Silicone Chip on My Shoulder

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Readers of National Review Online yesterday (August 22) had the pleasure of reading Dr. Sally Satel's piece describing her justifiable outrage regarding the continued restrictions on silicone breast implants. It is galling to those of us in public health that a strident group of activists can impose their will upon the overwhelming majority of consumers based upon nothing more than their version of what is "best" for everyone else.

Dr. Satel, an ACSH advisor, is a psychiatrist, well suited to make observations about human nature and responses to alarmist hype about the "dangers" of silicone breast implants (SBI). I am a rheumatologist, and therefore qualified to agree with her assertions about the lack of medical evidence supporting the theory that silicone leakage is associated with systemic illness. Of course, like any other intervention or therapy, there are known risks, both during and after surgery, including infection, hardening, and leakage. (See the ACSH publication Silicone-Gel Breast Implants, Health and Regulatory Update 2000.)

Nonetheless, the pusillanimous FDA continues to adhere to its politically correct stance, continuing to impose restrictions on women's "right to choose" to have SBIs. For a time -- though this is truly hard to believe -- even women recovering from disfiguring breast surgery faced bureaucratic impediments to having cosmetic replacements. All this was initiated, contrary to the activists' charges, by the G.H.W. Bush appointee Dr. David Kessler when he was the FDA czar (some self-styled women's groups have accused the current FDA of trying to appease its industry friends by eliminating the ban -- oops, I mean the "moratorium" -- on SBIs).

Perhaps now, with a new permanent Commissioner, the drug agency will have the gumption, at long last, to eliminate barriers to women who wish, for whatever reason and after informed discussion with their healthcare providers, to utilize this technology as they see fit, instead of having others decide what's right for them.

Gilbert Ross, M.D., is Executive and Medical Director of the American Council on Science and Health (,