Are My Fake Breasts Safe?

'At the end of last year,

'news of toxic breast implants hit the headlines.'

..women in Britain with silicone breast implants

made by a French company.

'Implants used across the world suddenly were found to be

'at risk of bursting, leaving women terrified about what this

'could mean for their bodies.

'My name is Gemma Garrett, and I'm one of nearly 50,000 women

'in Britain who was given those PIP implants.

'He felt along the lumps and then he said to me about PIPs.'

That was the first time I'd ever heard of them.

'After my own experience of double rupture

'and going under the knife again...'

I've never seen implants ruptured in this way.

'..I'm on a mission to find out how the PIP scandal

'was allowed to happen...'

These clinics have got a lot to answer to.

They should be footing this bill.

'..to meet the women it's affected the most...'

You have ticking bombs there.

I've tried to be so strong and laugh through it, but...

'..and investigate the implant industry as a whole.'

What size do you go to?

'I want to get to grips with what the risks really are...'

Oh, God.

The pain, you know, the scar is really sore.

'..understand why women gamble their health for a bigger bust...'

It's given me the confidence to live my dream.

The benefits for me outweigh the risks.

'..explore the alternatives out there...'

Your boobs get bigger after 30 days.

'..and ask on behalf of hundreds of thousands of women,

'are my fake breasts safe?'

'Boob jobs are by no means only reserved for celebrities

'and glamour models.

'You don't have to be under the spotlight to go for surgery.

'Last year in the UK alone, 25,000 women opted for breast implants.

'It's not just men who are fixated by women's breasts.

'As a fashion journalist and former Miss Great Britain, I know

'all too well the pressures heaped on young women

'to look a certain way.'

I was about size B, a large B, small C,

and one was bigger than the other.

I was just very self-conscious about it.

'That's why, at 26, I decided to get implants.'

I definitely didn't want a plastic look.

I ended up with breasts that just looked ridiculous,

because they were far too big for my small frame at the time.

And even worse, they were PIPs.

'It was three years later, in May 2011, that my nightmare began.

'Long before most people, including me, had any idea what PIPs were,

'I started to feel very ill,

'and one of my breasts began to dramatically change shape.

'I didn't know it yet, but my implants were faulty.'

This was the left one.

This is the one that I had the lump in,

and obviously, the lump was just silicone.

So it's completely ruptured.

'As soon as I felt ill,

'I tried contacting the clinic that had put the implants in.

'But when I didn't get a response, I lost faith in them,

'and found a new surgeon.'

He felt along the lumps as well, and then he said to me about PIPs.

And that's the first time I'd ever heard of them.

I like to keep them

because I like to show people how glamorous it is(!)

'PIP is the name of the French company that made the implants

'put in me and 400,000 other women around the world.

'Last December,

'news broke that a Frenchwoman with PIPs had died from cancer.

'The cancer was not found to be caused by the implants,

'but this story opened a can of worms

'that became an international scandal.

'It quickly emerged that PIP had been secretly using

'industrial-grade silicone.

'A French toxicologist even found their implants

'contained fuel additives and chemicals

'unknown in the medical world.

'And they had been skipping layers when making the shell,

'so they were more likely to rupture, just like mine did,

'leaking all of those chemicals into my body.'

Unfortunately, the rest of this implant is in my body.

That was the one that the doctor had all of the problems with,

because he had to tweeze all of the silicone out of my body.

So it makes me really emotional, actually,

even just looking at them and thinking that this was inside me.

Who knows? Like,

I don't know what lasting effects it's going to have.

A very good morning to you, our main story for you this morning,

silicone breast implants used by 50,000 women in the UK

are at the centre of a health scare. The French government...

'The boss of PIP, John-Claude Mas, was arrested, and is awaiting trial.

'But that was no consolation for the 50,000 British women like me,

'suddenly finding out that we had had the sort of industrial

'materials normally used to stuff mattresses put into our bodies

'by a company that had managed to trick

'every regulating authority along the way.'

Oh, yes, PIP. 405 cc.

'My implants had already ruptured and been removed.

'But other women were left wondering

'whether they'd been fitted with PIPs too,

'and if that meant they'd need to come out.'

I remember having my friend text me

and she said, "Oh, I've got these PIPs," and I said, "Oh, so have I."

But I said, "You know, I think we'll be OK,

"because we've gone with big companies."

Just close your eyes. Relax. We'll put the radio on for you.

'Sammy, a single mum of two, had PIP implants in 2005.

'A recent scan has revealed that she had a partial rupture which had

'been leaking silicone into her body and collecting in her lymph nodes.'

Sit down, then.

'Sammy had already gone back to her clinic three years earlier,

'after experiencing pain and lumps in her breast.

'But she was dismissed and told that was normal.

'And even when it was common knowledge PIPs were faulty,

'she didn't get much more help.'

I then rang and said, "Look, what's going on?

"I have these PIPs."

And it took probably a month to get an appointment.

And when I went back, I'd seen the surgeon,

and he said, "You do need an uplift."

And I said, "I don't want an uplift, you know,

"I just want to know what's going on with these."

'As Sammy's implants were just out of her six-year warranty,

'the clinic said they wouldn't help.

'Despite the fact that, within that period, she had already come

'back to them with all of the symptoms of a rupture.

