Let's inject a bit of common sense into implants debate

IT’S TIME we stopped being superior about plastic surgery and started reaching for some nice, strong legislation. I like to think I’m as sanctimonious as the next person – and some like to think I’m more sanctimonious than anyone you could hit with a stone – but this controversy over the faulty breast implants manufactured by the French company, PIP, may have brought me to my senses.

What the scandal has revealed, so far, is a lot of disapproval of women who’ve had breast implants. Even we sanctimonious types can see this isn’t terribly helpful. It is particularly unhelpful to the women across the world who are thought to have had PIP implants inserted into their bodies; 30,000 in France and perhaps 40,000 or 50,000 in Britain. About 1,500 in Ireland, according to an Irish Medicines Board statement.

According to the same statement, in Ireland the implants were inserted at only three private hospitals – in Cork, Kildare and Dublin. They were not used within the public health system in the course of reconstructive surgery after mastectomies. (Good lord, when you think about women’s breasts and the trouble they cause women – never mind men – you have to agree that they are our society’s fetish.)

Anyway, in Ireland at any rate, the affair seems to be another example, like the prescription of antibiotics discussed here some weeks ago, of public patients getting better health care by accident, simply because they can’t pay for the dodgy stuff. I am waiting for some clear-eyed young economist to come along and quantify the questionable effects that the business model has had on Irish medical care. But I’m not going to hold my breath on that one, unless I’ve got a really serious disease and am valuable for research purposes.

If anything, private medicine in Ireland is just too damn private. We need a couple of spotlights in there. By that I mean some laws, but not in the accepted Irish sense of the term. I mean some supervision, some regular policing. It’s infantile of us to expect doctors who are literally operating on the margins of the medical industry – because that is what it is – to impose a moral line on their own medical practice: history shows us that they never have.

After all, this is the profession that is altering young women’s genitalia to make sure that it more closely resembles the genitalia of women featured in pornography. The demand for these completely unnecessary and objectionable operations comes from the young women themselves – their poor brains are fried by a system that somehow manages to sell them their own bodies – yet the doctors oblige them at a disturbing rate. This recently led to the best feminist march of recent years, down Harley Street. Unfortunately the most impressive slogans against genital modification won’t make it into a family newspaper.

Our medical system has a pagan reverence for money, which is thought to protect you from everything, even your own madness. This is an irrational belief.

Of course equipment must sometimes prove questionable. Before we rush to patronise the women who’ve had the implants in question inserted, let’s remember the artificial hip joints that have recently been recalled.

But let’s not fool ourselves either: the public disapproval for women who’ve had breast implants is – excuse me – huge. Particularly from other women. There is a whole school of thought out there which reckons that anyone who is vain enough and stupid enough to want plastic surgery cannot complain when it looks as if the whole thing may have gone horribly wrong. There is no consensus yet that these implants have gone wrong and must be removed. But it is in the shadow of our disapproval that plastic surgeons make a great deal of money, feeding on the insecurities we all share.

The controversy is not just about implants which may or may not warrant removal. Breast implants are made of filler, and the injection of filler into the face, frequently performed by non-medical personnel in beauty parlours, is actually the most common cosmetic procedure of all. The British Association of Aesthetic Plastic Surgeons found, in a survey of its members, that one quarter of them had operated on patients who had such severe complications from facial fillers that surgery was the only option.

It is not enough for us to assume because a waiting room boasts some good magazines and some bad art that its owners are immune from supervision of any kind. We must start to embrace plastic surgery, and all its works and pomps. We must watch it very carefully.

It is hard to contemplate people undergoing unnecessary surgery in order to fulfil some Playboy fantasy. But human folly is limitless. As an ex-smoker I’m glad I’m not denied medical care on the grounds that I once was, and always have been, an idiot. Let’s not turn away from plastic surgery patients, and leave them at the mercy of good business.