The rise and fall of the implant—or how Houston went from an oil-based economy to a breast-based economy.
Timmie Jean Lindsay does not look like an experiment in medicine, social, and sexual engineering. Sipping coffee at a McDonald’s near Channelview, she looks like a lot of other grandmothers from the blue-collar town. She is 63 years old, a substantial woman in a nice print dress, with thick glasses and short tinted red hair. People who don’t know her story might search for a clue in the two rather adventurous earrings dangling from her left ear. People who do know about Timmie Jean will not be able to keep their eyes off her breasts. She is the first woman in history to have received silicone-gel implants.
Her story begins back in March 1962, when she showed up at the charity hospital to have her tattoos removed. It was the only way she knew to remedy the rough hand life had dealt her. Timmie Jean had run off at fifteen to get married, given birth to six children, and then at thirty, found herself divorced, stuck in a dead-end job, and struggling to keep her kids. The tattoos had become nothing more than a daily reminder of all the wrong turns she’d taken in her life. They were red roses, one over each breast, climbing like twin vines from her cleavage, and she wanted them gone, as if erasing them could erase her past.
But, after surgery, the doctors weren’t quite done with Timmie Jean. They had an intriguing proposition for her: Would she like to have better breasts? Doctors at the Baylor University College of Medicine were trying to come up with a special kind of device, an implant that would make a woman’s chest look young again. “They just looked at me and decided I was the perfect candidate,” she says. “You can imagine after six children I was a size 34 Flat Feet.” “Why not?” she thought, though when it came time for the operation, she refused to look at the glistening silicone-filled orbs they intended to put into her body. “Out of sight, out of mind,” she says. “If I looked at them, I might worry about them being inside me.” The doctors told her they would make her a full C cup, and for Timmie Jean, that was all she needed to know.
She stayed in the hospital four or five days after the surgery. Her chest felt like a ton of bricks was lying on it, but she was worried about losing her job, so she made herself get up and get back to work. It wasn’t until six weeks later, at a bar, that she became aware of the momentous change in her life.
Timmie Jean had picked out a pretty crop-top to wear, but that night it hung out over her breasts in a way it never had before. “The men just—well, that was a boost to my morale, she recalls, dusting off the 33-year-old memory with a broad, satisfied smile. “I thought I would never meet anyone. I thought I would never marry again. But, boy, things began to look up after that.” In fact, by New Year’s Eve, Timmie Jean was happily remarried and a new chapter in her life, and the life of the breast, had begun.
Of all the symbols of modern Houston—the oil derrick, the building crane, the designer skyscraper—the breast is the most unlikely. The ultimate emblem of femininity—it yields, it nurtures, it entices—the breast would appear to have no more than decorative use in a place that has always been known as a man’s town of big deals and big deeds, where self-invention has achieved the status of religion. Houston, it has always seemed safe to say, isn’t soft on anything.
But whether locals recognize it or not, Houston is in the grips of one enormous breast fixation. Boobs are ubiquitous here: Plastic surgery ads featuring young women with bountiful bosoms figure prominently in the local health and fitness magazines (“Summer’s here. Time to look your best”). Upscale topless clubs occupy prime real estate in the Galleria area, and their billboards line almost every freeway into town. Stories of women suing in local courts, contending that their implants cause disease, make headlines regularly and generate hundreds of millions of dollars in legal fees for Houston attorneys. Along with doctors and lawyers, the breast supports architects, designers, chefs, G-string purveyors, medical researchers, courthouse clerks, even hospitals. In Houston, you see, the breast that has invigorated the economy is not real but man-made, one that perfectly reflects the city’s obsession with sex and commerce, technology and individuality.
Pride may keep Houstonians from admitting that this peculiar union of erotica and entrepreneurship reveals a shift from an oil-based to a breast-based economy. But they couldn’t disagree that Houston’s relationship with the breast makes for a modern morality tale, one that says a lot about the fantasies and ambitions of the city, and how those dreams have changed the way women look around the world.
On the day of her implant operation, young Melissa Lovell envisioned herself storming the Victoria’s Secret store in the Galleria. “Open Up!” she would holler. “I’ve had my boobs done!” She didn’t care that her girlfriends told her it was a sexist operation that could make her sick. Melissa was enraptured with the idea of throwing away her bunchy Miracle Bra and the hateful Wonder Bra—the one with the pads that fell out at the worst possible moment. She longed to pour herself into a real bra, one with strong wires and lacy cups.
The impetus for this fantasy, indeed for Melissa’s surgery, was her mother, Cyndi, a starkly beautiful divorcée in her early forties who has enhanced her own breasts four times—three times with silicone implants and, more recently, with sacks filled with saline, which is the only implant now approved for general use by the Food and Drug Administration (FDA). For Cyndi, the decision to have her breasts augmented had been easy. She had always been flat-chested, and after giving birth to two children, she felt robbed of her femininity. “I had absolutely no chest,” she says. “I looked like a fried egg.” The operation turned out to be problematic—Cyndi, a nurse, developed a common complication known as capsular contracture, in which the breast hardens because of scarring of the tissue—but she didn’t mind, not even when she had to have three more replacement surgeries to correct the problem.
Cyndi Lovell is passionate about her artificial breasts. She now has 400cc implants—the equivalent of full, firm C to D cups—and she loves the way she looks, in and out of her clothes. Sure, men notice her far more than before, but that is beside the point. “I didn’t do it for any man,” she says, echoing the sentiments of many women who once chose breast augmentation. “I did it because it made me feel better about myself.”
And then came Melissa. An exceptionally pretty girl, Melissa was tall and blond, with a sunny disposition. But the child had no chest, as Cyndi liked to put it. One day, while Melissa was shaving her legs in the bathroom, Cyndi brought up the subject. “So, do you want your breasts done for high school graduation or college?” she asked.
