James Le Fanu

‘For every problem there is a solution: neat, plausible and wrong’. H.L.Mencken

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Why do women have such large breasts?

BIG BREASTS have been in the news a lot over the past month. First there was the “whiplash" case, when a 38-year-old physical therapist, Paul Shimkonis, claimed to have suffered a whiplash injury after a blow to his head from the size 69HH breast belonging to a stripper, Miss Tawny Peaks (not, apparently, her real name).

Mr Shimkonis’ allegations that Miss Peaks’ breasts were like “two cement blocks” was dismissed, following an examination by a female official of the court who found them to be “soft”.

Next, the United States company Dow Corling has agreed to a court ruling requiring it to pay sums of up to $250,000 to 170,000 women allegedly suffering long-term chronic illness from its silicone breast implants. The company denies liability, but the $3.2bn “compensation” deal is the price it has to pay to avoid bankruptcy from continued litigation.

Most recently, an independent inquiry in Britain (the third) has found these alleged health hazards of breast implants to be unfounded. “The suggested link with any significant disease does not stand up to scientific scrutiny,” according to the inquiry’s chairman, Roger Sturrock, Professor of Rheumatology at Glasgow University.

It is certainly a topsy-turvy world when people can voluntarily submit themselves to major surgery solely for aesthetic reasons, and then be rewarded with large sums of money for problems (real or imaginary) that are, it would seem, unrelated to the original operation.

In their different ways, both the case of Miss Peaks and the silicone implant controversy touch on one of the profoundest of all the mysteries of human biology: why do women have prominent breasts in the first place?

The shape of the human breast is quite unique in the first order of mammals, the primates, to which we belong. Among “our cousins”, the monkeys and the great apes, the breast of the female enlarges only slightly, even during pregnancy and lactation, and in the non-pregnant state remains almost completely flat, with merely the nipple projecting.

There is, needless to say, no satisfactory explanation for the astonishing discrepancy in breast size between other primates and ourselves. Dr Ashley Montague, an American physician, has suggested that it may act as a compensatory mechanism for the greater vulnerability to the cold of early humans (especially at night), due to their loss of hairiness.

“In most non-literate societies, fat women will be preferred to thin ones,” he writes. “Love in a cold climate is considerably assisted by central heating, and the forerunners of central heating in prehistoric times were fat ladies. Fat ladies have large breasts and this would have contributed to their increased size.”

The whimsicality of such Darwinian explanations only underlines the difficulty of explaining the unique human physical characteristics – such as breast size – in evolutionary terms.

And so, in the absence of any obvious functional purpose for the greater protuberance of the human breast, it is probably safe to infer that its shape is simply a defining characteristic of what it means to be human and female, and attractive to men.

It is thus entirely predictable that the flat-chested should seek the surgeons’ help in “breast augmentation”; and that, despite all the scares and litigation, they continue to do so and are very pleased with the results, with more than 90 per cent claiming “complete satisfaction”. There is, none the less, a very important warning in the litigation over silicone breast implants. It illustrates the collapse of standards of middle-class professional life. This certainly applies to the litigant lawyers, whose greed, venality, subterfuge, harassment of critical witnesses and complete disregard for the truth in pursuit of the big payout (and their own handsome cut) have been brilliantly documented by the executive editor of the New England Journal of Medicine, Marcia Angell, in her recent book, Science on Trial.

But it also applies to doctors – or, at least, to some doctors. The evidence that breast implants cause long-term serious illness is nugatory, but the procedure of placing a foreign object into the breast has to be done properly, and for the right reasons.

It is quite clear that even in Britain this does not always happen. An undercover survey of private clinics by Which? magazine last October revealed that high-pressure sales techniques were being used to cajole women into having the operation. And if the operation is botched (or, indeed, was unnecessary in the first place), then it is hardly surprising that some women should seek compensation on any grounds.

There are a lot of “cowboys” out there, and anyone contemplating surgery should, as a preliminary step, send a large sae for a list of reputable practitioners to: The British Association of Aesthetic Plastic Surgeons, Royal College of Surgeons, 35 Lincoln’s Inn Fields, London WC2A 3PN.

Copyright: Telegraph Group Ltd