Thursday, 12 January 2012

Are breast implants a genuine cry for psychological help?

A comparison between the feelings of a victim of abuse, whom I represent, and the angst of women who have had PIP breast implants, which may have gone wrong is, at first sight, inappropriate.

One firstly has to distinguish between breast implants which have been inserted in order to augment the size of existing breasts for cosmetic purposes, and women who, for example, have had mastectomies arising from breast cancer. I suspect that people have immediately assumed that breast implants have mostly been paid for by those who want bigger breasts rather than being given on the National Health to those who need them for medical reasons, and, presumably, have been provided free of charge on the NHS. There are also those who, for psychological reasons need breast implants because, for example, they are suffering from a mental disorder caused by their feelings about the size of their breasts. Mastectomy patients, however must deserve the most sympathy of all.

One has to ask the question of what responsibility the Plastic Surgeon who chose PIP breast implants at a cheap price should bear. Whilst the manufacturers were the villains of the piece in that they used industrial grade silicone the question is were or should the plastic surgeons have been aware that they were using substandard products? If so they would be liable in negligence. Proving knowledge of something many years ago would be difficult. Other plastic surgeons now say with the advantage of hindsight, of course, that they would not use PIP implants because they seemed poor quality.

The actual argument the lawyers involved are using is under the Sale of Goods Act. The plastic surgeon was a supplier of goods of unmerchantable quality which were unfit for purpose. As such therefore they are liable for damage caused in breach of the implied duties of sale. Simply a much more effective argument than negligence, and all that entails.

The lawyers are advising the government not to replace the implants on the NHS in the hope that they will be able to recover from the plastic surgeon, for the simple reason that under the Sale of Goods Act only the buyer has a right of action, and the government were not the buyers. I don't think David Cameron has had any implants to my knowledge - or has he?

So how do the victims of abuse compare with breast implant victims? Well all victims of abuse have low self esteem because abuse causes a lack of trust in other human beings. Some breast implant patients have the operation done because the size of their breasts has caused such low esteem, lack of confidence, and indeed mental illness that having larger breast will help restore that self esteem, and enable the patient to cope with life more easily. If psychiatrists authorise the operation  for psychiatric reasons alone, then low self esteem must lie at the root of the problem. Sadly, there is no quick cosmetic surgery fix for the victim of abuse. His/her damage is arguably incurable. Certainly, if there was a cosmetic surgery solution, you can bet that they would all go for it.

It is somewhat trite, however, to even attempt to draw similarities between the two types of victim, and I do so merely in a tenuous and somewhat insincere fashion. Indeed, even for the breast augmentation patient, larger breast will not cure a deep rooted inferiority complex, no doubt caused by other factors - even abuse in childhood. Some form of counselling is more likely to help.

Moreover a breast cancer patient would expect to be able to have breast implants put in on the NHS free of charge, and to have substandard implants replaced under National Health for the same reason. Indeed the public would gladly agree for such free treatment gladly. So let us not judge too quickly in ignorance.


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