Melissa didn’t warm to the idea immediately. In fact, she threw her mother out of the bathroom. But then she talked it over with her boyfriend. “It might help your self-confidence,” he suggested, and she began to reconsider. She had never really fit into her clothes—whatever clung to her hips hung like a sack around her breasts. To her mother’s delight, Melissa decided not to wait.
All of which explains why she is strapped to this operating table at Columbia/HCA Medical Center Hospital, in what a layperson cannot help but notice is a crucifixion position. Though the rest of her body is draped, her breasts lie exposed. They are inarguably tiny but unmistakably feminine.
Melissa’s doctor is Franklin A. Rose, a 43-year-old Baylor-trained plastic surgeon who has done between 2,500 and 3,000 augmentations. Balding and gregarious, with a sensual mouth and a soothing bedside manner, Rose became a major character in the local narrative after he began showing up regularly in the society columns (he was married to a silhouette artist for some years), ran ads featuring his massively endowed patients standing in front of luxury cars (“Auto by David Hobbs BMW, surgical sculpture by Franklin A. Rose M.D.”), and was the subject of a Houston Press profile, Breast Man, which revealed what could be politely described as his codependent relationship with Rick’s Cabaret, the city’s most prominent gentleman’s club. These days Rose says he has cooled on enhancing topless dancers (I’m doing a housewife from Humble tomorrow”), but nothing has dimmed his passion for augmentation mammoplasty—not the FDA, not lawyers, not anybody.
“Look at this. She’s very boyish,” Rose says, taking a felt-tip marker to Melissa’s breasts. “Barely an A cup.” Rose is one of the handful of doctors still permitted to use silicone-filled implants as part of an experimental program; because Melissa is thin and her chest is slightly concave, she is a perfect candidate for the highly controversial silicone implants instead of the saline kind approved for the general population by the FDA. Saline has proven far less popular than its predecessor. It tends to ripple on younger women with tighter flesh, producing what Rose calls “a cosmetically displeasing event.” Melissa and her mother are rare because neither has been swayed by the torrent of publicity and lawsuits suggesting a link between silicone implants and diseases of the immune system. “I’m not afraid of silicone,” declares Cyndi, who hopes to have her saline implants replaced soon.
There is nothing sensual about the way Rose handles Melissa Lovell’s breasts over the next forty minutes. After taking measurements to establish symmetry, he injects each breast with a drug to reduce bleeding. Then he makes a small incision under the right breast and, using scissors, a high-tech scraper, and a small light that reveals the interior of the breast to be both red and bright yellow, snips and pushes tissue aside to make a pocket for the implant. Shoving in the gel-filled sacs—enough to make the young woman a C to D cup, today’s breast size of choice—is something akin to giving birth in reverse. Rose pushes and prods Melissa’s breasts in a way that no conscious woman would permit, slapping them, squeezing them, molding them, sometimes stopping to shake the cramps out of his hand. Near completion, however, pride replaces frustration. “She’ll have a lovely result,” he coos. When he is done, Melissa has two volcano-like peaks on her chest that should, in the course of a few weeks, settle into soft, robust mounds.
Awakening briefly after the surgery, Melissa surveys her chest and smiles dreamily. “I’ve got boobs,” she says and then slips back into sleep.
“For some years now, at least in the United States, women have been bosom conscious,” Thomas Cronin and Frank Gerow, the inventors of the silicone-gel implant, wrote in the early sixties. “Perhaps this is due in large measure to the tremendous amount of publicity which has been given to some movie actresses blessed with generous sized breasts. Many women with limited development of the breasts are extremely sensitive about it, apparently feeling that they are less womanly and therefore, less attractive. While most such women are satisfied, or at least put up with ‘falsies,’ probably all of them would be happier if, somehow, they could have a pleasing enlargement from within.”
So went the rationale for the silicone-gel implant. Cronin, a clinical professor of plastic surgery at Baylor, and his resident Gerow, surely wanted to help women who had endured mastectomies, but the greater goal was to help the large number of flat-chested women be “happier.” The surgeons were typical Houston innovators—like those in the oil fields and those at NASA—who believed firmly in their right to improve upon nature and to bring glory upon their organization, which in this case was the young, ambitious Baylor University College of Medicine. If Michael DeBakey could repair a heart, Baylor’s cosmetic surgeons could build a better breast.
Cronin and Gerow, both of whom have died in recent years, are remembered by their colleagues as supremely dedicated. Cronin, a native Houstonian, is recalled as a polished, remote figure with a River Oaks address; his charity work is well known, as are the advances he developed for victims of burns and those with hand injuries. “He had a very large ego that was well contained,” says a former protégé. Gerow was just as devoted to his work but far more approachable. A Canadian immigrant, he arrived in Houston with little money; at first, he and his wife lived in an unair-conditioned home, and his idea of relaxation was to quiz his students in the back room of the Bacchannal, a Greek restaurant with belly dancers. “He was a genius,” says a colleague. “As soon as he found out about any new surgical procedure, he’d start modifying it.”
It did not intimidate these doctors that women’s breasts had long defied modification. Visionaries had been trying to improve upon nature for centuries, inserting such things as paraffin, ivory, animal fat, and sponges into the breasts—with no success. Silicone was first used after World War II when Japanese women, who tended to be smaller-breasted than their American counterparts, had it injected into their breasts to please American servicemen. The trouble with these augmentation procedures was that the substances didn’t stay where they were supposed to or the breast became too hard or the patient became extremely ill—or all of those things. The story goes that Gerow solved the problem one day at a blood bank when he first saw blood in a plastic bag as opposed to a glass bottle. He squeezed the bag, and it reminded him of…a breast. So, working with associates of Cronin’s at Dow Corning, the doctors experimented with a bag filled with silicone gel, and gradually, the silicone-gel implant, or “natural-feel prosthesis,” was perfected. Silicone was considered the perfect filler because it was heavier than water—closer to the real thing—and was believed to be inert; that is, nonreactive with body chemistry. Patients were told that the implants were safe and that they would last forever, because that was what the doctors believed. “They’re as harmless as water,” Gerow used to say.
