about-breast-implant-associated-illnessThere have been a lot of discussions lately about Breast Implant Associated Illness. Many women with breast implants are wondering about their choices. Having performed over 6,000 breast surgeries in my 29-year career as a cosmetic plastic surgeon here in San Diego, many of my patients are asking me for my thoughts. Having breast implants myself, this discussion also resonates at a personal level for me as well. 

My goal has always been to do whatever I can to make a woman feel more beautiful, whole, and self-confident. Despite having lovely breasts, many women still seek breast augmentation. I understand their desire to feel better about their bodies and to enjoy more clothing options. I never questioned why they would want to take on the risks associated with a surgical procedure, but thousands of women did, including me. The vast majority are very happy with their decision and the positive impact it has had on their life.

Fast forward to today. Many women with attractive augmented breasts are asking me to remove their implants. Some tell me they are experiencing symptoms, and others express concern about possible symptoms. They understand that if the implants are removed, their breasts will, at the very least, be saggy, and even possibly deformed. Unlike me, they do not accept the science behind the safety of the breast implant device which has undergone decades of testing and scrutiny.

It has been difficult for me to agree to these requests. I agonize every time a patient asks me to take out her implants because she feels they are making her sick. The last such patient had saline implants. To honor her request seemed to fly in the face of my Hippocratic Oath, “First, do no harm.”

Soul Searching

I searched my soul into what it was I have been doing for the past 29 years as an aesthetic surgeon. In thinking about it, I realized there is no true medical indication for augmenting perfectly healthy breasts just to make them larger. I do so because the patient believes it would enhance her enjoyment of her life. 

AHA! That was the heart of it; her belief, a psychological feeling, pure and simple. This epiphany changed my professional response. While I may not agree with a woman’s belief that her implants might be harming her, I do respect what it is doing to her feelings of safety. Why would I want her to live with these concerns any more than I would want her to feel less than a whole woman because of her small breasts?

How many hundreds of beliefs do we all have that others may consider wrong or misguided? The way you feel about anything is not right or wrong: it’s just what it is.

So now I “get it”. My heart is open to these women’s plight. I believe in the science and I am not removing my own implants. But, as a surgeon, I will honor my patients’ feelings, the psychology of their choice.  When it comes down to the very bottom line, this is what I do… I honor my patients.

– Lori H. Saltz, MD

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