London, United Kingdom – Around 40,000 women in Britain are living in fear right now. These women are living in fear that their breasts are going to burst, leaking industrial-grade silicone into their bodies. For some, it has already happened, leaving them suffering intense physical and emotional pain. These women are the devastated victims of a global health scare: the PIP breast implant scandal.

This global health scare started in Marseille, France, at the headquarters of Poly Implant Prothese (PIP), a worldwide supplier of breast implants. PIP was shut down in March 2010, after an investigation instigated by French surgeons, who noticed PIP implants were rupturing in patients. The discovery that followed is incomprehensible. The gel pumped into the implants was not medical-grade silicone. The PIP implants, manufactured and distributed on a global scale, that had and were going to be inserted into thousands of women, were full of industrial-grade silicone, intended for use in mattresses.

France makes arrest in breast-implant scandal

As this horror story continues to develop, there is another issue dangerously detracting attention away from the real scandal. The argument: “Why would a woman want to change her breasts?” is overriding the atrocity of “Why did 300,000 women over a 10-year period have industrial silicone implanted into their bodies?” The latter is what needs immediate investigation and accountability, not women’s rights and choices questioned, as if they are incapable of making their own carefully considered decisions.

Following the developments of the PIP catastrophe, I have heard, read and been driven to despair by those that judge, patronise and condemn women who exercise their right to do exactly as they wish to their body. We should hang our heads in shame that the UK has become a contemptuous society, lazily stereotyping the choice and right of body modification as vulgar vanity.

Instead of respecting and accepting the choices of women who are not oppressed by patriarchal pressure, their decisions are flippantly dismissed as those of “lipstick feminists”. Here are a couple of illustrative examples from this week:

“I’ve never understood why women have them. Big boobs may be sexier, but small boobs are cuter, and since cute trumps sexy approx 55.76 per cent of time, it’s kind of daft to have them!” “Women with average breasts might have to earn their own living.” “Miss X is representative of the vain, vacuous airheads that had these implants fitted in the first place.” “Most of the women who have cosmetic surgery have it done to attract the attention of men. Problem is that most of us prefer natural looking women.” “I agree. Also, are silicone breasts really that pleasing to men when it comes to the real thing? As far as my brief experience is concerned, the moment you can tell it is fake either from look or touch, it is a major turn off!”

It may be hard for some to comprehend, but if a woman decides to change her breasts she is not a vain, plastic bimbo that made her choice in order to help propel her to the dizzy heights of the top shelf of her local newsagents. Nor does she make her decision in order to please a man; she makes her decision to please herself. Many women have issues with their breasts, which are causing them anguish and unhappiness, and feel surgery is an appropriate solution to combat these feelings. And, of course, there is the issue of reconstructive surgery – which is a separate, sensitive topic and completely different from this discussion of choice and free will.

Sarah is a 45-year-old artist from London who had PIP implants 10 years ago. She is in constant pain because of a lumpy mass in her left breast, and has had blood leaking from her left nipple through her milk ducts. Sarah explained that after having breastfed her two children, her breasts went from a 34B to a 34AA. She said: “I always had small breasts and accepted them, but after breastfeeding all of my breast tissue had disappeared and I was literally left with two loose pieces of skin. It was awful, I just hated my body, it affected my whole life, I was so depressed and had no confidence. The implants restored my breasts to my original size of 34B. It was a private, personal decision and I didn’t even tell my children.”

Sarah told me about the widespread misconception and criticism women that have breast surgery are faced with. “Educated, intelligent women have surgery, but you wouldn’t believe it from the way we are judged. I shouldn’t have to defend my decision, but I do. Cosmetic surgery is always associated with glamour, modelling and not associated with restoring one’s body after childbirth. I’ve even had to justify why I had paid for my operation in full, rather than depending on finance, which seems to another sloppy stereotype directed at those who choose to have surgery.”