In the beginning, the only notable problem was what came to be known as capsular contracture—the body tended to wall off the implant, forming a “capsule” of scar tissue that distorted the breast. To treat the problem, doctors did everything from massaging patients’ breasts to pounding them with medical textbooks; one journal even ran a story to help doctors with their hand pain. In the early eighties, the outer shell of the implant was thin and textured to abate scarring; it helped, but some say it caused more-serious problems, which went undetected for years. In early photographs, implanted breasts looked less like real breasts than hyperreal breasts, perfectly symmetrical and pointed, in the torpedo style fashionable at the time.
It isn’t hard to understand why the operation was popular throughout most of the sixties, when a big bust was the prevailing symbol of femininity. But, ironically, when fashion ideals changed—remember Twiggy?—and feminism attacked the treatment of women as sex objects, demand for breast enhancement grew. A new generation of Baylor residents, trained by Frank Gerow, perfected their talents on homemakers and secretaries, psychologists and elementary school teachers. It particularly appealed to young white women who worked among powerful white males: on airplanes, in hospitals, in law firms, and in courthouses. Though most women asked to be made “normal,” what came to be normal in Houston was larger that the national average—a C cup.
When women try to explain why they so craved this surgery, they mention almost universally that they believed it would help their “self-esteem,” a pop psychology term vague enough to mean just about anything. That was equally true of the desire for enhanced breasts in the seventies and early eighties: A new, improved bust line could be the solution to any and all inadequacies women were feeling during a time of enormous social and sexual change. The augmentations could ease a woman’s retreat from the pressures of feminism, signifying a return to more-conventional notions of womanhood (“My husband loves ‘em!”). Or they could simply make the breaks available to naturally busty women—better service in restaurants, free upgrades on crowded airplanes—available to everyone. Side effects like breast hardening and reduced sensation were of little concern. Women were used to suffering for beauty.
And boob jobs were cheap. In the seventies, a middle-class shrinking violet could have the same breasts as a movie star for about $4,000. “This was something that a secretary, a nurse, someone in college could afford. It wasn’t like a face lift, which was for the carriage trade alone,” says Houston cosmetic surgeon Laurence Wolf. The doctors and hospitals loved it almost as much as the patients: The surgery was not covered by insurance, so there were no reimbursements to wait for. Augmentation mammoplasty was strictly COD. (Eventually cosmetic surgeons got the best of both worlds, lighting on a reimbursable category for extreme flat-chestedness called hypoplasia.) “It was,” says Wolf, “a happy operation.”
And the best was yet to come.
When Robert Watters talks about silicone breast implants, an unwelcome wind of negativity ruffles his cool, supremely confident demeanor. “I preached against them for years,” says Watters, 44, who is the owner of Rick’s Cabaret, the most famous topless bar in Houston, and perhaps, the world. To him breasts aren’t the point. “We’re a species of weak egos,” he says in an almost professorial tone from the dim balcony of Rick’s VIP Room, the place where the likes of Warren Moon and Sting have gotten a very special eyeful. According to Watters, Rick’s isn’t about breasts; it’s about seduction. Personality, not surgery, salves the lonely, hungry hearts of men. “You come into Rick’s and, for the grand sum of $20, you can buy the individual sexual attention of a woman for five minutes.” Luckily for Watter’s business—and that of the silicone-gel implant—the topless dancers who worked in his clubs didn’t quite see it that way. “In the early and mid-eighties, the first material acquisition the dancers saved for,” he admits, “was breast augmentation.”
No two products were more interdependent than Rick’s and the implant. Today, the former attorney and Touche Ross tax consultant—crisp, clean, and handsome in his white button-down and khakis—can ponder his role in the community like any other concerned entrepreneur, grousing about the lack of convention business as he soft-pedals the possibly objectionable aspects of his establishment. “It’s not a horrifying thing for someone to say they’ve been at Rick’s,” Watters says lightly. “There’s a playful innocence about it.” But innocence or no, the club wouldn’t exist if cash-bearing men hadn’t come from all over the world to get a look at the beautiful women with the big breasts at Rick’s. Just as some fashion emanates from the street, and some can be traced to the eccentric thriftiness of the upper class, the eighties image of the perfect breast—when the ideal shifted from the merely big to round, erect, and very big—was disseminated through one particular club in Houston. Implant manufacturers could not have invented a better marketing campaign than the one Rick’s provided free of charge.
Rick’s opened in 1983, a nightmarish economic year for Houston, as the oil bust settled in. It wasn’t founded by Watters but by a reclusive, heavyset man named Dallas Fontenot, a Bellaire High School dropout who had made a name for himself running old-fashioned Houston topless bars like Hiphuggers. It was Fontenot who leased Trumps, a faltering disco, from an oil trader named Salah Izzedin, with whom he subsequently formed a partnership. Fontenot also brought in his attorney, Watters, a Canadian with a degree from the London School of Economics. Trumps was located just off Richmond, a block or so from the street’s revolving club scene and, more important, a mile or so from the international sophistication of the Galleria.
It was sophistication that would distinguish this new gentleman’s club from a conventional tittie bar. The partners turned down the music, so that people could talk, and turned up the lights. They hired architects and decorators to convert the club into an ersatz mansion, complete with fountains, chandeliers, and hidden rooms with even more-hidden balconies. The standard sandwich and chips were replaced with a real menu that included everything from burgers to lobster, steaks, and pasta. Customers could even buy corporate memberships, just like a real private club (“We’ll do everything in our power to make your next business deal your best business deal,” says the brochure). The idea was to make the club respectable and, in the process, make the patrons feel like, well, gentleman.
