoted in Haiken, Venus Envy, p. 273.

  Carol Doda: For more on Doda, there’s a great section on her breasts (and the infamous piano) in Mike Sinclair’s San Francisco: A Cultural and Literary History (Oxford: Signal Books, 2004), pp. 84-85.

  “Carol Doda’s breasts are up there”: Thomas Wolfe, The Pump House Gang (New York: Bantam, 1969), p. 67.

  strippers instantly saw their tips increase: Bernard Patten, author interview, January 2011.

  Houston became the strip-club capital of the world: Michael Ciaravino, author interview, January 2011.

  Rick’s Cabaret: For more on the history of Rick’s Cabaret, see Swartz, “Silicone City.”

  restricted the use of the “medical-grade” stuff: On the FDA restrictions on the “medical-grade” stuff and reports of infection, gangrene, and so on, see Haiken, Venus Envy, pp. 274-275.

  Many patients—41 percent, according to a 1979 study: G. P. Hetter, “Satisfactions and Dissatisfactions in Patients with Augmentation Mammaplasty,” Plastic and Reconstructive Surgery, vol. 64, no. 2 (August 1979), p. 151.

  An enormous percentage of patients—around 25 to 70 percent: Neal Handel et al., “A Long-Term Study of Outcomes, Complications, and Patient Satisfaction with Breast Implants,” Plastic and Reconstructive Surgery, vol. 117, no. 3 (March 2006), pp. 757-767.

  “They were like doorbells”: Bernard Patten, author interview, January 2011.

  Early dissections of the affected tissue: Thomas Biggs, author interview, January 2011.

  The operation itself: Michael Ciaravino, author interview, January 2011.

  Company salesmen were told to wash the leaking implants: This comes from an internal Dow Corning memo dated January 15, 1975, that was made public when the group Public Citizen sued the FDA; cited in Jack Doyle, Trespass against Us: Dow Chemical and the Toxic Century (Monroe, Maine: Common Courage Press, 2004), p. 257.

  causing a prolonged inflammatory response and “microencapsulations”: See Michelle Copeland et al., “Absent Silicone Shell in a MEME Polyurethane Silicone Breast Implant: Report of a Case and Review of the Literature,” Breast Journal, vol. 2, no. 5 (September 1996), pp. 340-344.

  manufacturer of the foam was apparently surprised: See Nicholas Regush, “Toxic Breasts,” Ms. Magazine, vol. 17, no. 1 (January/February 1992), pp. 24-31.

  Many surgeons remember these implants fondly: Thomas Biggs, author interview, January 2011.

  76 foam-covered implants continue to be used: Handel et al., “Long-Term Study of Outcomes.”

  “we know more about the life span of automobile tires”: David Kessler, quoted in Spanbauer, “Breast Implants as Beauty Ritual.”

  Dow Corning declared bankruptcy: On Dow Corning’s bankruptcy history, see Dow Corning’s publication “Highlights from the History of Dow Corning Corporation, the Silicone Pioneer,” available at www.dowcorning.com/content/publishedlit/01-4027-01.pdf (accessed October 10, 2011); and John Schwartz, “Dow Corning Accepts Implant Settlement Plan; $3.2 Billion Earmarked for Health Claims,” Washington Post, July 9, 1998.

  anaplastic large-cell lymphoma: Denise Grady, “Breast Implants Are Linked to Rare but Treatable Cancer, F.D.A. Finds,” New York Times, January 26, 2011.

  “The message that never reaches the public”: Spanbauer, “Breast Implants as Beauty Ritual.”

  from a high of 150,000: Marcia Angell, “Breast Implants— Protection or Paternalism?” New England Journal of Medicine, vol. 326 (June 18, 1992), pp. 1695-1696.

  the FDA approved: On FDA approvals, see “Breast Implants,” U.S. Food and Drug Administration, at http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/Implantsand Prosthetics/BreastImplants/default.htm (accessed October 14, 2011).

  roughly $820 million a year: Denise Grady, “Dispute over Cancer Tied to Implants,” New York Times, February 17, 2011.

  Between five and ten million women: Grady, “Dispute over Cancer Tied to Implants.”

  product insert data sheet: For Mentor’s product insert data sheet, see http://www.mentorwwllc.com/global-us/SafetyInformation.aspx (access
ed October 2011).

  a major review of the literature from the Institute of Medicine: Safety of Silicone Breast Implants (Washington, D.C.: Institute of Medicine National Academy Press, 2000). Also available through the Institute of Medicine website, at www.iom.edu.

  “It is not known if a small amount of silicone”: For information on the effects on nursing infants, see “FDA Breast Implant Consumer Handbook—2004,” at www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/ucm064242.htm.

