Figure Perfect
Implants serve more aesthetic than medical purpose
By Michelle Ciriacruz
Photos courtesy of Dr. Irene Tangco
 The search for perfection reaches new heights. The fame of pop icons Jennifer Lopez and Britney Spears, with their flawless features and sculptured bodies, has made envy a business on its own.
These days, the idea of just putting on make up and dressing up to improve one's looks has become so archaic as the popularity of facial and body sculpting surges up with each appearance and performance of these body-beautiful celebrities.
The media scare more than a decade ago over breast implants lies forgotten in the dearth of evidence regarding the link between breast cancer and breast implants.
There are more beauty-conscious individuals who are willing to put up with a surgeon's scalpel than ever before.
The face and the female breasts are no longer the only candidates for enhancement or augmentation. The buttocks, chest, arms, thighs, legs, and calves of that well proportioned male or female may just owe their endowment to a cosmetic surgeon's skill.
The Learning Curve
The use of implants became popular with society's passion for voluptuous-looking women and women's desire to please and to conform. Barbie Doll idealized womanly perfection, with her prominent cheekbones, hourglass figure, and long legs. Marilyn Monroe became a legend-her figure an appropriate tribute to the innate sensuality she projected so effortlessly on screen. And, of course, Pamela Anderson's shot to fame had more to do with her exaggerated assets than with her acting skills.
Even before their manufacture and use in the United States were regulated as medical devices in 1976, breast implants have been lifting the self-esteem of numerous women as well as anatomically for more than a decade. This technology was adapted from reconstructive surgery, where implants found their niche correcting deformities and disfigurements caused by trauma, congenital defects, developmental abnormalities, surgeries, or certain diseases. Implants were also widely used in heart and abdominal surgery.
It was only when the potential of implants to augment body parts was realized that their use became controversial, explains plastic surgeon Dr. Irene Tangco-when the focus became form alone, leaving out function.
Actually, the aesthetics are an integral part of plastic surgery, she says. "Implants, originally used in reconstructive surgery, are now more often used in aesthetic surgery."
Essentially, intention defines whether the procedure performed was aesthetic or reconstructive. The two fields share techniques that deliver outwardly similar results.
Aesthetic surgery thrived though. At first, its practitioners and beneficiaries shrouded their activities in mystery-preferring to attribute their cosmetic improvement to natural causes. Gradually, its practice became more open as more men and women expressed satisfaction over their perkier body contour and facial profile.
Most implants used for breast augmentation were silicone shells filled with either sterile salt solution or silicone gel. Silicone was the preferred material for other implants as well, since its component, the element silicon, is one of the most common elements on earth. Everyone has therefore been exposed to silicon.
Dr. Tangco explains that silicon is an inert substance that has been in use in the medical profession for a whole century already. "It is not just in prosthetics that we use silicone-even in tubes that we use to place deep inside the patient's body."
Going Against the Curve
The idea that silicone is a perfectly safe product burst when fears regarding the safety of implants, particularly breast implants, grew into hysteria.
Some implants ruptured and leaked silicone gel into the body. This was blamed for the incidence of cancer and autoimmune diseases among women who had silicone gel-filled breast implants.
In 1992, the US Food and Drug Administration (FDA) restricted the use of silicone gel-filled implants to reconstructive purposes, correction of congenital deformities, or replacement of ruptured silicone gel-filled breast implants that were used for augmentation.
Based on present evidence, however, the fears proved largely unfounded. The FDA reports that most studies came out with a negative or doubtful answer on whether breast implants increased the risk for certain debilitating illnesses. It cites a study by the Institute of Medicine in the US that shows breast cancer is no more common in women with implants than those without implants.
Dr. Tangco sums up: "The FDA in the States investigated the whole situation and found out that there was no increased incidence of breast cancer or rheumatoid disease in any of these females who had silicone implants."
Saline-filled implants were not as touched by controversy as their purely silicone counterparts. The FDA allowed these implants to be used for aesthetic purposes, eventually giving them a stamp of approval in 2000 when two manufacturers were able to prove that their products were safe and effective.
Not that a woman should expect a worry-free future in breast implants. It is a foreign element surgically introduced into the body. There are risks and possible side effects specific to breast implants. In addition, there are risks associated with the effects of the anesthesia, analgesics, and antibiotics.