Rick’s was different in another crucial way: The women who worked there didn’t look like old-fashioned strippers. The partners presented the Playboy mythology in 3-D—the Rick’s dancer was someone a man might actually consider dating. She might be, in the words of a prospectus for a subsequent Rick’s imitator, “the college girl up the street, your office’s receptionist, and the young single mother who…drives a new Corvette.” One newspaper reported that Rick’s dancers who brought in their class schedules could arrange their work around their course loads.
But a Rick’s dancer was also more glamorous than any student, thanks to her pair of silicone-gel implants. The average bust size at Rick’s was a 38D, a proportion rarely found in nature. Better yet, the customer could get a good look at those breasts: For $20 plus tip, the likes of Anna Nicole Smith would dance right at a customer’s table. With the AIDS epidemic in high gear, Rick’s provided the safest, most glamorous sexual experience around.
The message of Rick’s was clear: Outside, Houston might be steeped in economic misery, but inside, the party was still going strong. Valets parked the Porsches, Mercedes, and Jaguars out front, while guys like Jon Bon Jovi, Michael Caine, George Strait, O.J. Simpson, President Bush’s secret service men, and multiethnic, multinational multitudes of wannabes anted up for table dances. Robin Leach deemed Rick’s “the place to find your champagne wishes and caviar dreams.” The club’s billboards became an in-joke: “More fun than the law allows,” said one, which did not endear the club to the vice squad. When Houston Civic Center Director Jordy Tollett explained why he spent several thousand dollars in taxpayers’ money escorting visitors to Rick’s, “They wanted to go there” became the quote on another billboard. Tollett’s public reprimand from the mayor led to what may have been the apogee of Rick’s public acceptance, a Houston Chronicle editorial that declared, “As a city trying to attract convention business, we must spend money to make money, and if Tollett was bowing to the demands of clients to go to topless bars, we probably shouldn’t fault him too much.” The ongoing publicity drew the kind of regular customer all successful businesses require. In the mid-late eighties, it was the average tab of $200—not the occasional $10,000 one—that kept Rick’s first on the Texas Alcoholic Beverage Commission’s Houston revenue list time and again. The club was also, for the same period, American Express’ best charge customer. Rick’s had become a brilliant example of economic diversification, one of Houston’s first post-bust business triumphs—pun intended.
One of the secrets of Rick’s success was that the club appealed as much to the fantasies of the women who worked there as to the men who patronized it. “I get to go in there for eight hours and feel desired and feel pretty and get money thrown at me,” says one topless dancer. The clubs offered women without education or connections access to an otherwise closed world of wealth and power. Like news of the Gold Rush, word spread through Houston that a pretty women could make a minimum of $600 a night dancing at Rick’s. Women believed that with implants, they could make even more. They might catch the eye of someone who was exceptionally solvent—an 89-year-old multimillionaire oilman, in the case of Anna Nicole Smith—or, perhaps, a scout from Playboy or Penthouse.
This happened just enough to legitimize the fantasy: In the space of a few years, more centerfolds—22 of them—came from Rick’s than from any other club in the U.S. And as clones of the club proliferated around the country, so too did clones of the women who worked there. By the end of the eighties, thanks to the clubs, the magazines, and the men who supported them, the Rick’s ideal had become the American ideal: a girl next door with firm, grapefruit-size breasts.
Soon, ordinary women wanted the same kind of boobs. It wasn’t unusual for a patient to enter the office of a Houston cosmetic surgeon bearing a picture of a centerfold that same doctor had augmented. No one seemed to notice Anna Nicole Smith’s surgery scars in the erotic videos she made for Playboy; no one seemed to care that Franklin Rose had given Lynn Johnson the spectacular proportions that won her the role of Penthouse Pet for that magazine’s twentieth-anniversary issue in 1991, along with $600,000 in prizes. Augmentation had become just another form of self-improvement. An ancient biological truth had acquired an economic veneer: Women with attractive breasts—whether they were topless dancers or corporate lawyers—attracted powerful men. Then, too, ordinary women discovered in their implants what topless dancers had always felt: Big breasts felt sexy.
Houston women bought lots of new breasts during the boom, but their buying actually increased during hard times, giving new meaning to the term “bust years.” Nationally, Texas ranked third behind California and Florida in the number of breast augmentations, with Houston serving as the state’s implant central. One theory holds that breasts are more important in the Sunbelt, where they are exposed more often. Another is that because the implant was invented in Houston, it was marketed more heavily there. Whatever the reason, the delight of patients went a long way toward lifting the pall that had settled over the city.
The surgery had become the pick-me-up of choice for the newly divorced and a boon for boudoir photographers and retailers who sold figure-enhancing attire. No woman thought it rude to open her blouse in public and show off her new additions. The Galleria’s North Beach Leather, once a haven for the sexually assured, became a magnet for the newly augmented; many were even referred by their plastic surgeons. “Most of the women wanted to look sexy,” says store manager Alton Causey. “The biggest thing was ladies in their thirties who had never looked that way. The tighter, the shorter, the deeper, the better.” Causey had to ask one woman to stop trying on feather halter tops in front of the store window because of the hooting crowd that had gathered outside.
Franklin Rose describes the late eighties as a “breast-implant free-for-all.” No one worried about safety; most women’s main concern was how quickly they could get on the doctor’s schedule. “Twins would come in, sisters would come in, and I’d go from room to room,” Rose says of his typical operating schedule back then. Gerald Johnson, another plastic surgeon, recalls that by 1986 he was holding “Grand Teton Days” once or twice a month. “The most surgeries we did in one day was seventeen,” says Johnson. Breast docs accustomed to six-figure salaries saw their incomes soar to between $1 million and $3 million a year. Johnson even built a breast-shaped pool with a nipple-shaped hot tub to celebrate. By 1990, it was estimated that more than one million women had had breast augmentations, and dozens of companies were selling up to sixty kinds of implants. “There wasn’t a pair of breasts we couldn’t give,” says Rose.
