Jeremy Simmons’s documentary film, Explant, produced by World of Wonder, exposes the horrors of the breast implant industry alongside RuPaul’s Drag Race judge Michelle Visage.
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Watching Jeremy Simmons’s Explant feels more like sitting through a spine-curling body horror film than a facts-based documentary. It’s one of several recent documentaries that explores how medical science repeatedly disregards women’s health and bodies, from The Dilemma of Desire to Unrest. It’s a subject that both fascinates and horrifies me. Explant succeeded in doing both.
Explant is a deep dive into the breast implant industry, particularly in the US, and how it is harming women. Our “way in” to this topic is Michelle Visage, who is most well known as a judge on RuPaul’s Drag Race (Explant was produced by World of Wonder, the company behind Drag Race). Before we learn about the bigger picture, we’re introduced to Visage’s personal struggle with “Breast Implant Illness”. Visage’s implants are no secret: early in the film, her teenage daughter sarcastically remarks, “Your entire brand is built off your boobs.” Visage regularly playfully comments on them on Drag Race, and even occasionally bares them for all to see.
Despite her pride in her breasts, they’ve been making her very sick. Since getting her implants decades ago, Visage has experienced chronic pain, often leaving her drained of energy and bedridden. Doctors have repeatedly insisted that there’s nothing wrong with her, that implants are 100% safe, and that her symptoms are psychosomatic. Then, Visage found a community of women online describing the exact same symptoms as a result of their own implants, none of whom were believed by their doctors either. They describe “explanting” (having implants surgically removed) as a miraculous transformation wherein their symptoms gradually disappeared, or for some women, disappeared overnight. Explant follows Visage through her own explanting journey, as she discusses her decision to undergo the surgery and physically prepares for it.
Using Visage’s story as a jumping off point, Simmons peels back the many layers of cover-ups and decades-long medical negligence that lead to Breast Implant Illness. It’s horrifying to behold. Simmons takes us back to 1961, when the first silicone breast implants were developed by plastic surgeons Frank Gerow and Thomas Cronin. Simmons straight away establishes that America’s capitalistic healthcare system was a key factor in the poor development of breast implants. We’re told that Gerow, who was born in Canada, moved to the US because he had capitalist ambitions and wanted to work under a healthcare system he could profit off of (aka not a free one). Therein lies the problem: the development, and later, the distribution of breast implants has always prioritised profit over the wellbeing of the women who get them.
Explant uncovers how the money-driven US healthcare system and good old-fashioned misogyny work together to the great detriment of women’s health. Very early on in trials for silicone breast implants, there were signs that silicone was sometimes leaking out of the implant and into the body, causing serious health consequences. Still, the manufacturers continued production, through some combination of greed and a disregard for women’s health.
There’s a stomach-churning story (accompanied by images) later on in Explant that details a Texas doctor’s wildly unsafe attempts to create larger breasts than even average implants could achieve. He intentionally causes an allergic reaction in the women’s breasts so that they will swell up with liquid, which has to be repeatedly syringed out so the breasts don’t reach breaking point. It’s an extreme example, but this anecdote portrays an outlook we see throughout the entire film: it’s worth it to put women through intense pain, and sometimes irreparable physical damage, in order to shape their body to fit patriarchal ideals.
Simmons and his subjects draw attention to how easily history repeats itself by detailing how the disappearance of silicone implants was swiftly followed by the appearance of saline ones. As a result of lawsuits, the silicone variety was temporarily banned, so manufacturers produced a new type of implant, which had a silicone shell but was filled with saline. One of the most shocking parts of Explant is an interview with a biochemist who worked on the production of the saline implant. He details his experiments which revealed how the implants still left women vulnerable to dangerous silicone leakage, and how those discoveries were dismissed in favour of sending the product to market quickly. The manufacturers simply didn’t care. They even commissioned a study to prove the safety of the implants, which was poorly researched and biased. But it was enough to be perceived as consensus and perpetuated amongst plastic surgeons.
There are parts of Explant that will hit hard with audiences who have just lived through over a year of the SARS-CoV-2 pandemic. When a plastic surgeon justifies his support of the implant industry by holding up an implant and waxing poetic about how safe it “looks”, I couldn’t help but groan. It sounds so much like things I’ve heard this past year, such as when everyone was prematurely returning to public, indoor spaces to socialise and talking about how safe it “feels”. (Newsflash: “look” and “feel” are not the same as “is”.)
There’s also the way that science communication from the establishment differs from, and is sometimes less helpful than, science communication online. “Breast Implant Illness” had to be coined by online communities. Their alternative system of virtual information sharing was necessary because their condition wasn’t recognised by medical authorities, who have to worry about profit and saving face, and are riddled by medical misogyny. It reminded me of how I’ve gotten much better pandemic-survival advice from science communicators on Twitter than I have from my government in the UK, because the former aren’t likely to sugar-coat the facts in a bid for political clout and self-preservation.
This overall informative, infuriating, and comprehensive documentary is let down only by a few glaring missing pieces. For a film so smart about male privilege, it’s disappointing that Explant completely overlooks other forms of privilege, such as class privilege. The cynical part of me wonders if this is because Visage is portrayed as a triumphant, heroic figure in her explant journey, and acknowledging her privilege might detract from that. There are no women of colour with breast implants interviewed in the film. Nor is there a discussion of the class privilege needed to explant: very few doctors in the US perform the procedure, so the cost must be quite large. What happens if you’re suffering but you don’t have the money to explant? What if you’re a trans woman, and explanting would cause you significant gender dysphoria? The existence of trans women is never once acknowledged in the film. It’s disappointing. But hopefully, this eye-opening film prompts some more inclusive studies of Breast Implant Illness and explanting.
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