'Many clinics out there have refused to help.

'So if women want their implants replaced, they will have to pay.'

They've done this, they chose to go cheaper

and have these implants, and they put them in us.

They need to rectify that. You know, it's insane

how they're asking us for, basically, three grand.

And that's a goodwill gesture. That's not a goodwill gesture to me.

£3,000 is a hell of a lot of money to me and to anyone.

'A huge unexpected expense.

'In Wales, the NHS are willing to remove

'and replace PIP implants where medically necessary.

'But generally, in the UK, the NHS have offered to remove

'but not replace - simply called an explant operation.'

I did actually see this brave woman,

because I've been going Twitter mad on PIP implants and everything,

and I've seen this picture and it came up, and I literally cried,

and she had an explant, and that, for me,

just confirmed that I just couldn't go through that.

Mentally, I think I couldn't cope with that.

So basically, you've just been given an option that's not an option?

You know, to actually have this now leaking into my body, that is

what is just really, really scary.

I just feel like I'm living a nightmare. I really do.

'Sammy's next step is to seek advice from a new surgeon,

'to work out how urgently her implants need to come out.'

Hello, nice to meet you, I'm Nigel.

-Hello.

-Come and have a seat.

-Now, your armpits.

-Yeah.

The scan shows pretty clearly that, on the right side,

you've got some signal in the nodes in the armpit.

-They're probably about the size of a pea.

-Yeah.

A lymph node's natural function is to act as a sieve.

They pick up all the rubbish and they keep it,

and the body then tries to remove it.

When did you hear about PIPs, and have you used them?

I personally haven't used any PIPs.

I've always had that feeling, if something is that cheap,

if it's too good to be true, it is too good to be true.

The other manufacturers didn't start to drop their prices.

So, if the bona-fide manufacturers can't match that price,

then, in my head, that doesn't quite add up.

'In fear of what this criminally-manufactured silicone

'will do to their bodies, women around the country

'and the world are asking the same question.'

How much time would you say that I have to play with now,

-with having these PIPs in?

-We genuinely don't know.

From your situation, we know you've got some silicone in the auxiliary notes, so therefore, there is some

sort of interchange of what's inside it to your body going on.

It's difficult to put timeframes on things, but I wouldn't

want these to be in

for much more than another six to eight weeks or so.

You have ticking bombs there.

I've tried to be so strong and laugh through it, but...

No, no, I think...

What I'm going to do next, it's just still a gamble. It's a minefield.

It's a money issue. It's a health issue.

I kind of feel like I've been given a little bit of time.

But then even if I do have to go the NHS route,

which they are literally just removing and not replacing, you know,

I just feel like I'm just going to be forced into a decision which

I just cannot even bear to think about.

'The clinics were bulk buying these PIPs

'at a fraction of the cost of other implants

'without asking questions about how they could possibly be so cheap,

'and without passing on the saving to patients at all.

'Many of us paid top prices for these bargain implants,

'being promised that they were the best available.

'With so many women in the same position as Sammy and I,

'who's going to take the blame for this being allowed to happen?

'There were warnings about PIP implants in medical journals

'as far back as 2007.

'Surely the clinics have to take some responsibility.

'On Harley Street, Professor Kirwan,

'a leading aesthetic plastic surgeon,

'leaps to the defence of the clinics.'

Who do you feel is responsible for the whole PIP scandal?

I think it's easier in some ways to say who's not responsible.

I like to say that physicians are not responsible,

because this is an approved product, and as far as I know,

they haven't acted illegally or unethically in any way.

Do you not think, though, that alarm bells should have been ringing

when surgeons saw just how cheap these implants were,

compared to the other ones on the market?

Well, clearly not. I mean, the NHS was using them,

and we do use our best abilities to analyse every product that we use

and to understand it as fully as possible.

But that responsibility doesn't extend to a minute examination

of the manufacturing process, whether it be

an aspirin or implants or a hip replacement or anything else.

And that's why we depend on regulatory bodies.

-So we just have to put our faith in the Government?

-Yes. We do.

CHANTING

'Women have rallied together online and in the streets, protesting,

'demanding someone helps them, be it the clinics or the Government.

'I want to find out where these women stand legally.

'I'm meeting with Kevin Tims, who, alongside four other solicitors,

'is mounting a group litigation on behalf of PIP victims.'

-Thank you. How much is that?

-This is an exceptionally large case.

The scale that this has become is monumental, really.

Who are you actually going after?

Normally, what we would do is we would pursue the manufacturer

of a defective product, and unfortunately, PIP is insolvent,

and it doesn't have suitable insurance

to cover claims outside of France.

'These implants were passed by a European regulator

'and given a CE mark,

'a recognised stamp of approval in the UK.

'But it was after that that PIP secretly changed the ingredients.'

Are the clinics really to blame?

Obviously, you know, they took on these implants in good faith.

They've been passed by our Government.

Even though the clinics didn't realise that there was

an inherent defect in the implants, they still sold a faulty product,

and those consumers are entitled to make a claim.

The legal process will take months.

In the meantime, these women need to make decisions about their health.

This is a lady whose implants have ruptured,

and as soon as the surgeon cut into her,

all this stuff came oozing out of it.