And the health care professionals, like the oilmen who preceded them, thought their boom would go on forever. “The cultural influence is such in this city that for a woman to feel attractive usually includes a Mercedes, a gold Rolex, and three or four operations—nose, breast, liposuctions,” Rose told a reporter in 1991. “The Texas woman is a combination of many things, not the least of which is the surgeon’s scalpel.” Doctors Cronin and Gerow had drilled a gusher by tapping deep into the psyches of American women.
The first sign that the breast boom was entering a new phase came, fittingly enough, at Rick’s. In 1989 the partners exchanged allegations of narcotics use, encouraging prostitution, and misappropriated funds. (More than $2 million was unaccounted for, a fact noted by the IRS.) After a bankruptcy filing, the founders went their separate ways. Salah Izzedin went to Dallas and created the Cabaret Royale, Watters held on to Rick’s, and Fontenot created a competitor, the Colorado Bar and Grill.
The times may be different, but Rick’s and its imitators continue to extract money from men eager to see naked breasts. Rick’s and the tonier Men’s Club still lure sports stars intent on handing Houston NBA championships: New York Knicks star John Starks was at the club the night before the last game of the finals last year, and the Phoenix Suns’ Charles Barkley performed on the stage at the Men’s Club before his team lost to Houston in this year’s playoffs. The clubs now support an array of businesses, from architectural firms (Texas Architect recently featured the $1 million renovation of Michael’s) to cab companies (drivers can expect a $5 tip every time they take a customer to Rick’s). Robert Watters estimates that Rick’s has paid close to $4 million in state taxes in its existence. “Imagine the number of kids that we have provided schooling for,” he says without a trace of a smile.
Like any smart entrepreneur, cosmetic surgeon Thomas Biggs has learned to anticipate and adapt to change. A protégé of Thomas Cronin’s, he has performed thousands of augmentations and still remains in awe of the female breast. “It’s a mystical thing,” he says. “No one understands it.” But one thing the wiry and energetic 62-year-old Biggs does understand is panic, specifically the panic of women who have implants and, because of an explosion of negative publicity and lawsuits filed in the early nineties, believe they are hatching horrible diseases in their breasts. “Did you hear those phones ringing?” Biggs asks, cocking an ear toward his receptionist’s desk in his gilded and draped office near St. Joseph Hospital downtown. “Those are implant patients.”
To help other cosmetic surgeons cope with the barrage of anxious and angry patients, Biggs has devised a slide show and lecture titled “Silicone Catastrophe.” He offers psychological advice—“You need to handle these patients very tenderly, because they’re worried patients”—and possible courses of action, such as removing the implants entirely, replacing the silicone implants with saline or the body’s own fat, or doing nothing. Like many cosmetic surgeons, Biggs is in agreement with the dozens of studies from such august institutions as Harvard and the Mayo Clinic that have found no link between implants and disease.
He suspects that an immune-system glitch makes some augmented women sick, though not in the massive numbers reflected in the lawsuits. Out of the more than one million women implanted worldwide, about half a million have filed claims against various implant manufacturers. “Have you ever read Bonfire of the Vanities?” Biggs asks, making an analogy between the breast-implant crisis and the Tom Wolfe best-seller. “You throw all these agendas into a pot and you have a conflagration.”
Perhaps because the mid-eighties were a boom time for implant manufacturers, no one paid much attention to the small number of women who began appearing in their doctor’s offices with vague and myriad complaints—everything from chronic fatigue, weakness, and forgetfulness to rheumatoid arthritis and rare, disfiguring diseases of the immune system, such as lupus and scleroderma. Some even had children born with inexplicable rashes and joint pain. Few physicians made any connection between breast implants and illness, though in 1984, because of consumer complaints, the FDA began requesting more product-safety information from manufacturers. Then came the day of infamy for implant makers and cosmetic surgeons: a December 1990 Connie Chung Face to Face program. The segment featured woman after woman, each more seriously ill than the former, who blamed the Surgitek breast implant for their illness. The show set off a national frenzy among women with implants, which only increased after Californian Mariann Hopkins won a $7.3 million judgment against Dow Corning in December 1991 for her ruptured implants. When the FDA banned the sale of silicone-gel implants one month later, a new kind of breast-implant free-for-all had begun.
The women’s anger was understandable. They had been told their implants would last forever. That did not appear to be so. “By the mid-eighties, women would come in with breasts that were distorted in shape and we would find that the implant was not intact,” says Biggs. To prevent ruptures, doctors and manufactures revised themselves and began recommending replacement of the devices after five to ten years—not such a bad deal for the manufacturers or surgeons, as it happened. But the illnesses the women complained of could not be so easily remedied. For the sickest patients, life became a hellish spiral of fatigue, expensive and experimental treatments, more symptoms, more pain. It was the bitterest form of punishment: Healthy women had purchased a product believing it would augment their vitality; now they believed it was transforming them into wheelchair-bound crones, unable to enjoy dinner out, much less a night of sexy lingerie and unbridled passion.
Everyone abandoned them. Family physicians, unable to determine a physical cause for the women’s malaise, tended to diagnose that great psychiatric catchall, depression. Manufacturers absolved themselves by citing the many pro-implant studies but covered themselves by adding a warning label—inside the sealed package, where it wouldn’t be seen until the patient was on the table, the doctor had scrubbed, and the implant was ready for surgery. Insurance companies didn’t want to take any chances either. Women with breast implants, sick or not, were denied coverage. The fact that there were plenty of fakers, women who called their cosmetic surgeons wondering how they might cash in on what was beginning to look like a legal bonanza, added another dimension to the sense of betrayal felt by the women who were really sick.