The FDA cautions that some women with breast implants may experience one or several local complications. Some will be felt immediately after the operation, like pain, infection, hematoma (collection of blood around implant), seroma (collection of fluid around implant), and changes in nipple and breast sensation. They are usually addressed by medical treatment and are temporary.
And although complications do not arise with every operation, some women may need resurgery to correct some complications, like shifting of the implants, deflation, rupture, and leakage. Over the course of the women's lives, capsular contracture (tightening of the scar tissue or capsule the body forms around the implant) may also occur.
This is because breast implants are not considered lifetime devices, the FDA stresses.
The implants manufactured today are more reliable than those manufactured in earlier years, but so far, no artificial medical device has proved to cope as well as a biological body part with the stress our body is subjected to everyday.
Dr. Tangco notes, however, that the general safety and durability of breast implants these days could be attested to by the very good record shown here among patients who availed themselves of breast augmentation using breast implants.
Nevertheless, while serious complications can be avoided with a properly trained surgical specialist, patient education on both benefits and risks of the implant procedure is crucial to the patient's decision to submit to it.
Deflated Misgivings
When these scientific findings quelled fears on the cancer link, the popularity of breast implants was revived. Despite the possible complications inherent in their use, most women seemed happy with their implants, including those who needed them for reconstruction following breast cancer surgery.
According to the American Society of Plastic Surgeons (ASPS), breast augmentation is the second most commonly performed cosmetic surgical procedure after liposuction. It reports that from 1992 to 1998, the number of breast augmentation procedures more than tripled. Meanwhile, breast implants were used in 21 percent of breast reconstruction procedures in 1998 (www.plasticsurgery.org).
The ASPS statistics also show than in the past 10 years, breast reconstruction performed by plastic surgeons certified by the American Board of Plastic Surgery increased 174 percent.
Dr. Tangco observes that breast augmentation is also a very popular aesthetic surgical procedure here in the Philippines. Only rhinoplasty and liposuction precede it.
Bottoms Up
An ironic twist in the body consciousness saga of people is the recent trend for buttock augmentation and contouring of other muscular parts like the pectoral muscles in men, calf muscles, biceps, and triceps of men and women.
If before, getting skinny at all costs is the name of the game, now it is adding volume, especially in the rear.
Jennifer Lopez may have sparked this new craze. Fans seem as fascinated with her shapely backside as with her talent. Plastic surgeons in the US who specialize in body shaping credit her continued popularity with the growing demand for their services.
People with poor muscular development in certain areas pay to have them cushioned with either silicone implants or micro fat grafting (only for the buttocks). For some individuals also, frequent and intensive workouts at the gym may not be enough to provide them the body contour symmetry they desire.
Dr. Tangco says that among the few requests like this in the local practice, fat injection had been used.
Chin Up
In facial cosmetic surgery, facial shaping has now supplanted the superficial tightening of the face, which merely stretches the skin tightly across the face. In the early days of this practice, recipients of the technique usually end up with a windtunnel look. The result enhances the artificiality of the face and not its looks.
With implants, however, natural-looking volume and angles can be sculpted into the face. The nose, cheeks, and chin are ideal for shaping.
Implants are just one kind of tool used in a facelift. Plastic surgeons have several techniques at their disposal. Some they prefer more than others. The patient, together with the surgeon, should be able to find the ones most suitable for her or his cosmetic requirements.
Perfectly Normal
It is in a human being's nature to aim for something higher or something better. This is perfectly normal.
The catch is, many people have nothing wrong with their bodies except poor self-image, exacerbated by misplaced values.
It is a fact of life that youth and physical beauty often are prioritized and favored. It is the awareness of this that leads so many down the path of dependency on something they believe could solve their image problems.
It is probably the prevalence of these wrong reasons among individuals who sought cosmetic enhancement that was partly responsible for the controversy that befell the practice of aesthetic surgery.
Implants could recreate form, shape an ideal one, and correct deformities. Moreover, Dr. Tangco clarifies: "It can achieve beauty, in accordance to the standards of an individual. The safety of implant usage can be enhanced when they are utilized for the right reasons and the surgery done by a certified plastic surgeon."
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