I don't know what it is - silicone, pus? It's nasty.

I've come to meet Vicky,

whose implants are being removed tomorrow,

and I'll be going along to watch.

Her clinic said they couldn't help her,

but she couldn't stand to have the PIPs any longer,

so is playing for removal and replacement herself.

I was lucky.

When my implants came out, there was enough breast tissue left

for my breast to be reshaped without needing new implants.

But not everyone is in the same situation,

and many feel they have no choice but to have replacements put in.

Removal only for me wasn't an option.

I had these done because I had nothing.

I don't mean small boobs - I mean no boots.

I couldn't imagine what I'd be left with.

Just so much more than vanity?

Oh, God, yeah. I mean, you only have to look at me.

That is not vain, that is a B cup.

-What size were you beforehand?

-AA.

I had nothing. Well, I didn't even fit in a AA bra. It was nothing.

We went in and, yes, we chose to have surgery, but if the implants rupture,

the stuff that comes out of them is medical-grade silicone,

and we all signed up knowing that those were the risks.

We did not go in blindfolded, we're not stupid.

Where to lay the blame is a complicated one.

I think these clinics have got a lot to answer to,

and I think they should be footing this bill.

I think it's disgusting they expect the NHS to do it.

But the Government need to realise they're not without blame.

Everyone should be fixed.

They shouldn't be left like this, it's absolutely disgusting.

It's immoral, desperately immoral.

Women are worried. It's not worth the chance.

Whether mine are perfect or whether they're done in,

they need to come out.

"You are literally my rock, Vicks, and I love you."

Oh, I'm feeling a bit emotional!

-You're going to get it all sorted tomorrow.

-Yeah, yeah.

It will be all sorted.

For Vicky, tomorrow's op cannot come soon enough.

The fear of going into surgery again

is outweighed by the thought of being free of the PIPs at last.

It gives me some idea where the capsule might be.

Her implants rupturing

and releasing an unidentified material into her body

has been a terrifying prospect.

The scars have healed reasonably well...

I'm so nervous for her.

I'm about to see Vicky go through what I did,

and I'm hoping to God

that her implants don't come out in bits like mine.

There's like a smell of burning flesh.

They are going to take the implant out now.

So, we'll take this implant out first.

You can see now that she's very, very tiny. Almost like a boy.

I mean, she has to have implants go back in. She has to.

As Vicky is taken through to the recovery room,

reeling from seeing my first surgery,

I'm desperate to find out how it went.

It probably was just about to rupture.

There was no free gel in there.

I think it's a very, very tiny hole, but if we squeeze them,

-you can actually see the tiny tear there.

-Yeah.

-So, just in the nick of time?

-I think so, yes. I think so.

Have you seen many PIPs that have been ruptured badly?

Yes, I've seen a surprising number of the ones we've taken out.

My impression is that the rate is quite high,

but for PIP implants, I believe they should be taken out,

because they contain industrial-grade silicone,

and we just don't know

what the long-term effect of industrial silicone is.

'That's what I find most frightening.

'While the Government is telling women like me

'there's nothing to panic about, they're still doing tests.

'In the meantime, the experts that I've met are saying

'they have no idea what this silicone could do to our bodies.

'So we just have to wait and pray we are OK.

'It's made me think how shocking it is

'that the surgeon who put my PIPs in

'has not made any effort to contact me.

'I called him when I'd had mine taken out to get my notes,

'but he never got back to me.'

Would I be able to speak to him?

'I want to find out how he's dealing with the situation,

'now they're more aware of the scandal.

'How is the clinic reacting to patients

'who they think still have the PIPs in their bodies?'

Yes, I was just wanting to know

if I could make an appointment to see him?

Is he giving out any advice to people of what to do or anything?

So he's not going to replace them for free?

OK, thanks for your help. Bye.

Was that him?

No. That was the secretary. Sorry...

I don't even know why I'm upset. I'm not upset for me,

I'm just upset that she obviously thinks I still have PIPs in, and

that's obviously happening to other women out there, it's just crazy.

I can't believe if I still had my PIPs,

they would be fobbing me off like this,

offering me an appointment in three months' time.

Just not that helpful, you know, no urgency about it, and no apology.

I think that's why I got so upset there,

I just can't believe that he hasn't phoned me.

You know, that's how much

the surgeon wants to be involved with you after surgery.

So, nice(!)

I am shocked at the response women are getting from their clinics.

I want to go back and visit the surgeon who did take my PIPs out -

Mr Matti on Harley Street.

Now I realise just how many women had faulty implants like mine,

I want to find out exactly what happened during my op.

-The first time I even heard of PIPs was from yourself.

-Yes.

Was that the first case that you'd ever taken out?

Yes, indeed. This was the first time,

and I was amazed how this implant was not as good.

I've done over the last 30 years a lot of this work.

I've never seen such implant ruptured in this way.

I will show you some of the pictures of the implant.

You can see it's totally ruptured, all bits and pieces coming out.

I have to spend a lot of time to clean it, clear out the breast,

make sure every bits and pieces of this silicone has to be removed.

And when you opened me up, did you know as soon as you seen,

did you know straightaway they were PIPs?

-Yes, straightaway I knew.

-When was the first time you heard about them?