Stories of individual reprisals made the rounds of local support groups, fueling the collective anger. The mayor’s wife, Elyse Lanier, was suing over her ruptured implant. One Houston woman made a scene in her plastic surgeon’s waiting room, lifting up her shirt to display her rock-hard mangled breasts to patients awaiting augmentation. Another sliced into her own breast after her doctor refused to remove her implants. But those were isolated incidents compared with the rebellion yet to come. Science or no, women wanted retribution on a much larger scale.
If testosterone could propel a plane, then this chartered jet carrying Houston attorneys John O’Quinn, 53, and Richard Laminack, 44, would be home by now. The two are returning from a bankruptcy hearing in Michigan, one involving Dow Corning, the largest breast-implant manufacturer in the U.S. and a business that these lawyers have practically crushed. In just a scant few years, Dow Corning’s millions—and the millions made by the other manufacturers of the silicone-gel implant—have become O’Quinn’s millions.
“Nobody works harder than we do,” O’Quinn snaps, defensive about a recent Dow publicity campaign suggesting that most breast implant-related autoimmune diseases are the creation of shrewd, exceedingly greedy lawyers. “Nobody gets a better result for their clients that we do. We-do-not-do-this-for-the-money,” O’Quinn adds, slowing his cadence without lowering his volume.
Watching his partner emote, Rick Laminack grins, a wide one that is simultaneously city-cynical and country-genuine, just like his law firm. “We do it because we have hee-ro complexes,” Laminack explains.
O’Quinn leans forward in his seat, still boring in with his eyes, unable to stop himself. “Shane—that’s my favorite movie of all time. My daddy took me to that movie and pointed to the screen and said that’s what a man is all about. You don’t think that would have an impact on a kid?
“When the bad guys come, who do you want?” he continues, the waves of his shimmering brown hair vibrating with intensity. “You don’t want some namby-pamby son of a bitch. If the companies obeyed the law, I’d be the Maytag repairman.” Slamming back in his seat, he rests his case.
O’Quinn triumphs in the arena of breast-implant litigation because he understands that scientific evidence is nowhere near as powerful as age-old myths about femininity, in particular those of women wronged. Every O’Quinn trial allows the jury to become the plaintiff’s rescuer, a strategy that has earned him more than two thousand clients—more than any other attorney involved in implant litigation. Not coincidentally, it is largely because of O’Quinn and a handful of other plaintiff’s attorneys that Harris County has more implant cases on file than any other jurisdiction in the United States—about three thousand of them.
O’Quinn’s first victory was in December 1992. Implant litigation had become a growth industry across the country by then. Sometimes the plaintiffs won, sometimes the defendants did, so no one paid much attention to the case of a Pearland woman named Pamela Johnson. She sued Bristol-Myers Squibb, claiming that her ruptured implants had caused immune-system problems that led to a partial mastectomy. In the eyes of defense lawyers, Johnson wasn’t that sick. Her complaints were vague and could be linked to previous medical problems or, perhaps, her heavy smoking. And, of course, science was on their side. The most illustrious institutions of American medicine had concluded, in essence, that the number of sick women with implants was proportionate to the number of sick women in the general population. In other words, these women would be just as sick even if they hadn’t had their breasts enlarged.
In the Johnson trial, O’Quinn struck right at the heart of that argument. Though the plaintiff has the burden of proof in a civil trial, he forced the manufacturer into claiming unequivocally that implants were safe. Then, after submitting evidence that manufacturers had skimped on animal research, O’Quinn co-opted the defense’s star witness, Noel Rose, a Johns Hopkins immunologist. Once Rose testified that more research was needed to prove the effects of silicone on the body, O’Quinn coaxed the doctor into admitting that he was lucky not to be a sick woman forced to endure the glacial progress of scientific research. “I am indeed,” the doctor admitted softly. The jury awarded Pamela Johnson $5 million in actual damages and $20 million in punitive damages, setting a new standard for implant-case awards.
Then, in 1994, O’Quinn turned his guns on three more companies, 3M, Inamed Corporation, and its subsidiary the McGhan Medical Corporation. Again, the manufacturers scoffed. The plaintiffs in this case did not even have ruptured implants. But O’Quinn put on evidence of “gel” bleed—showing that traces of silicone had seeped out of supposedly sealed implants. More important, he directed a domestic drama for the jury. He put the beefy husband of one of the plaintiffs on the stand, an ex-jock who agonizingly testified that he had ignored his wife’s complaints as she had grown progressively sicker. “He was saying he thought, ‘Well, she just cain’t play hurt. She ain’t tough,’” O’Quinn says. Then, in open court, the man apologized to his wife for not having faith in her. The jury awarded $44 million. As impressive as those verdicts are, they don’t really explain why O’Quinn’s client base went from 52 women in 1991 to 2,000 in 1994, and why silicone-gel implants have become, essentially, items for time capsules. (Only one company still makes implants.) That story has less to do with the psyches of women than with the psyche of John O’Quinn, and his need to win ever bigger, even better.
His firm is a rather unlikely champion of aggrieved women. It is considered something of a horny boy’s club, and the gum-chewing O’Quinn is not known for his polish. He is, simply, a weapon of mass destruction, the driven son of a West University mechanic, first in his law school class at the University of Houston, one of the rare few to abandon the cushy corporate culture of Baker and Botts for the treacherous but far more remunerative field of plaintiff’s law. O’Quinn’s career has been successful as it has been controversial: He has won more than $1 billion in judgments in a dozen years, but he was also sanctioned by the state bar amid accusations of jury tampering, barratry, and other abuses in 1989. Like the implant surgeons and club impresarios before him, he is entrepreneurial to the core, a man who wants to be the best there is. In the process, he takes no prisoners.
