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‘We can get you to the beach the next day’: Breast implant marketing plays on insecurities, minimizes risks

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  • This investigation is part of a global media collaboration with CBC News, Radio-Canada,Toronto Star and the Washington-based International Consortium of Investigative Journalists that examined tens of thousands of medical devices and how they’re made, approved and monitored by regulators worldwide.
  • Learn more about your medical device by searching the CBC News database of Health Canada records.

The ailments listed on Nikki Carruthers’s medical chart read as follows: blackouts, memory loss, fainting, vomiting, thyroid problems, angina, hypertension, heart palpitations, high-blood pressure, migraines, chest pain, ulcers, depression, anxiety and exhaustion that keeps her in bed for at least 18 hours a day.

Carruthers, 29, had barely seen the inside of a doctor’s office until 2013, when she decided to get breast implants. The cascading health issues that followed have triggered dozens of hospital and doctor visits.

“My entire body was shutting down,” said the Winnipeg woman, who has been unable to work since July. “My throat is burning and [it] hurts to swallow. It feels like someone is sitting on my chest when I try to breathe.”

The promotional machine driving the $1-billion global breast implant industry runs on tastefully lit, aspirational images of perfect bodies, glowing testimonials and inspirations from celebrities — but in many cases provides little mention of the potential risks, a Toronto Star/CBC Marketplace investigation, in partnership with the International Consortium of Investigative Journalists, has found.

Breast augmentation is the most popular cosmetic surgery in the world, with 10 million women opting for breast implants during the past decade. Most have not reported adverse health issues, and some studies point to high satisfaction rates. Manufacturers stress that there have been many studies over the years that have demonstrated that their products are safe.

A Marketplace producer, posing as a patient who wanted breast implants, visited three Toronto plastic surgeons with a hidden camera to learn how they explain and market the procedure. (CBC)

But Carruthers is among the increasing number of women across Canada who have suffered health complications they believe are associated with their breast implants. They also believe they were misled by surgeons who reassured them that the health concerns of the 1990s were addressed more than a decade ago.

There remains no cause-and-effect directly linking implants with some of the symptoms described, but research has linked textured implants to a rare cancer known as breast implant-associated anaplastic large cell lymphoma, or BIA-ALCL.

Since Monday, the ICIJ has heard from more than 540 women responding to an online callout for responses to the global series of stories on breast implant health issues. Among the 45 Canadians who responded are women complaining of infections, hair loss, body inflammation, muscle weakness, trouble breathing, neurological issues, suicidal thoughts and implant rupture.

The promotion of implants

A review of 25 websites belonging to plastic surgeons in the Toronto area show plenty of alluring images but little detail on the adverse outcomes associated with breast augmentation.

Undercover visits to three Toronto plastic surgeons by a CBC Marketplace producer — who posed as a prospective patient — revealed sales techniques, some of which a leading medical ethicist called “very problematic.”

At age 23, unhappy with her body image, Carruthers came up with $6,300 — financed through a line of credit — for breast augmentation.

It seemed safe and easy. She said she was told little about the medical risks beyond the standard warnings associated with any surgery.

“It was made to seem like getting a haircut,” she said. “He told me there were only very minor cosmetic risks which he would fix in a touch-up procedure should something go wrong.”

Nikki Carruthers explains why she initially decided to get breast implants:

Nikki Carruthers explains why she decided to get breast implants 0:55

The message on the plastic surgery websites she visited were full of promises of confidence and perfection.

Any excitement about her new body was soon undermined by health problems, said Carruthers, who had the implant surgery in 2013.

Just over a year later, she had a second surgery to relieve severe pain in her chest. The implants had bottomed out and dropped too low on her chest.

While informed consent for each separate medical procedure is not actively enforced by the province or a provincial physician watchdog, it is a principle intended to ensure that patients are fully aware of the potential outcomes.

There is no standard script plastic surgeons use to inform patients of the risks. Each physician has their own approach.