  “Fortunately, patients undergoing plastic surgery of the breast”: Eugene H. Courtiss and Robert M. Goldwyn, “Breast Sensation before and after Plastic Surgery,” Plastic and Reconstructive Surgery, vol. 58, no. 1 (July 1976), pp. 1-13, quoted in Haiken, Venus Envy, p. 270.

  Mentor’s study to date: Summary of the study is available at http://www.mentorwwllc.com/global-us/SafetyInformation.aspx (accessed October 2011).

  critics like Naomi Wolf: Naomi Wolf, The Beauty Myth (New York: William Morrow, 1991), p. 242.

  Barbie’s proportions are naturally found: Kevin I. Norton et al., “Ken and Barbie at Life Size,” Sex Roles, vol. 34, no. 3-4 (1996), pp. 287-294.

  a twenty-nine-year-old named Gloria: I’ve changed the names of Dr. C’s patients to protect their privacy.

  CHAPTER 5 • TOXIC ASSETS

  “I tell people I come from a different planet”: Sylvia Earle, author interview, February 10, 2012.

  nature writer and biologist had received a disturbing letter: For a description of Huckins’s experience with DDT, see Eleni Himaras, “Rachel Carson’s Groundbreaking ‘Silent Spring’ Was Inspired by Duxbury Woman,” Patriot Ledger (Quincy, Mass.), May 26, 2007.

  “elixirs of death”: Rachel Carson, Silent Spring (New York: Ballantine Books, 1962), pp. 24-43.

  “The sedge is wither’d from the lake, / And no birds sing”: Carson, Silent Spring, p. 12.

  “For the first time in the history of the world”: Carson, Silent Spring, p. 25.

  “I was born with a plastic spoon in my mouth”: The Who, “Substitute,” 1966.

  The term endocrine disruptor: Theo Colborn, founder and president of The Endocrine Disruption Exchange and professor emeritus of zoology, University of Florida, Gainesville, author interview, March 2010.

  women reportedly get better at verbal and fine-motor skills: For example, see Elizabeth Hampson, “Estrogen-Related Variations in Human Spatial and Articulatory-Motor Skills,” Psychoneuroendocrinology, vol. 15, no. 2 (1990), pp. 97-111.

  do humans cultivate marijuana: For more on the wonders of evolutionary adaptations of marijuana, see Michael Pollan, The Botany of Desire: A Plant’s-Eye View of the World (New York: Random House, 2001).

  Giant fennel, found by the Greeks in the seventh century BC: Timothy Taylor, The Prehistory of Sex: Four Million Years of Human Sexual Culture (New York: Bantam Books, 1996), p. 90.

  BPA’s molecular structure is simple and elegant: Jeffrey Stansbury, polymer chemist, University of Colorado, Denver, author interview, March 2011.

  Now produced in mind-boggling quantities: Fact sheet, “Bisphenol A (BPA) and Breast Cancer,” published by the Breast Cancer Fund, December 8, 2008, available at www.breastcancerfund.org/assets/pdfs/bpaandbc_factsheet_120808.pdf.

  DES: For the effects of DES on daughters and sons, see Nancy Langston, Toxic Bodies: Hormone Disruptors and the Legacy of DES (New Haven, Conn.: Yale University Press, 2010), p. 135.

  BPA has been shown to cause: A. G. Recchia et al., “Xenoestrogens and the Induction of Proliferative Effects in Breast Cancer Cells via Direct Activation of Oestrogen Receptor Alpha,” Food Additives and Contaminants, vol. 21 (2004), pp. 134-144; S. V. Fernandez and J. Russo, “Estrogen and Xenoestrogens in Breast Cancer,” Toxicologic Pathology, vol. 38, no. 1 (January 2010), pp. 110-122.

  There is something about BPA: Sarah Jenkins et al., “Oral Exposure to Bisphenol A Increases Dimethylbenzanthracene-Induced Mammary Cancer in Rats,” Environmental Health Perspectives, vol. 117, no. 6 (June 2009), pp. 910-915.

  In other rat experiments: Milena Durando et al., “Prenatal Bisphenol A Exposure Induces Preneoplastic Lesions in the Mammary Gland in Wistar Rats,” Environmental Health Perspectives, vol. 115, no. 1 (January 2007), pp. 80-86.

  Higher EZH2 levels are associated with an increased risk: Leo F. Doherty et al., “In Utero Exposure to Diethylstilbestrol (DES) or Bisphenol-A (BPA) Increases EZH2 Expression in the Mammary Gland: An Epigenetic Mechanism Linking Endocrine Disruptors to Breast Cancer,” Hormones and Cancer, vol. 1, no. 3 (2010), pp. 146-155.