Breast-implant litigation actually began with another Houston plaintiff’s attorney, a Joe Jamail protégé named Richard Mithoff. In 1977 he represented a Cleveland woman who said her ruptured Dow Corning implants had caused everything from breast pain to mental anguish. Mithoff won a $170,000 verdict against the manufacturer, the largest implant award up to that time, but the case received little publicity and did nothing to slow the breast-implant boom.
The person who really saw the implications of the implant was O’Quinn’s partner Richard Laminack. In 1988 he was representing a Beaumont woman with ruptured Bristol-Myers implants in what he thought was a medical malpractice case. After contacting the woman’s plastic surgeon, Laminack was told, “I know you’re suing me but I could be your best witness.” The doctor educated Laminack in what he believed to be the flaws of implant design, and a case of medical malpractice became a case of product liability—allowing for the possibility of a much bigger judgment against a much richer defendant (the manufacturer instead of the doctor) and increasing the prospect of multiple defendants, the biggest bonanza of all. Laminack went after the manufacturer and settled the suit for an undisclosed amount after producing evidence that the company had ignored warnings that the product needed more testing.
What happened next was something akin to any entrepreneurial start-up. O’Quinn’s firm began to build a client base. Joining with public action groups, Laminack appeared on talk shows and began running ads. “Are beautiful breasts to die for?” one print asked, suggesting that capsular contraction is fatal, which it isn’t. As time went on, attorneys from the firm lectured support groups, sponsored legal seminars, and even held teach-ins with medical researchers. The Johnson verdict of 1992 was, in that regard, not just a trial but a powerful advertising vehicle. “That’s when we loaded up the truck and we moved to Beverlee,” says Laminack. With each victory, the attorneys attracted more clients, enabling them to pick their plaintiffs from the sickest and most virtuous. Topless dancers were out, for instance—a case in Colorado proved juries didn’t like women exposing their breasts.
While O’Quinn’s firm was in a growth phase, more other attorneys around the country were in a settlement phase. Implant manufacturers had agreed to put $4.2 billion into what was known as a global settlement, overseen by a federal court in Birmingham, Alabama. They wanted to pay off all victims with awards ranging from $204,000 to $1.4 million in a single agreement and get on with business. Crucial to the success of the settlement was getting O’Quinn to the table. He declined, threatening the peace, perhaps because such newly developed mass tort solutions benefit the group at the expense of the individual—“The global overpays women who don’t deserve money and underpays those who do,” Laminack says—and perhaps too because the firm’s 40 percent standard fee could garner a much higher return at trial.
Either way, O’Quinn forced the companies into a war of attrition, making them pour into the global while fighting him at the courthouse. And it wasn’t just any courthouse, either. Most plaintiff’s attorneys had to take their chances with the strict rules and appointed judges in federal court. But because so many women got their implants in Houston, O’Quinn could sue the doctors (who were invariably dropped from the suit on the day of the trial) and get the case into state court, where rules are looser and judges are elected—often with the help of generous campaign contributions from plaintiff’s lawyers. (O’Quinn donated $183,000 to political campaigns from 1990 to 1994.) It is a strategy that one person close to the firm estimates has brought in an estimated $12 million to $13 million a month in settlements, a figure O’Quinn disputes. “It’s too low,” he jokes.
Late in 1994, O’Quinn turned his attention to the last remaining major manufacturer. He went to trial against Dow Corning. But he also sued Dow Chemical, the company’s billion-dollar parent, claiming it had overseen development of the implant and knew of its defects. It was a huge gamble, the results of which were inconclusive. With tort reform in the air, O’Quinn’s client won only $5 million, and the judge threw out the portion of the judgment that found Dow Chemical partially responsible. On the other hand, Dow Corning subsequently filed for bankruptcy—O’Quinn and his clients are part owners of the company now—and he’s going to trial against Dow Chemical this fall. “I’m gonna whip Dow Chemical with the stinging sword of truth and justice,” he says.
Defense lawyers are not quite correct when they say that O’Quinn has won these victories without science. In a quiet corner of O’Quinn’s firm beyond the clerks installing information on CD-ROM, beyond the wall of videotapes showing patients having their implants removed, is a wall of refrigerators. Some are the kitchen variety, and some are the kind you see at convenience stores, with the word “beverages” written merrily across the top. Inside are thousands of implants floating in cloudy liquids, some in plastic containers, some in glass jars. Some are gray; some have yellowed with age. They are a hideous sight, half human, half not, pieces of women attached to pieces of silicone. They are not just trial evidence but evidence of a second medical boom in implants, this one fueled by attorneys and involving removal and research.
Because O’Quinn will not represent a woman who doesn’t have her implants removed, there are doctors who’ve made millions taking them out. There are doctors making millions off experimental treatments—the kind that have been investigated by Baylor committees and CNN—attempting to establish the existence of silicone disease. The lawsuits have been a jackpot for magnetic resonance imaging centers. Almost every woman diagnosed with silicone illness gets a brain scan (around $1,100) and sometimes a breast scan ($1,800). Pharmacists have made out too. Prescriptions can run as high as $800 a month. Even the hospitals have cleaned up. Controversial neurologist Bernard Patten was the single largest admitter to Methodist Hospital until he retired, after Baylor officials refused to allow him to lecture students about implants. It is not stretching the point to say that his treatment of thousands of implant patients may have kept the financially troubled institution afloat.
“We are the science,” breast-implant patients like to say when confronted with the fact that no scientific evidence exists proving the existence of silicone disease. These women believe that, given time and money, their lives and their body parts will some day be used to prove that the implants are toxic. Perhaps this is the final irony created by a simple invention thirty years ago: The lawsuit boom has forced plaintiffs into a position every bit as experimental as that of the women who laid down on the operating table for Thomas Cronin and Frank Gerow.
