Confidence, contempt and cosmetic surgery

It’s been an instructive few weeks for finding out what the cosmetic surgery industry really thinks about women. This is the industry, remember, that wanted women to feel nice and confident about ourselves, with our neat little bags of silicone and our wrinkle-free foreheads. ‘Confidence starts with the Harley Medical Group,’ as one firm’s current advert would have it, with what sounds like quite a bit of chutzpah, in the circumstances.

So who’s confident in the industry now? The estimated 40,000 UK women who had breast implants filled with silicone intended for mattresses probably wouldn’t use that word. And if you think I’m having a gloat, far from it. I’m outraged on behalf of these women, who entered into a contract in the full expectation that they would be supplied with goods and services that were appropriate for the intended use. I have every sympathy with the women who’ve been left with these sub-grade implants, whether they needed implants after mastectomy, or whether they simply wanted to change the way they looked. Cosmetic surgery is marketed as a safe and effective choice, and people who choose it have every right to expect it to live up to the marketing.

The trouble is, as we’ve seen, the companies who are so keen to make a buck out of women’s insecurities are much less keen to carry the buck when things go wrong. The department of health quickly discovered that record-keeping in this arena is terrible, with many clinics unable to tell them what the rupture rates for the sub-standard implants were.

Actually, this is unsurprising. I spent some time this week trying to find out what the average rate of implant rupture is. According to the most reliable source I could find – the UK’s Medicines and Healthcare Products Regulatory Agency – there is ‘little information’ on rupture risk, generally. The lifespan of modern implants, they say, is ‘unknown’. The only evidence-based figures I could find (from EBM site Bandolier, dating from 2000) showed one in 10 implants is expected to have ruptured after 8 years, rising to more than nine in 10 after 20 years. So an 18-year-old girl wanting to ‘boost her confidence’ has a 1 in 10 chance of needing the implants removed or replaced before she’s 30, and will almost certainly have experienced implant failure by the age of 40. I don’t remember any of those glossy, smiley ads on the tube mentioning that.

Put the rupture rate aside for one moment. The goods supplied were sub-standard. They did not contain what they should have contained. In any other consumer field, surely, women would be able to take them back and exchange them for non-faulty goods, at no cost to themselves. Instead, we hear of clinics charging women even to look at their records and check which implants they had. While some clinics are replacing implants free of charge, some of the biggest groups, like Harley Medical Group, say there’s ‘no cause for concern‘ and are trying to blame it on the MHRA. Another big group, Transform, intend to charge women £2,800 to have them removed, never mind replaced. The department of health, admirably, has said any sub-standard implants provided on the NHS can be removed or replaced, if that’s what women want. And in the many cases where fly-by-night clinics have come and gone, or are refusing to fund treatment, the NHS will, as ever, pick up the tab.

We hardly needed to hear the boss of PIP, Jean-Claude Mas, insulting women who intended to sue the company as ‘money-grabbers’ to know how much contempt he and his firm had for women. But it has been interesting to watch the industry as a whole try to wriggle out of their moral obligations, while still mouthing platitudes about how much they care for their patients. If any good at all comes out of this horrible saga, it will be that we stop trusting people who want to make money out of our insecurities to have our best interests at heart.

UPDATE: Read the Department of Health’s statement on the situation, 10 Jan, here:

UPDATE 2: Harley Medical Group confirm they won’t replace implants. Chairman Mel Braham (no oil painting himself, I notice) whines:  “We’re an innocent victim like everyone else, we’re attempting to do our best for our patients… We can’t take on this whole thing on our own, especially when it wasn’t our fault.” Here’s a suggestion, Mr Braham – replace the implants using that budget you use to plaster the London Underground with adverts trying to make women feel inadequate.

UPDATE 3: On 25 January, Transform Medical Group announced it would remove implants free of charge. Replacement will cost £2,500. Also, the British Association of Aesthetic Plastic Surgeons have called for an end to advertising of cosmetic surgery.

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