‘You do need to understand’

When the Marketplace producer asked about recovery time at the three clinics she visited, the answers ranged from 24 hours to six weeks.

“We can get you out to dinner the night after surgery, we can get you to the beach the next day,” said Dr. Mahmood Kara.

When asked to explain the specific technique, Kara replied: “You don’t have to understand, just need to know that I can deliver, and I’ve done it on thousands of patients.”

University of Toronto bioethicist Kerry Bowman says that response fails to provide the understanding necessary for the patient to have informed consent.

“That would worry me, because you do need to understand,” said Bowman. “Ethically and legally … you have to have a capable patient and she needs to fully understand and appreciate all of the risks.”

University of Toronto bioethicist Kerry Bowman says it’s very important for patients to understand all the risks of any surgery, including something cosmetic, like breast augmentation. (Dave Macintosh/CBC)

The presentation of medical risks associated with breast implants are also of concern.

During the consultation, Kara outlines what he called the common risks of the surgery, such as bleeding, infection and internal scarring around the implant, known as capsular contracture.

But on his website, Kara calls it a “myth” that implants leak into the body if they are ruptured.

Dr. Jan Willem Cohen Tervaert, director of the rheumatology at the University of Alberta’s medical school and a co-author of several studies detailing connections between breast implants and autoimmune illnesses, says that advice is challenged by research.

“There are plenty publications demonstrating leaking of silicone with new implants,” he said.

In a list outlining the risks of implants, the U.S. Food and Drug Administration also notes silicone gel from ruptured devices can migrate away from the breast.

Kara declined repeated interview requests.

Consent forms can be hard to get

At the clinic of plastic surgeon Dr. Martin Jugenburg — known as Dr. 6ix on his website — the journalist asked for a copy of the consent form that describes the procedures, surgical risks and post-op instructions that she would have to sign before making the decision and providing a $2,000 deposit to book the surgery.

“I don’t think I’m allowed to do that for some reason,” said a clinic nurse, though she later provided the consent form.

“I’m amazed that there’s so much pushback on getting the consent forms,” Bowman said after reviewing Marketplace’s hidden-camera footage. “I think asking to pay in advance is very problematic from an ethical point of view.”

More than 10 million women worldwide have received breast implants over the last decades. But some patients have since had the devices removed, saying they have suffered health complications they believe are associated with their breast implants. (CBC)

In a written response, Jugenburg said his clinic does not require patients to pay in order to view or receive consent forms.

“This was not clear during your researcher’s visit, and as a result of your feedback, I made sure in the future there will be no confusion.”

At a third Toronto clinic visited by Marketplace, Dr. Sean Rice spent time describing the implant surgery itself. His nurse provided a lengthy consent form and told the producer she would need to take it home and read it, and then contact the clinic if she had questions or concerns.

Dr. Sean Rice spent time describing the implant surgery itself. (doctorseanrice.com)

In an email to Marketplace, Rice said, “I want to ensure all patients fully understand risks associated with their surgical procedure. I offer an opportunity to discuss the consent form after review to allow any followup questions before surgery. Patients deserve time to evaluate and question a consent from before endorsing.”

Bowman believes time for patients to reflect on the decision they are making is crucial, though there is no prescribed period outlined in college guidelines to physicians.

The Marketplace producer was offered a range of available surgery dates at the three clinics visited: 24 hours after the consultation, four days later, and a few weeks later.

Before-and-after photos

The overwhelming majority of plastic surgeons’ websites contain testimonials and “before-and-after” images that appear to breach provincial legislation and the policies of the Ontario College of Physicians and Surgeons.

“Where we have been alerted to the use of before-and-after photos in the past, we have held that they constitute testimonials in contravention of the regulation,” said college spokesperson Shae Greenfield, noting the regulator has penalized physicians for doing this.

Last year, the college cautioned Kara for using before-and-after photos in a magazine advertisement.