Eric and D’eva Redding are looking for the perfect pair, and neither of them is all that happy about it. Playboy wants to do a pictorial that could loosely be titled “Girls of the Gentlemen’s Clubs,” and this Houston-based husband-and-wife team—photographer and stylist, respectively—are screening applicants. Eric, who is short, blond, and almost confoundingly good-natured, has taken these kinds of pictures for years; with D’eva he also served as Anna Nicole Smith’s manager from September 1991 to August 1993, the celebrity’s pre-Guess Jeans, pre-Playmate of the Year period. As such, Eric and D’eva are authorities on the changing fashions in Houston topless clubs and Houston breasts, scholarship that can be a burden. D’eva, who is ethereally pretty but canny from time spent on the Vegas strip, can get downright irritable after a few hours of the hand-holding centerfold scouting requires. Nevertheless, the two head for the Colorado Bar and Grill, preparing for more of the same.
The scene has changed since Rick’s was the center of the topless universe. The six-year-old Colorado, otherwise known as Dallas Fontenot’s revenge, has picked up where Rick’s left off, and in so doing has surpassed its predecessor in liquor sales—$300,000 a month—and gestalt. It stands to reason that if Houston has changed in its recovery from the oil bust, the dominant club would change too, and it has. Rick’s was worldly, linked to the boom with its mansionlike decor and status-conscious VIP Room. The Colorado, in contrast, is cavernous and rowdy, a faux ski lodge on the Southwest Freeway that is a regular guy’s twofer, a combination sports and topless bar. TV gets equal billing with dancers at the Colorado. The club has 5 satellite dishes and 51 televisions, including 6 big screens. Other wall decor includes photos of centerfolds who got their start here, beer commercial girls who got their start here, and memorabilia from sports stars who got slowed down here, along with a framed $250 check from professional rake Charlie Sheen, payment for destroying a $3 soap dispenser.
The women are different here too, in keeping with the frat party atmosphere. One dancer even wears glasses, a double-breasted jacket, and pearls—“My interview outfit at A&M,” she says pertly, though presumably she wore a skirt to her appointment at the college. But most profoundly, the number of augmented breasts appears down by half, a barometer of the state of the silicone-gel implant. Some women have silicone, some have FDA-approved saline versions, some are even remarkably, naturally flat-chested. In this era of diminished expectations, it appears, any breast will do. The dancers, representing an astounding multicultural mix, look like what they are—likable self-starters from places like Sharpstown or Baytown, whose fantasy is to make enough money to pay the baby-sitter. They know the women who made $600 a night didn’t always make it by dancing.
This reality quotient poses certain problems for Eric and D’eva, who trawl the club for prospects without much success. They’ve seen most of the women and their breasts here tonight.
“You’ve changed,” Eric says to a tiny, wide-eyed blonde who greets him with an embrace.
“Yeah, I grew out my bangs,” she says, not quite catching his drift. “What are you doing here?”
Eric explains about the pictorial, and the woman shakes her head, mumbling something about her thirty-pound weight loss.
“Lemme see,” he says, not convinced.
She grabs the strap of her stretch top and pulls it down, exposing her breasts. “Can you airbrush these out?” she asks, indicating the ripples on her chest, evidence of the saline implants her weight loss now accentuates. The arbiters of breast style confer wordlessly. D’eva looks dubious, but Eric makes an appointment.
“Playboy still wants the girl next door,” Eric says. “It doesn’t matter if she has implants or not, as long as they look natural.” He can fix in the darkroom what the surgeon could not.
“I was a guinea pig,” says Timmie Jean Lindsey, the implant pioneer, “but I was treated so royally I didn’t feel like one.” Her life and that of the implant have remained eerily entwined. She continued to see Gerow over the years, and the two became friends of a sort. When the doctor suggested she recommend the surgery to her friends, she did, sending in her sister-in-law; when the controversy erupted over the safety of the implants in 1991, she agreed to go on a local morning TV show with Gerow and later appeared before the FDA to say that she had no complaints. She enjoyed the days when women recognized her on the street and whispered confidences: “I wouldn’t trade ‘em for the world,” they said of their implants.
Timmie Jean doesn’t like to dwell on that dark time in the seventies, a period when her body seemed to turn on her. She had joint pain, rashes, dry mouth, dry eyes, and chronic fatigue. “I had all the same symptoms of those others,” she says referring to the women who a decade or so later started suing implant makers, claiming the implants made them sick. After several years and several doctors, the best Timmie Jean got was the standard diagnosis of depression. She took her medication and felt her sadness lift but still had physical problems. A few years ago, her right knee joint was replaced, a problem some might relate to silicone-induced rheumatoid arthritis, and some might relate to growing old. No one really knows.
Though lawyers have approached her over the years, Timmie Jean has never had any desire to sue. Her sister-in-law did and so did Timmie Jean’s daughter, who has implants and a form of lupus. Both are now awaiting awards from the global settlement, joining women who are deathly ill and women who have little wrong with them beyond a vague dissatisfaction that a cash award might cure.
Timmie Jean has come to the point where she has outlived a lot of people who mattered. She misses her husband and, oddly enough, she misses Gerow, who, struggling to comprehend a painful divorce and the thousands of lawsuits filed against him, died of a stroke. But Timmie Jean is different from Frank Gerow and all the other people whose dreams and drive reside in the small bags of silicone still nestled in her chest. For better or for worse, she has no passion for either perfection or profit, and immunity that has made her a big player in this narrative, one in which one of the loveliest parts of a woman’s body was turned into a laboratory for the impatient dreams of men and the secret self-hatred of far too many women.
That was even true last November, when she fell, landing on her chest, and her doctor found a small tear in her 33-year-old implant. “Let’s wait and see what happens,” he told her, and Timmie Jean agreed.