In 2016, I became the owner of a dangerous product that has since been recalled. Considering its significant cost — an average of $4,875, not including “anesthesia, operating room facilities or other related expenses,” according to the American Society of Plastic Surgeons — you might wonder why it took me eight years to return it to the manufacturer. Believe me, I wanted to do so — possessing this item made me nervous and paranoid, for reasons that will become apparent. I even consulted a few professionals who I thought could help me begin the process. Each sent me away, condemning me not only to keep this product indefinitely, but to clasp it quite literally close to my heart.
The product is a pair of Allergan Natrelle textured, “gummy bear” breast implants, which, according to the Food and Drug Administration, have been shown to cause lymphoma in a small number of women. Because of the risks, the product was voluntarily recalled and removed from “shelves” in 2019; however, many of these implants are not on shelves. The ones in question sat in my chest for eight years, looking quite perky despite their deadly potential. For those eight years, a return was only possible via surgeons who refused to help.
I’ve been running scared of cancer since my mother died slowly and painfully of it at age 53, during my last year of college. During her treatment, she ran on a treadmill for the first time in her life and drank kombucha made from a monstrous-faced mushroom that lived above the fridge. Among her eclectic life accomplishments — ranging from actress to general contractor — my mother was a former journalist and wrote about her experience with Stage 4 cancer in 1994, the year after she was diagnosed. Her article made the cover of a local paper. I stuffed my copy under my bed, afraid of where my family was heading.
Sixteen years after my mother’s death, I learned that I had the BRCA-1 mutation — probably inherited from her, though we will never know for sure. I stopped running and turned around to fight. I was determined to live with verve and abandon the way my mom did, but to die differently. The -ectomies and -erapies began soon after: a tumor caught unusually early because of my knowledge of hereditary risk; lumpectomy; chemotherapy; bilateral, double mastectomy; reconstruction; preventative oopherectomy.
Luckily for me, by 2016, when I opted for breast reconstruction after my mastectomy, plastic surgery had so improved that, for a $35 co-payment, I walked into the hospital with decently attractive, B-cup, 40-year-old breasts and was wheeled out the same day with the sprightly C-cups of a 25-year-old. I chose the flatter, so-called “gummy bear” implants because they were the most “natural-looking”; however, by June 2023, the FDA would associate the product with the deaths of 63 women and the illnesses of 1,264 worldwide.
Most women who develop lymphoma from textured implants have had them for three to 14 years; I was in possession of mine for eight. My partner and I are lucky to have an exemplary insurance policy through my employer that covered my treatments and reconstruction in full. However, unless I actually contracted breast implant-associated anaplastic large cell lymphoma, or BIA-ALCL, my first- and second-opinion plastic surgeons said they would not remove them. They had the support of the FDA, which says, “we are not recommending the routine removal of these or other types of breast implants in patients who have no symptoms.”
The FDA’s and many insurers’ decision not to support “routinely” removing potentially hundreds of thousands of no-longer-wanted implants is thinly veiled in a risk-versus-reward calculus for the patient. But with the Women’s Health and Cancer Rights Act of 1998, breast reconstruction was finally recognized for its potential to improve mental health outcomes in breast cancer survivors who want the surgery. Insurers are required to cover it. Now it’s time to recognize the converse: For many cancer survivors, potentially carcinogenic implant removal is, obviously, integral to our peace of mind. Having a ticking time bomb in one’s body is, ironically, to be imprisoned in the same situation from which many of us struggled brutally to be freed. Whether the risk of BIA-ALCL is extremely rare is, in our case, not just beside, but beneath, above, adjacent to, and opposite the point.
As part of this struggle against cancer risk, I made the decision in 2016 to remove my then perfectly healthy ovaries in response to the more-than-likely, looming threat of ovarian cancer from my genetic mutation. (Upon awaking from surgery, I was thrust into instant menopause, a 40-year-old Sleeping Beauty kissed by the crone instead of the prince.) The act of abandoning these organs and all they kept greased and efficient — my moods! my memory! my midsection! — was to take a leap of faith. I was betting that I could reduce my future ovarian cancer risk, to be around for my kids not just to enter college but to graduate—something my mother never got to see. Those were odds I was willing to accept.
Fortunately for me — and mostly owing to the dumb luck of a folded implant and a sympathetic radiologist — my insurer finally relented and covered the cost of my implant exchange in 2024 in response to a “suspicious-looking” ultrasound. If they hadn’t, my partner and I would have scraped together the substantial funds to pay for it ourselves. But hundreds of thousands of American women without my luck, economic privilege, or fancy health insurance are stuck with these defective products (and thousands of them have created communities on social media to air their fears and frustration). I stood with these women for eight years in a long line of angry customers, receipt in hand, my return clutched to my chest. Like many places these days, there’s still no one at the register.
Oceana Callum, M.A., M.F.A., is a writer and English professor at Coastline College in Southern California. She is the faculty adviser of StoryLine, a student “arts and letters” magazine.