-I heard about these in a meeting in Cannes 15 years ago.

-What?!

A surgeon presented this material where he shows three cases

where the badge at the back of the implant was not stuck properly.

I felt, "Oh, this company I'm not going to use.

"It is not as good as they sound. Full stop."

Looking at images of my ruptures

leaves me terrified to think what has been left in my body.

When the PIP scandal broke,

the Government was quick to reassure the public...

The Government has said there is no evidence to recommend

the urgent removal of substandard breast implants.

..despite estimates on how likely the implants are to rupture

rocketing from an initial one in 20 chance to one in three.

I want to get the Government's take on all this.

I've arranged to meet with public health minister Anne Milton

to find out if they could have done more.

-Thank you so much for meeting me today.

-It's a pleasure, Gemma.

I have my implant here.

I don't want to disgust you, but the remainder of this is inside me.

How worried do you think we should be

about the lasting effects of this?

I think, you know, the cold reality of life is that anything,

any medicine you take, any implants you have,

is only as good as the evidence that is out there.

At the time they were put in, they were put in in good faith.

There was no evidence out there to suggest otherwise.

The moment there is evidence, then we do communicate that.

The Government and the clinics knew well before the public.

Do you think that we should have been told sooner?

Well, there's been a review on whether the regulator did enough.

It probably did enough in terms of what it should have done.

The question is, do we need to go further? And we clearly do.

Communication hasn't been good -

telling the surgeons, telling the NHS people isn't necessarily enough.

We need to make sure that we can communicate better

directly with people.

What really frustrated me

was that I didn't get a phone call from my surgeon or my clinic.

I had to find out that there was something wrong with my implants

through becoming ill and seeking advice somewhere else.

I think that's a story I've heard from a lot of people.

They were sitting down, watching the news,

they saw this on the news, they had no idea what implant they had.

-This period of uncertainty has been awful for women.

-Terrifying.

I know it has been terrifying, and as I say,

it's not just the women who have PIP implants.

There's a lot more women out there

who've maybe had surgery or had interventions

that will be worried about it.

The PIP scare has had a huge impact on industry as a whole.

Surveys suggest around two thirds of women considering breast implants

have changed their minds.

But even with the PIP factory closed down,

should we be worried about other implants? Are they safe?

And what makes girls opt for implants for cosmetic reasons?

If it's not asymmetry or a completely flat chest,

what is it that drives a young girl onto the operating table

to boost the assets she has?

A friend of mine from back home who runs a salon has just turned 21,

and even though she knows all about my nightmare with implants,

she's still decided surgery is for her.

What is your problem with your boobs?

Do you feel like they're not big enough,

like they're sagging? Or what's the problem?

Just too small. Whenever I'm in a bikini, I feel self-conscious.

-And what size are you?

-I'm between a B and a C.

-But Carly, you're a size 8, would that be right?

-8 to 10.

8 to 10, so a size B to C is perfect.

Do you feel pressurised to look a certain way?

A wee bit, yeah, yeah. I think I do.

People have a certain portrayal of you,

and you always have to be glamorous and your hair always has to be done

cos you're in a salon all the time.

Even now, I have people constantly asking me, "Have you had Botox?

"Have you had this? Have you had that?"

You know, because the salon provides all those services.

I do feel pressurised to have all those things.

But your salon isn't doing boob jobs.

-Do you have a padded bra on now?

-Yeah.

And I always wear a bra size smaller as well.

-To give it more oomph?

-Yeah.

So, like, my nipple's almost hanging out of my bra!

Lovely(!) Be really, really honest with me,

because we're friends - who are you doing this for?

Is it for your boyfriend? Is it for your image?

Or is it just for your own self-esteem?

Probably a bit of all three. To be honest, he doesn't like them anyway.

He's like, you know, he's been with girls or whatever who have them

and he's like, "I prefer natural boobs."

Hi. You all right?

It really upsets me that young girls are feeling

so much pressure that they think surgery is the only option.

Even the best implants don't last forever,

so it's never going to be just one op.

What size did you go to?

It seems crazy to me. Carly already has a good-sized bust.

I just can't help but weigh in with my opinion.

You know how much I care. I want you to learn from my mistake.

I don't want to be a hypocrite either, or sound patronising.

I'm just saying as one of your close friends.

It did, like, it did put me off.

I have silicone in my body, I don't know the lasting effects.

I just want you to know how serious it actually was.

You're such a beautiful girl,

and I just think it would be definitely the wrong decision.

There's nothing wrong with your boobs.

That's putting yourself through a major operation every decade, say,

for the rest of your life.

Are you going to be able to find five grand every decade?

I'm probably not thinking ahead, Gemma, to be honest.

I haven't really thought about that.

Despite my reservations,

I will help Carly through the process of making up her mind,

as the worst thing she can do is

not get all the right information and support.

-Hello.

-Hi, how are you? I'm Carly.

Carly. Stephen Sinclair.

-Gemma. Nice to meet you.

-Have a seat.

Choosing surgery is a huge decision,

and I'm worried young girls like Carly

are making it blinded by the short-term benefits,

and without realising everything they're signing up to...

Nice, normal, symmetrical chest,

and your breasts are a good shape and a good size.

