Fake Boobs

Yes, I'm talking about breast implants.  And since there is a political angle on everything today I'm sure there is one for this one too.  But I am going to leave that part of the story alone and look at the subject from the perspective of Science.  And, as is my custom, I use history as an organizational tool.  Where to start?

I am going to start with the invention of the bra.  There are a lot more "origin stories" about this item of clothing than most people realize.  But I am going to stick with the one that is popular in the US.  I choose it because it involves a direct line from invention to the manufacture and distribution of a commercially successful product.

The story goes that in 1910 Mary Phillips "Polly" Jacobs, also known as Caresse Crosby, was getting ready to go to a debutante ball.  She initially struggled into a whalebone corset.  This device cinches in the waist and pushes the boobs up and forward.  If you add a bustle (think a fabric version of Kim Kardasian's butt) the result is an "hourglass figure", full through the bust and hips, thin at the waist.  This had been the height of fashion for some time but we were about to move into the "flapper" era.

Anyhow, Polly was apparently a full figured gal so she didn't need any help up top.  And the whalebone reinforced corset was very uncomfortable to wear.  So she took two handkerchiefs, some ribbon, and a needle and thread, and fastened together a garment that provided coverage but not much support.  It turned out to be an ideal match to the sheer gown with a plunging neckline she was wearing.  And it was an instant smashing success (apparently both the gown and her invention).

The popularity of the garment was apparent from the start.  This led her to get a patent for the design in 1914 and to begin to manufacture them.  But her interests were elsewhere so she sold the rights to the Warner clothing company.  Initially Warner did not make much of a success but they were smart enough to license it widely.  In the hands of others it quickly became popular.

It became so popular so quickly that it became a standard of apparel for women in no time.  Dorothy L. Sayers casually mentions one in a "Lord Peter Wimsey" murder mystery she wrote in the mid thirties.  She was English and the book was set in London. As a murder mystery with a male lead the book did not concern itself with the minutia of women's fashion.  But twenty-five years after the patent was issued everyone took it for granted that British women wore them as a matter of course.  And so it quietly played its role as part of the ambience of a book whose focus is most decidedly elsewhere.

We would not recognize the initial design.  But the standard band, cups, and straps design emerged quickly.  Another innovation that showed up early was the underwire.  And that sets the stage for the next subject I want to cover.

Not every woman is built like Polly.  But many women feel it is important to put on a show, to appear to be built like Polly.  The addition of the underwire made another innovation possible, the padded bra.  Foam rubber, first manufactured in 1929 but widely available by the late '30s, could be used to fill the void between what nature provided and what a bra with a fuller cup presented to the outside world.  And foam had the great advantage of being far lighter than the materials nature used.

So a woman could comfortably and inexpensively and inconspicuously wear a padded bra under the now more conservative clothes that came in when the flapper era ended with the end of the '20s.  And a lot of women did.  This was especially true of Hollywood actresses of the '50s.  Clever work by skilled costume designers could even make it possible to maintain the illusion of a "full figure" in what would otherwise seem like quite skimpy outfits.

And this got taken to extremes.  Mamie van Doren was a Hollywood fixture in the '50s and '60s.  She was as well endowed or even better endowed than Polly had been.  But in some situations "there's no such thing as too much".  So she often appeared in a specially made padded bra that made her bust size appear to be not just substantial but literally awe inspiring.  But the times, they were starting to change.

During this same period, the padded bra era, strip tease enjoyed a considerable degree of success.  The problem was that the artists ended up wearing so little that a padded bra was not feasible.  But there were always enough "full figured girls" who "came by it naturally" to provide a sufficient pool to fill the demand for ecdysiasts, as strippers were called in polite circles.  But what if a less well endowed girl was interested in entering the business?

Carol Doda, initially a waitress at a club in San Francisco called "The Condor" was just such a person.  She actually had a pretty good figure.  But again on the theory that "there's no such thing as too much" she let herself be talked into being the first person to try a new procedure.  Initially the new procedure took her bust measurement from 34 to 44.  So she got the result she was looking for.  But the procedure she underwent looks pretty barbaric from the perspective of the present.

She had silicone injected directly under her skin and into the breast area.  Why silicone?  Was this some kind of underhanded plot by scheming corporate executives?  The exact opposite was true.  No one in the business of manufacturing medical devices or producing silicone for use in medical procedures even knew what was happening.  Instead people in the entertainment business were looking for a way to give strippers or potential strippers bigger boobs.  A little research showed that medical grade silicone had a long track record of being safe.  And it wasn't particularly expensive.

It was also obvious quickly that just injecting it was a bad idea.  It didn't cause medical problems but it did tend to wander.  So "shapely" quickly turned into lumpy, and lumpy in strange places.  The solution was obvious and quickly adopted.  Put the silicone in a bag and insert the bag.  The bag would keep the silicone in place.  This turned out to work very well and women started getting silicone breast implants in large numbers.