  Scientists call this “phenotypic plasticity”: For an interesting overview, see Richard G. Bribiescas and Michael P. Muehlenbein, “Evolutionary Endocrinology,” in Michael P. Muehlenbein (ed.), Human Evolutionary Biology (New York: Cambridge University Press, 2010), pp. 127, 137.

  DES was still manufactured: Furthermore, its illegal use as a growth hormone in cattle continued well into the 1980s. For more on DES and its dates of use, see http://www.websters-online-dictionary.org/definitions/Diethylstilbestrol; Nancy Langston offers a compelling history in Toxic Bodies, p. 117; see also Orville Schell, Modern Meat: Antibiotics, Hormones, and the Pharmaceutical Farm (New York: Vintage, 1985), p. 331.

  In the United States, every chemical is assumed safe: Lynn Goldman, “Preventing Pollution? U.S. Toxic Chemicals and Pesticides Policies and Sustainable Development,” Environmental Law Reporter, vol. 32 (2002), pp. 11018-11041.

  Of the 650 top-volume chemicals in use: Rick Smith and Bruce Lourie, Slow Death by Rubber Duck (Berkeley, Calif.: Counterpoint, 2009), p. xiv.

  “They leave the mammary gland in the trash can”: Ruthann Rudel, director of research, Silent Spring Institute, author interview, February 2011. See also Ruthann Rudel et al., “Mammary Gland Development as a Sensitive Indicator of Early Life Exposures: Recommendations from an Interdisciplinary Workshop,” presented at The Mammary Gland Evaluation and Risk Assessment Workshop in Oakland, Calif., November 2009. Also see S. L. Makris, “Current Assessment of the Effects of Environmental Chemicals on the Mammary Gland in Guideline EPA, OECD, and NTP Rodent Studies,” Environmental Health Perspectives, vol. 119, no. 8 (2011), pp. 1047-1052; and Florence Williams, “Scientists to Chemical Regulators: Stop Ignoring Boobs,” Slate, June 27, 2011, available at http://www.slate.com/articles/double_x/doublex/2011/06/scientists_to_chemical_regulators_stop_ignoring_boobs.html.

  In the body it appears to increase: J. L. Raynor et al., “Adverse Effects of Prenatal Exposure to Atrazine during a Critical Period of Mammary Gland Growth,” Journal of Toxicological Sciences, vol. 87 (2005), pp. 255-266.

  The journal Cancer reported in 2007: Ruthann A. Rudel et al. “Chemicals Causing Mammary Gland Tumors in Animals Signal New Directions for Epidemiology, Chemicals Testing, and Risk Assessment for Breast Cancer Prevention,” Cancer, vol. 109, no. 12 (2007, Supplement), pp. 2635-2666.

  Roughly one thousand chemicals: Theo Colborn, author interview, March 2010.

  “The possibilities of DDT are sufficient”: For this quotation from Simmons and other information on DDT, see Will Allen, The War on Bugs (White River Junction, Vt.: Chelsea Green, 2008), p. 171.

  by the early 1970s, 1.3 trillion pounds had been sprinkled: EPA report, “DDT Regulatory History: A Brief Survey (to 1975),” excerpted from DDT, A Review of Scientific and Economic Aspects of the Decision to Ban Its Use as a Pesticide, prepared for the Committee on Appropriations of the U.S. House of Representatives by EPA, July 1975, available at http://www.epa.gov/history/topics/ddt/02.htm.

  shortened duration of lactation: For a good introduction to the potential links between chemicals and mammary gland dysfunction, see Ruthann Rudel et al., “Environmental Exposures and Mammary Gland Development: State of the Science, Public Health Implications, and Research Recommendations,” Environmental Health Perspectives, vol. 119, no. 8 (August 2011), pp. 1053-1061; also available at http://ehp03.niehs.nih.gov/article/fetchArticle.action?articleURI=info%3Adoi%2F10.1289%2Fehp.
1002864.

  The younger women, the ones exposed to the most DDT: See Barbara A. Cohn et al., “DDT and Breast Cancer in Young Women: New Data on the Significance of Age at Exposure,” Environmental Health Perspectives, vol. 115, no. 10 (October 2007), pp. 1406-1414.

  women born after 1940 have much higher levels: See Tom Reynolds, “Study Clarifies Risk of Breast, Ovarian Cancer among Mutation Carriers,” Journal of National Cancer Institute, vol. 95, no. 24 (2003), pp. 1816-1818.

  Cheap by-products of fossil-fuel production: Theo Colborn, “Foreword,” in Smith and Lourie, Slow Death by Rubber Duck, pp. viii-x.

  Today we use thirty times more synthetic pesticides: Theo Colborn, Diane Dumanoski, and John Peterson Myers, Our Stolen Future: Are We Threatening Our Fertility, Intelligence, and Survival?—A Scientific Detective Story (New York: Penguin Books, 1996), p. 138.