..especially when they have perfect breasts

and are just doing it to add

that extra bit of oomph to their cleavage.

In your honest opinion, do you think Carly needs breast implants?

Physically, you don't.

Physically, you have a good size and shape of breast.

It won't change your life or make you a different person,

but it can make you feel better about yourself and a bit more confident.

Breast surgeon Mr Sinclair runs through

all the shapes, sizes, options and risks

to give Carly a clear idea of what to expect if she does go for it.

Any clinic that would offer incentives for surgery,

you should really stay away from.

Anybody who says, "If you have your surgery carried out next week,

-"then you'll get 500 or £1,000 off," almost...

-Alarm bells.

-Alarm bells should ring.

-That makes me really angry.

This is such a good consultation. Like, I didn't get this at all.

Did you not?

I think mine probably lasted about seven minutes.

Thank you so much.

'All I can hope is Carly took on board what the surgeon said

'about her breasts being absolutely fine

'and that she can withstand the pressure to go under the knife.

-Bye.

-Bye-bye.

So, why do we aspire to bigger boobs? Where does this come from?

Is it fashionable to be busty?

I think different shapes go in and out of fashion.

Lorraine Candy is the editor of Elle magazine.

So, with her finger on the pulse of fashion,

she knows exactly how young women want to look.

If you look at history and the history of fashion,

our shapes have changed very dramatically.

The '50s was very hourglass, the '90s was very grunge.

Over the years, women's attitudes do change towards body image,

and that's just about a zeitgeist.

We now have the ability to physically change our shape.

It is like changing your hair.

Styles go in and out, and unfortunately,

we now have a whole raft of people

who can do that physically with surgery.

Do you think women are a little bit confused

about what they're aspiring to be?

They want to be thin but they also want to have good boobs?

Yes, I think there are, in the media,

some very unrealistic body shapes for women to aspire to.

Lorraine is the first to admit that she,

as the editor of one of the UK's biggest magazines,

needs to be aware of how much of an effect she has

on how women feel about their bodies.

We all have to be responsible about how

we influence their point of view, but I think it has to come from home

and from school and other influences as well.

Does Elle magazine touch on surgery or address it in any way?

Yes, we do address the issue,

because it is something women are incredibly interested in.

We have a column called Beauty Extremist,

and we do it from a very scientific point of view.

Is it going to give you what it promises?

I would say, probably not everything does.

So why do you feel that image is so important now to women?

I think it's very important to young women now, because of social media.

Young women today live on Twitter, Facebook, Tumblr, Instagram.

Their image is associated with everything they do,

and I think they need it to look good and they want to look good,

and they want to present

the most positive, powerful, beautiful image they can,

so it's the very forefront of their minds at the moment.

So, is undergoing surgery

to increase the size of your bust purely vanity?

Since mine ruptured,

I've felt very negative towards implants in general.

But maybe everything that's happened with PIPs has made me forget

that being confident about their breasts

really can make women feel better about themselves.

I've come to meet Gemma Trotter,

who in her early teens lost her leg a car accident.

She was fitted with a new, high-tech prosthetic leg,

but felt there was still one thing holding her back -

her flat chest.

Not having a leg is one massive big deal.

I've always felt very sort of inferior.

I didn't feel very feminine, having lost my leg at that kind of age.

That's when you're moulding into a young woman, and of course,

I didn't have what all the other young women had.

I was completely flat, felt like a boy.

So it was in no way for vanity reasons, it was for 100% confidence?

I don't want people to ogle at me.

I would hate to think that people were thinking that

I did it to impress men, because I definitely didn't.

I really did it for myself.

Ready, go!

After 30 operations on her leg,

Gemma chose to go under the knife again to go from a 32 AA to a D cup.

Out of everything that you've been through, losing your leg,

the thing that you really think was keeping you back

from being a fitness instructor was being flat-chested?

When you've had a knock,

you kind of have to piece yourself back together,

and that was just one part of it.

I always had that missing, and I thought, "How can I appear confident

"if I'm not really confident, because I'm so flat-chested?"

Tell me just how much it's changed your life.

It's definitely given me the confidence to become a fitness instructor.

I think I couldn't have done that knowing, you know,

I'm on show and I have to instruct people.

It's given me the confidence to actually live my dream.

When I started this journey, I was so against implants,

but I have no idea what it's like to be completely flat-chested.

The benefits, for me, outweigh the risks.

For me to be able to fulfil my dreams, I just think,

if it's actually helped me do that,

it's just part of the process, really.

My views on implants do waver when I meet people like Gemma Trotter.

I had my implants as one breast was bigger than the other,

but is that really different to why she did it?

For her, they were the last piece in the puzzle.

She genuinely felt she could never be truly confident without them.

But why is it that our confidence is so linked to our bodies?

I want to understand the thought process behind surgery.

What does psychologist Emma Kenny make of it?

So, Emma, thank you so much for meeting me here today.

I am so fascinated about the psychology behind

why people get boob jobs done in the first place.

I guess the root of that comes because a lot of women out there

really do feel that there's a massive pressure to look perfect.

Who do you think's to blame for that pressure?

I think the psychology comes from both a marketing level,

from a societal pressure level of conformity - so, wanting to fit in.

But I've met women who feel

their lives have been greatly improved by implants.