“Given his repeated breaches of advertising policy and regulation, the [college complaints’] committee was not satisfied that he would change his behaviour without further guidance,” the decision reads.

‘We can get you out to dinner the night after surgery,’ Dr. Mahmood Kara told a Marketplace journalist posing as a potential client interested in breast augmentation. (drkaraplasticsurgery.com)

But prominently featured on his website today are more than 260 before-and-after photos of plastic surgery procedures.

Jugenburg is currently facing a disciplinary hearing before the college, which alleges he committed professional misconduct for advertising methods, including permitting a film crew into a surgical procedure without the patient’s consent, making “improper” use of her images and posting “pre- and post-operative images of her on his social media accounts without her consent,” along with “pressuring her to follow and contribute to his social media accounts.”

In a written response, Jugenburg said the allegations are “denied and being defended.”

The use of before-and-after photos is “widespread” in medicine, he wrote, and the images provide “pertinent information to the public, as patients increasingly perform their own research on the internet, demand more transparency … and more self-directed decision-making ability.”

Dr. Martin Jugenburg — known as Dr. 6ix, an allusion to The Six, a popular nickname for Toronto. (torontosurgery.com)Jugenburg’s website currently has more than 250 before-and-after images for a variety of plastic surgery procedures.

Some plastic surgeons shun the practice of posting before-and-after images.

Toronto plastic surgeon Dr. Leila Kasrai explains on her website why she does doesn’t: “Due to the advertising regulations of the College of Physicians and Surgeons of Ontario imposed on all doctors in Ontario, we cannot display photos and testimonials of our patients.”

Opting for an explant

Worsening symptoms eventually led Nikki Carruthers to undergo a third breast surgery last September: This time to have her implants removed although she never received a clear diagnosis that attributed her symptoms to the implants.

When they came out, a discovery: The right implant had ruptured and both implants showed capsular contracture, according to an analysis of the removed implants by Pierre Blais, a former Health Canada senior advisor and chemist who now runs an Ottawa company that tests the devices.

“This type of rupture is common and indicates … material fatigue,” his report reads. “It is not the outcome of trauma or accidental … damage.”

Chemist Pierre Blais analyzed Nikki Carruthers’ implants for CBC’s Marketplace. (Dave Macintosh/CBC)

In an interview, Blais said Carruthers’ right implant rupture, which “broke into four parts,” is hardly unique.

“When you look at the instructions for use for a product like this … it says a rupture may happen,” said Blais. “It’s not really right. They should say a rupture will happen — it depends how long you have it.”

Carruthers said Blais’s findings were a vindication. “My instincts were correct. I was not going insane.”

Since her explant, Carruthers said a liver tumour has shrunk. But she has yet to return to work due to pain and fatigue, cognitive impairment, tremors and autoimmune symptoms.

“I can only imagine how many women are out there right now … having no idea what’s wrong, feeling hopeless and crazy,” she said. “The whole thing makes me sick to my stomach every time I think about it.”

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Bill Gates: Third Shot May Be Needed to Combat Coronavirus Variants

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With more than 40 million Americans having received at least the first dose of the Pfizer or Moderna vaccine, a third dose may be needed to prevent the spread of new variants of the disease, Bill Gates told CBS News Tuesday.

Gates’ comments come amid growing concern that the current vaccines are not effective against the more contagious Brazilian and South African variants.

Pfizer and Moderna have stated that their vaccines are 95% and 99% effective, respectively, against the initial strain of COVID. However, some scientists have questioned those statements. Additionally, the World Health Organization and vaccine companies have conceded that the vaccines do not prevent people from being infected with COVID or from transmitting it, but are only effective at reducing symptoms.

Gates told CBS Evening News:

“The discussion now is do we just need to get a super high coverage of the current vaccine, or do we need a third dose that’s just the same, or do we need a modified vaccine?”

U.S. vaccine companies are looking at making modifications, which Gates refers to as “tuning.”