Sarah is one of many women who’ve joined the Ruptured Breast Implants Awareness (PIP) group on Facebook. She and others marched in Parliament Square last weekend, protesting over the government’s lack of compassion towards PIP patients and lack of regulation in the cosmetic surgery industry. The group is also petitioning to change the current legislation in relation to the regulation of prostheses in the UK.

When I asked Sarah how the march went and what the response was, she explains that, as the group marched from Parliament Square to Downing Street, they were met with disapproval and tutting from other women watching. “I just don’t understand women sometimes,” she said.

“Here we are joining together and supporting each other, yet getting judged and condemned for the choices and decision we have the right to make. Maybe I’m naive, but I really did believe women were all in it together.”

What is health?

According to the World Health Organisation, the definition of health is: “A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

With that definition in mind, why then are we as a society begrudging how individuals choose to achieve their personal “state of complete physical, mental and social well-being”? A woman’s decision to change her body, for whatever reasons she chooses and desires, is absolutely a feminist issue. If someone has negative feelings towards their body and low levels of self-esteem, more power to them if they choose to end that destructive cycle. It is no one else’s concern whether that’s through diet, exercise or surgery; or whether it’s breasts, bottom, stomach, legs – whatever matters to you, matters the most.

The cries of “Oh, don’t worry about it, it doesn’t matter” and “It’s vain to change your appearance, there are more important things to worry about in life” just doesn’t hold any resonance. Should someone sob into their pillow over the way they feel about their body, but just “deal with it” and “get on with it” because society thinks it’s shallow and vacuous to invest in self-investment?

What about exercise? That’s self-investment – putting time and effort into how you feel and look – and releases endorphins, the same chemicals you get during sex (or while eating a huge slab of chocolate). What about makeup, moisturiser, colouring your hair, painting your nails? They can all be classified as self-investment. Are you shallow and vacuous if you choose to indulge in these?

What about body art? Tattoos, piercings – they can be defined as body modification. It’s the same principle, but with hypocritical differences. A woman who has her belly button pierced would receive none of the condemnation or judgment that a woman who chooses to change her breasts would. There is also this assumption that choosing to have breast surgery must mean desperation for a Katie Price-esque physique. That is absolutely not the case, says Fazel Fatah, President of the British Association of Aesthetic Plastic Surgeons. Choosing to have implants does not necessarily mean that a woman wants to be a glamour model. Fatah explained:

Women of all ages at different stages in their life choose to have breast implants for many different reasons. Patients are counselled before and after surgery to make sure they are confident in the decision they are making. We are, in the vast majority of cases, treating a psychological condition where the patient has a distorted body image. It’s important to understand that surgery is a last resort for these patients, they have thought about it carefully for years and a reputable surgeon will not operate unless they are confident the patient understands the outcome and potential risks.

Catherine, a 39-year-old woman from Dartford, tells me women experiencing pain from their implants leaking and rupturing can be made to feel like “it’s our fault for wanting to have it done in the first place”. Catherine, like Sarah, decided to have PIP implants eight years ago. She explains she made an informed and personal choice after becoming very self-conscious about the reduction in shape and size of her breasts after her two children were born.

She is now experiencing a constant burning feeling under her left armpit, has lumps in her left breast and developed a very low immune system. A recent scan confirmed her left implant had indeed ruptured, and Catherine has fought a long battle to have her implants taken out and replaced. She says she initially felt fantastic after having the implants done, but now deeply regrets her decision. “I did not sign on the dotted line to have industrial silicone implanted into my body. I was sold – and signed on the dotted line for – medical-grade silicone. I have my own business and I’m petrified about the long-term health consequences of PIP. The worst thing is no one knows what’s going to happen as this has never happened before. There is no evidence. We are the evidence.”

As the PIP victims are left wondering and waiting what the latest medical reports will mean for their health and future, this murky moral questioning of women’s rights and choices must immediately end, and clear analysis and accountability of this horror story immediately begin.

Siobhan Courtney is a British freelance broadcast journalist and writer. She is a former BBC World News presenter and BBC News journalist who has reported and written for BBC Newsnight.