It makes sense that somebody who becomes suddenly

societally conformist and acceptable feels better about themselves,

because the way the world acts and responds to them is nicer.

But that doesn't challenge the problem.

How awful is that we live in a society that we say that,

if you have a breast that's not the right size compared to the other one,

you should value yourself so poorly?

Many times, what we've found in the research regarding cosmetic surgery,

plastic surgery in general, is that the benefits are very short-lived,

because the problem has nothing to do with their physical shape.

It must be much deeper.

It would be, for me, professionally,

an external reason for an internal problem.

I think there is a small number of people

who are just going to do it for themselves.

OK, they're putting themselves at risk going under surgery,

but there's nothing else going on deeper, it's just, "You know what?

"Life's short, I want to have a good one,

"this is going to make me feel better, more confident

"and I'm going to enjoy the rest of my life."

There have been studies for those experiencing breast augmentation

that they have much higher suicide rates

than their counterparts who don't.

Spend the £5,000 that you were going to on breast augmentation

on a great therapist.

It'll cost you a fifth of that amount,

even if you have long-term therapy, and you'll feel better forever.

You'll never need them replaced,

and it will work for the rest of your life.

# Keep young and beautiful... #

'We may live in the age of the lunchtime boob job,

'but I want to find out how implants even became an option.

'Where did this craze start?

'In 1962, Timmie Jean Lindsey

was the first woman in the world to have silicone breast implants.'

Is it a wee bit frightening to look back and just realise

that you were actually a guinea pig for this surgery?

Really?

Yeah!

It was an unusual agreement.

She was approached to be part of a study and struck up a deal -

if they pinned her ears back,

she would have this new device fitted in her chest.

But Timmie has suffered pain from her implants, amongst other side effects.

You never know!

If something did go wrong, how does it make you feel

that you might have to have an operation to fix it at 80 years old?

Well, it's scary.

Timmie has struggled with these vintage implants.

But what about breast augmentations happening now?

If you're not fitted with faulty ones like I was,

does that mean the whole procedure is straightforward?

Katie is only 20 years old.

The implants she had weren't PIPs,

but they've still caused her a huge amount of agony,

proving implants aren't always

the quick, risk-free procedure they're marketed as.

Awful. Like, when I woke up, I was in so much pain.

I thought that it was going to be what I was waiting for,

and then it wasn't, not even close.

This was my initial ones, which I don't really want to look at.

So, it's clear that there was a problem with one of your breasts.

It is obvious. There was definitely something wrong.

When Katie hit puberty,

she soon realised she wasn't developing like other girls.

Her left breast was not growing at all.

She had her first operation at 17, but it did not go to plan.

It was just pointless, and it was painful and complicated,

and I was always on medication, antibiotics.

I was on painkillers for about two years.

After a second op, she continued to have complications.

I had an infection in the scar. It was just not nice.

That's where I got the infection.

Every time I touched it, pus just poured out, it was horrible.

Katie now faces a third operation on the scar on her right breast,

which is too tight and causing her debilitating pain.

I take five, four times a day.

I still have to take regular painkillers.

-Six months later?

-Yeah.

I still have to wear a sports bra, because any other bra really hurts.

It's the pain, it's like inside, burning.

It's not nice, and nothing takes it away.

And how do you feel about breast augmentation or breast surgery

in general now, for people who want to have bigger boobs?

I would never do it for vanity.

It's just not worth it.

It's not worth what you might have to go through

if there's nothing wrong in the first place.

Everybody thinks it's just something you can go and have done,

in and out, and it isn't like that at all.

It is a whole healing process, and if there is complications in it,

they're not easy - not from my experience, personally.

It's just been a long road, and not a very nice one.

As if Katie's experience of infections and scarring wasn't bad enough,

there's a whole catalogue of terrifying things

that can go wrong with implants, whoever's made them.

Victoria Rose is a consultant plastic surgeon

at the University Hospital, South Manchester.

She feels women aren't always fully informed

and wants to run me through the main risks.

The most important thing I tell people about breast implant surgery

is something called capsular contracture.

And that's really scarring around the breast implant.

When it's got nothing constricting it,

if we touch it, it can freely move.

If I then sort of enclose that in a bag of scar tissue,

if you now touch that, it's a lot further and harder.

It can actually be so tight that it squeezes the implant.

So, your implant can take on a completely different shape now

and distort the breast.

When young women have implants, they're not always thinking ahead.

What happens when everything naturally starts to head south?

The skin around the implant starts to sag,

forming what we would call a double bubble kind of effect.

There's definitely been a deflation of the skin

and it's now almost hanging off the bottom of the implant

in that picture.

These are the main issues but by no means the only ones.

There is post surgery bleeding,

affected nipple sensation,

the implant trying to make its own way out,

and the chance of the pockets being too close,

creating the uniboob effect.

What would be your advice to someone

who has taken into consideration all the risks, all the complications,

and still wants to go ahead with the augmentation?

Where do they find the surgeon for them?

Two organisations will help you look for an accredited surgeon,

who has achieved a UK standard of training.

The BAPRAS Association or the British Association of Aesthetic Surgeons as well - BAAPS.

That's probably the best starting point.

So, a lot of girls are driven by price, obviously,

when it comes to augmentation. What's your views on that?