People who have had two shots may need to get a third shot and people who have not yet been vaccinated would need the modified vaccine, explained Gates. When asked whether the coronavirus vaccine would be similar to the flu vaccine, which requires yearly boosters, Gates couldn’t rule that out. Until the virus is eradicated from all humans, Gates said, additional shots may be needed in the future.

AstraZeneca in particular has a challenge with the variant,” Gates explained. “And the other two, Johnson & Johnson and Novavax, are slightly less effective, but still effective enough that we absolutely should get them out as fast as we can while we study this idea of tuning the vaccine.”

The Bill & Melinda Gates Foundation is funding the studies being conducted in Brazil and South Africa, CBS News said. The foundation has also invested in the AstraZeneca, Johnson & Johnson and the Novavax vaccines, which are being tested against new variants. Once the AstraZeneca vaccine is approved, the Global Alliance for Vaccine Initiative or GAVI, founded by Gates, will distribute it globally.

“Gates continues to move the goalposts,” said Robert F. Kennedy, Jr., chairman and chief legal counsel of Children’s Health Defense. “Meanwhile the strategies he and others have promoted are obliterating the global economy, demolishing the middle class, making the rich richer and censoring vaccine safety advocates, like me.”

Kennedy said that the exclusive focus on vaccines has prevented the kind of progress required to actually address and recover from the pandemic:

“From the pandemic’s outset, clear-headed people familiar with the challenges inherent in the vaccine model have understood that the path out of crisis would require multiple steps. Those steps would need to include the development and/or identification of therapeutic drugs, the sharing of information among doctors to hone improved treatment models that reduce infection mortality rates below those for flu, and the kind of broad-spectrum long-term herd immunity that protects against mutant strains and that only derives from natural infection.”

Instead, Gates and vaccine makers are proposing a lifetime of boosters, supporting insufficient testing to determine safety and failing to address the inadequate monitoring of vaccine injuries, Kennedy said.

The views and opinions expressed in this article are those of the authors and do not necessarily reflect the views of Children’s Health Defense.

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Young nurse suffers from hemorrhage and brain swelling after second dose of Pfizer’s COVID-19 vaccine

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(Natural News) A 28-year-old healthcare worker from the Swedish American Hospital, in Beloit, Wisconsin was recently admitted to the ICU just five days after receiving a second dose of Pfizer’s experimental mRNA vaccine. The previously healthy young woman was pronounced brain dead after cerebral angiography confirmed a severe hemorrhage stroke in her brain stem.

Her family members confirmed that she was “breaking out in rashes” after the vaccine. She also suffered from sudden migraine headaches, and got “sick” after taking the second dose of the vaccine. At the very end, she lost the ability to speak and went unconscious. The migraines, nausea, and loss of speech were all symptoms of a brain bleed and brain swelling, something her family did not understand at the time, and something nobody would expect after vaccination.

While on life support, neurologists used angiography to image the damage inside the brain. They found a subarachnoid hemorrhage, whereas a bulging blood vessel burst in the brain, bleeding out in the space between the brain and the tissue covering the brain. The ensuing swelling cut off oxygen to the brain and caused brain death. On February 10, 2021, Sarah reportedly had “no brain activity.” Some of the woman’s organs are now being procured, so they can be donated to other people around the world.

Doctors warn FDA about COVID vaccines causing autoimmune attacks in the heart and brain

Experimental COVID-19 vaccines may cause inflammation along the cardiovascular system, leading to heart attack and/or stroke. This serious issue was brought forth to the Food and Drug Administration (FDA) by Dr. J. Patrick Whelan, M.D., Ph.D. and further confirmed by cardiothoracic surgeon, Dr. Hooman Noorchashm, M.D., Ph.D. The two doctors warned that a recently-infected patient who is subject to COVID-19 vaccination is likely to suffer from autoimmune attacks along the ACE-2 receptors present in the heart, and in the microvasculature of the brain, liver and kidney. If viral antigens are present in the tissues of recipients at the time of vaccination, the vaccine-augmented immune response will turn the immune system against those tissues, causing inflammation that can lead to blood clot formation.