But it is important to note that even in this period when breast implants were flying off the shelf the companies that were making the implants saw the business as a small sideline.  It was never a big moneymaker.  They were just meeting a demand and making a few bucks along the way.  But then some women noticed they all of a sudden were having strange medical problems.  And these medical problems seemed to start when or shortly after they got breast implants.  So it must be the fault of the implants, right?

Now a real problem did surface with a significant number of women who got implants.  Their bodies manufactured scar tissue around the implant.  This made their breasts hard and in some cases detracted from their visual appeal.  But this scarring did not cause any serious medical problems.  It was just not the result they wanted.

But what about all these mysterious medical maladies?  The first thing to recognize is that many women had serious medical problems that were completely real.  So the question was not:  "had they suffered a serious medical problem?"  It was:  "was the cause of the serious medical problem the implants?"

Given the history of implants no serious research or testing had taken place.  Putting the silicone in a bag was an obvious improvement over just injecting it.  And both the silicone and the bags were materials for which a lot of experience existed.  There was no reason to believe that they would cause problems.  So the companies just went ahead and provided the product the public demanded.  So early on there was a plausible argument to be made that the implants were the cause.

But it quickly turned out that women experienced a variety of problems.  It wasn't just one thing.  And all these problems were of the type that had always been happening.  But they had only been happening to a few women.  So the rarity of occurrence of any one of these illnesses had made it hard to draw much interest or attention to the illness.  So there was not much known about them.  That is before they all got lumped together and blamed on breast implants.

These women went to court and told their tale.  The companies involved were big companies that had a lot of money.  When it came out that the companies had done little or no "due diligence" and that the women were suffering horribly from one affliction or another juries awarded the women a lot of money.  All of a sudden the companies involved found it in their interest to find out what was what.

By this time literally millions of women had gotten implants.  So the first question to ask was "are these women getting sick more often than women without implants?"  It turns out that the answer was no.  The next question was "is there any evidence that the illness is being caused by the implants?"  Here too the answer was no.

But big companies misbehave frequently.  And the women really were sick.  So juries kept making large awards.  So the companies and others dug in and did more research.  The research kept coming up with nothing.  But the public was not interested in some scientific study.  This was especially true if the study was funded by a big company.  Over a period of years various large well done and very expensive studies were done.  Nothing.  And the jury awards kept rolling in.

Finally in desperation the companies replaced the silicone with saline, salt water.  Eventually this put an end to the law suits.  Everybody knows that disinfected salt water is not dangerous.

But then a funny thing happened.  Women found they did not like the saline implants.  They didn't jiggle right.  So first a few and then more and more women said "I don't care if it is dangerous.  I want my silicone."  And people finally noticed that the vast majority of implant customers did not have any of the horrible problems that had started the whole circus.

Things have changed slightly.  In the old days plastic surgeons made a large slit and inserted the bag with the silicone already in it.  Various techniques were employed to hide the scar.  But the size made it hard to conceal completely.  So some doctors started inserting an empty bag.  This could be done using a small incision which was far less noticeable in the first place and much easier to conceal.  It was also easier on the body which improved the healing process.

They would then inject the silicone somewhat in the manner used on Carol Doda.  But this time the silicone went into the bag.  It was inflated just like a balloon.  There had also been leaking problems with early implants.  That problem was also fixed.  But none of these "fixes" made implants any more or less dangerous.  They just improved the user experience of women getting implants.

The result was that ultimately the science prevailed.  Everybody figured out eventually that implants are safe.  And the occasional law suit that someone still tries to file is routinely thrown out without even a hearing.  And implants, who has them, are they safe, etc. is not something that gets anybody riled up anymore.

Science won, eventually.  And it's the "eventually" part that is troubling.  We are still going through the same kind of thing with the anti-vaxers.  The science is in.  Vaccines are safe and they do a lot of good.  As was (and is) the case with implants, people get sick, sometimes horribly sick, at the time of or shortly after they get the procedure.  But as was the case with implants it doesn't happen very often.  And the science has looked thoroughly into the issue and concluded "it's a coincidence".  This is exactly what was going on with implants.  The difference is that with vaccination we haven't gotten all the way out from under the issue.  There are still a lot of people who believe that the anti-vax people are right.

But whether a woman gets implants or not just affects the woman in question.  But when parents fail to vaccinate their children the child can get very sick and perhaps die.  That's bad.  But there are others who for one reason or other can't or have not gotten vaccinated.  And these people can also get very sick and perhaps die.  So the anti-vax people hurt not only themselves and their loved ones but they hurt innocent strangers.

The breast implant controversy and the anti-vax controversy are part of a larger anti-science movement.  The implant controversy hurt some companies and their stock holders.  It amped up the anxiety level of a lot of women.  But it ultimately had a small impact on society as a whole.  The anti-vax movement has had a bigger negative impact on society as a whole.  But the anti-science movement is a much bigger problem.

I wish I knew what to do.  But people have proved over and over that they will find a way to believe what they want to believe.  And they are proving every day that they are impervious to anything short of applying a two by four vigorously to side of the head (or so the old story about mules recommends), when it comes to what will change their minds.