My main concern with people that can offer it

at the lower end of the scale is that that's the sort of,

you know, outfit where it will be very difficult for you to go back

and see the surgeon that did it a year or two down the line.

So, price is really the worst way to pick a surgeon.

I am shocked that there are so many things that can go wrong.

If I had known about half of this before I had my surgery,

I'm not sure I would have gone ahead with it.

But some women seem undeterred.

So, there was a recent survey done on young girls

and about 50% of them would trade intelligence for bigger breasts.

Does that just drive you crazy?

Yeah. I mean, that stands for everything that concerns me

about women today because the whole reason

we are free women is because we recognise our worth.

This says that people would trade the thing

that gave us that worth - our minds - for boobs.

Do you want to get going?

Emma is taking me to meet with a group of 15 to 16-year-old girls

who are already feeling the pressures to have the perfect bust.

I've been stunned to hear that over 40% of girls

in their early teens are already considering

a cosmetic procedure of some kind.

With 62% wanting bigger breasts.

-Hey, girls!

-Hiya!

I want to find out how these girls feel about their chests.

-Where do you think the pressure's come from?

-I think it's mainly the media.

Everyone like in films and adverts even these days.

They all look perfect.

-Perfect!

-Any pressure from boys?

What do you think lads want?

Big boobs.

Just how important are boobs to you at the minute?

-Is it a big factor?

-Yeah.

-Yeah?

You feel pressure from everyone at school...

It's like when you're in the changing rooms, they're all looking.

You feel like everyone's looking. Don't look at me!

-Do you feel as if people compare in the changing rooms?

-Yes.

And what are they wanting to achieve?

Do they want bigger boobs or smaller boobs?

Do you feel as if you would want to have a boob job when you're older?

Well, kind of. All my friends have got like really big boobs

and I feel like there's nothing there compared to them.

You and me both then. That's been my life.

-So, how old are you now?

-15.

So you've got a good couple of years still to grow or whatever.

Would you not look at people like maybe Keira Knightley,

and other people who are flat-chested,

and not be inspired by that?

Kind of. But, like, I don't know.

Do you know the risks of boob jobs, having an operation?

You have to have it done every ten years.

I didn't know that.

-They might rupture.

-I know that one.

How did that make you feel about boob jobs

when you've seen that in the press?

I was really worried. It kind of really put me off.

I've never really considered it.

There's like bras in the shops, you can make yourself

look like boobs and you don't.

You could still look big and you've not been under the knife.

I didn't have anything until like Year 8 and then they just came in.

They arrived!

I have thought about getting a boob reduction

but, I think, it's just because my boobs are so big for my age,

I think that's what it is.

When I grow up, I don't think it'll matter that much.

Sometimes it proper like gets to me

because, they're all like, "We all have big boobs,

"and then there's Charlotte with nothing."

I'm kind of like, "Well, it's not my fault."

I also feel like it is my fault for not developing fast enough.

I understand why these girls already feel so much pressure.

When I was their age, I was so conscious about how I looked.

Only in the last few years I've learned to relax.

Even if they decide not to opt for surgery,

there are still many options out there to tempt them.

There are all sorts of lotions and potions on the high street and online.

Costing anything from just a few pounds to hundreds.

And all making some very grand claims about how, supposedly,

you can have bigger breasts.

This says, "firms and tones skin around the bust area.

"Lifting treatment for the bust."

Here we have a "super lift."

"Extra lift" gel.

"Shapes and tightens."

This is an enhancement programme for fuller, firmer and larger breasts.

It just says that your boobs get bigger after 30 days.

Worry over implant safety might make these look like a better option

but do any of them actually work?

There are a lot of alternatives out there,

probably nothing quite as road tested as breast augmentation though.

The biggest thing at the moment is injecting fat into a breast.

Fat transfer uses liposuction to remove fat

from the abdomen or thigh, which is then injected into the breast.

Since the PIP scandal, there has been an increasing number

of women opting for this type of treatment - over breast implants.

But fat transfer can only give an increase of about a size

and the fat can be reabsorbed into the body.

Until recently, boob jobs were also used,

where filler is injected directly into the breast.

But the main product, Macrolane, was banned in April of this year,

as it can affect breast scans.

As it scars, it can form quite hard lumps in the breast.

That can lead to problems interpreting mammograms in future.

Perhaps the most bizarre way to boost your bust is suction cups.

Worn for 16 hours a day for ten weeks straight.

Even if you can stick that, the results are often short lived.

But that still might be longer than some of the products

you'll find on the high street.

What about the more basic methods, like pills and creams?

My feeling would be that, if they did work,

they'd probably be something we'd use quite readily in the NHS,

as it would be more cost-effective than surgery.

With any type of treatment, whether it's fat injection,

augmentation with implants, or, you know, these pills and creams,

everything is invasive and it's going to have its own pros and cons.

Whether that's that it doesn't work at all or that you have,

you know, a list of complications that could occur from it.

So, basically, the only safe way of having bigger boobs

is to wear a better bra.

Probably the only 100% safe way, yeah.

But I can go one better than stuffing your bra.

Jo started Silicone Sally when she realised

the chicken fillets on the market were not up to scratch.