This severe adverse event is likely cause of death for the elderly who are vaccinated despite recently being infected. There is no adequate screening process to ensure that this autoimmune attack doesn’t occur. The elderly are not the only people vulnerable to vaccine injury and death. Pfizer’s experimental COVID-19 vaccine could be the main cause behind the sudden death of Sarah Sickles, a 28-year-old nurse from Wisconsin. The Vaccine Adverse Events Reporting System has captured five permanent disabilities in Wisconsin, 58 ER visits, and eleven deaths in just one month. This is the first case in Wisconsin of someone under 44 years of age suffering from severe COVID-19 vaccine side effects and death. There are now more than 1,170 deaths recorded in the U.S. related to the experimental mRNA vaccines, a reality that the FDA and CDC continue to ignore.

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Powering hypersonic weapons: US armed forces eyeing dangerous 5G tech

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(Natural News) Much of the conversation surrounding the benefits of 5G is geared toward the consumer side of the technology. People will be able to download videos at lightning speed and will be more connected than ever, proponents claim, although there are serious questions regarding its safety. However, some of the most important 5G applications are not civil at all – the technology will be used extensively in the military domain.

Some of its military uses are outlined in the Defense Applications of 5G Network Technology report, which was published by the Defense Science Board. This federal committee gives scientific advice to the Pentagon. Their report states: “The emergence of 5G technology, now commercially available, offers the Department of Defense the opportunity to take advantage, at minimal cost, of the benefits of this system for its own operational requirements.”

The 5G commercial network that is being built by private companies right now can be used by the American military for a much lower cost than if the network had been set up exclusively for military purposes.

Military experts expect the 5G system to play a pivotal role in using hypersonic weapons. For example, it can be used for new missiles that bear nuclear warheads and travel at speeds superior to Mach 5. These hypersonic weapons, which travel at five times the speed of sound and move a mile per second, will be flying at high altitudes on unpredictable flight paths, making them as hard to guide as they will be to intercept.

Huge quantities of data need to be gathered and transmitted in a very short period in order to maneuver these warheads on variable trajectories and allow them to change direction in milliseconds to avoid interceptor missiles.

5G for defense

This type of technology is also needed to activate defenses should we be attacked by a weapon of this type; 5G automatic systems could theoretically handle decisions that humans won’t have enough time to make on their own. Military bases and even cities will have less than a minute to react to incoming hypersonic missiles, and 5G will make it easier to process real time data on trajectories for decision-making.

There are also important uses of this technology in combat. 5G’s ability to simultaneously link millions of transceivers will undoubtedly facilitate communication among military personnel and allow them to transmit photos, maps and other vital information about operations in progress at dizzying speeds to improve situational awareness.

The military can also take advantage of the high-frequency and short-wavelength millimeter wave spectrum used by 5G. Its short range means that it is well suited for smart military bases and command posts because the signal will not propagate too far, making it less likely that enemies will be able to detect it.

When it comes to special forces and secret services, the benefits of 5G are numerous. Its speed and connectivity will allow espionage systems to reach unprecedented levels of efficiency. It will also make drones more dangerous by allowing them to identify and target people using facial recognition and other methods.

Like all technology, 5G will also make us highly vulnerable. The network itself could become an attractive target for cyber-attacks and other acts of war being carried out with cutting-edge weaponry. In fact, the 5G network is already viewed as critical infrastructure and is being carefully protected before it is even fully built.

While the focus on 5G’s dangers to human health and the environment is absolutely warranted, it is also important not to lose sight of the military implications of 5G. After all, it is not just the United States that is developing this technology for military purposes; our enemies, like China and other countries, are also making great strides in this realm.

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