So set out to design an ergonomic range,

which are perfectly shaped to fit in bras to give lift or fullness.

I have brought my friend, Carly, to meet Jo,

to see if I can convince her that surgery isn't her only option.

I have a full range of ten styles

of breast enhancements of various sizes and shapes.

Even the most simple one, like this one,

would be kind of like the ones that I would have.

But it's made much better.

I've just seen this wee one. That's perfect for a bikini.

You can wear all of them in a bikini.

The more supportive bikini the better...

Obviously like the smaller ones.

-What kind of people actually buy this product?

-Everybody, everybody.

Yeah. From teenagers up to

my oldest customer has been 90.

Obviously, a lot cheaper than surgery,

-and a lot safer than surgery.

-Yes.

-A lot more flexible.

-Yeah. You can take them out at night.

You can take them out at night, and if you want to go running.

OK, will we try some on?

-What are you, a C cup?

-Between a B and C.

-What would you like to be?

-Probably double D.

They are nice, like. Really nice.

Yeah. Yeah. I really like that size.

-I love them.

-What is this bra - a 30...?

-It's an A.

Let it just see one without.

Wear them on a night out, it gives the effect that you ultimately want.

Then, at night, you can take these out.

-Put them back in their little box.

-You can't really feel it at all.

-It feels comfortable.

-Does it feel secure?

-Yeah.

-It's all about the bra?

I think you should buy these and have these for maybe a year.

Yeah. I love them. I definitely love them. That would be perfect.

Coming in at around 20 quid a pair, they're a damn sight cheaper

than a six grand op.

Not only just six grand,

-it's maybe four or five operations in a lifetime.

-Yeah.

Carly seems happy enough to put the silicone in her bra,

rather than her breast.

At least for now.

I'm delighted she won't be rushing off for surgery any time soon.

But I'm not so naive to think I can persuade everyone

with their heart set on bigger breasts to stuff their bra.

So, where does that leave women still determined to go for surgery?

We know that when the PIP implants were made,

safety went out the window.

So, how confident can we be

about what other companies are putting in their implants?

I want to restore my faith

and find out how implants that do meet regulations are made.

I've come to Nagor in Scotland -

the only British-based implant manufacturer -

to witness the process first-hand.

Everything is conducted in a clean room environment.

So, suited up, we're ready to go.

I am fascinated by the care and attention

that goes into making each implant, to such an exacting standard.

I'm reassured to hear they only use top-quality medical grade silicone.

-We can inspect the shells against the criteria.

-Every single one?

Every single shell goes through this criteria.

Anything that doesn't pass any of the criteria would be scrapped.

It seems to be tests, tests and more tests.

While the PIP factory may have broken all the rules,

seeing how carefully they check out everything here does make me

realise that other companies are doing everything they can

to make implants as safe as possible.

Nice to meet you. You too. Thank you for having me here.

I want to ask Douglas Black, the director of Nagor,

what has changed since the PIP scandal?

The regulatory bodies are starting to come to a factory unannounced,

to do checks.

That's one of the key things that's started.

I'm sure there will be more to come.

What do you think is going to change?

There will be a lot of good that comes out of this bad.

It's not only products that will be regulated, it will be surgeons,

also hospitals.

This whole tightening is going to be for the benefit of the patient.

The scandal will lead to improvements in safety

throughout the whole industry.

If spot-checks had of been done at the PIP factory,

problems with implants like mine just wouldn't have happened.

The boss of PIP is under investigation

on a criminal charge of causing bodily harm

and his case will come to trial in October of this year.

We know the Government is cracking down on monitoring implants

but what else is going to change in the light of the PIP scandal?

How can we be assured that this won't happen again?

There's got to be improvements.

I don't think anybody wants to be in this situation again.

This is sort of catch up time. This was a sort of criminal offence.

We need to make sure actually that we get the right regulations in place.

It'll get better as a result of it,

which is no consolation to women who had to go through this.

So, what exactly is being done?

So, the NHS medical director is undertaking

a review of the cosmetic industry.

We need to make sure that women are protected -

that they are reassured - that the industry that's providing them

with those opportunities is regulated

to such an extent that keeps them safe.

Well, that's very reassuring.

The PIP scandal is a terrifying case.

Ultimately, it's a criminal issue.

It doesn't affect the way the rest of the implant industry conducts itself.

Even so, I still don't think implants are worth the risk, I suppose.

There are so many other things that can still go wrong

when you go under the knife.

I recognise implants have their place in reconstructive surgery

and have met women who feel they've helped them reclaim a natural femininity

without any desire to resemble a glamour model.

But I still think this pressure on women to be something they're not,

alongside their heightened awareness of their physical flaws,

is a dangerous cocktail,

and only encouraged by easily available surgery.

I think we are the cause of our real problems.

We say we're not good enough.

I don't think that men would ever judge each other

as harshly as we judge ourselves.

My family tried to talk me out of having implants. I wish I listened.

I was 26 at the time

but I still didn't realise what a big decision it was.

Or know enough about the dangers.

It's not something to go into lightly.

In a cosmetic situation, I think you need to be fully informed.

All I can hope is the Government take

a serious look at the industry they promised to and for any women

who are still considering breast implants,

that they think long and hard about it,

and they are armed with all the facts.

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