IAP A2: summary for assessment


Of the three sisters in my family, middle sister Jane has always been the queen of glamour, so it was no great surprise when she decided in 2007 to have breast implants. I was more surprised to learn at the beginning of 2019 that she was going to have them removed, because until then I was unaware that one of her implants had ruptured during a routine mammogram. Neither had I heard of breast implant illness (BII), nor did I know that Jane’s and other Allergan-brand implants had by then been heavily implicated in 457 global cases of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) and nine patient deaths – figures that soared in the following months to reach 573 cases and 33 deaths by July 2019, when the FDA requested Allergan to recall a number of its breast implant products after establishing that 481 of the cases and 12 of the 13 deaths with identifiable implant brands involved Allergan products.

Neither was I aware how complex and painful it is to have breast implants removed, or how long the recovery period is, both physically and psychologically. All these things I learned only after Jane’s explant, when she asked me to accompany her while she had additional minor reconstructive surgery, in the immediate aftermath of which she would be unable to carry anything and might need some degree of personal care. In June 2019 we travelled together to Birmingham for what turned out to be the first of two reconstructive procedures, with the second taking place in January 2020.


After Jane asked me to accompany her for her reconstructive surgery I joined a Facebook BII group she recommended, which opened my eyes for the first time to all the abovementioned implant-related issues. In terms of photographers, I had the work of several artists in mind as I approached this assignment, most notably Philip Toledo’s Days with My Father, Matt Finn’s Mother, Elina Brotherus’s Annonciation and other projects, and Nigel Shafran’s Dad’s Office along with his other portrayals of the domestic environment. The main thing I took from all these photographers was that I aimed to make images capturing something of the impression and feeling of being alongside Jane as she went through her surgical procedure rather than attempting to document any of the specific clinical details.


On our first trip to the clinic in Birmingham in June 2019 I took a few pictures with no particular intention in mind. The second time I took far more photos with the aim of using them for this assignment. Revisiting Jo Spence’s work in January 2020 just before I set off to meet up with Jane prompted me to make a mental note to include images with the sense of an action taking place rather than just static poses. Together with my experiments with continuous shooting during the exercises for A2 which demonstrated the value of having several similar shots to choose from, this led me to decide that I would shoot all the images for the project using continuous shooting. Since there would likely be movement in the images, I also again decided to use shutter speed priority mode in order to minimise movement blur.

I had no opportunity to review the images I shot for this project before I returned home, so was disappointed to find that despite the fast shutter speeds my decision to use continuous shooting had caused many of the images to lack the sharpness of focus I would have liked them to have. This was especially the case for the pictures of Jane herself, and in some cases the problem was exacerbated by the presence of visible noise, which was a consequence of shooting in some poorly lit locations with only available light and attempting to compensate for this by setting the ISO at a level that in retrospect I can see was higher than advisable. There was no possibility of reshooting, but I learned a valuable lesson for the future, being that it really is a better idea to optimise the settings for each image individually rather than going for the scattergun approach I took here.

On the plus side there were things I was only half aware of at the time I shot the images that turned out better than I expected. The fortuitous scattering of petals in the first image which emphasise the impending vulnerability also suggested by her prone posture. The way the clinic and its clinical waste shed can be seen to represent the two faces of the cosmetic surgery industry – the glossy brochure on the one hand and the mundane reality on the other. And the way that Jane and the painting behind her in the final image evoke Munch’s The Scream, yet the preceding image of evening light on the curtain anchors it into calmness and reflects the fact that this traumatic process is drawing to a close. And I feel the colour palette of warm dark earth tones and greens that runs through the images works to pull them together as a set.

In his feedback my tutor pointed me to a video of Larry Sultan discussing his project Pictures from Home (1983–92), in which Sultan spoke about an issue that I have also encountered in this project with my sister – the feeling that I am in some way betraying a trust as I present her experience in my own images and words, which I know are not the ones she would use herself. This issue is compounded for me by the fact that I have been attempting to offer a candid and non-glamorised account of a subject that has its very origin in Jane’s ongoing long-term project of creating the most glamorous possible version of herself.

In fact, her attitude towards breast implants has changed in the past couple of years, but the glamour dilemma touches other aspects of her personal history and preferences, too. She has for decades worked as an artist’s model, so presenting herself in a glamorous way is second nature to her. She has a highly developed understanding of how to arrange her body and facial expressions to best advantage, and it is as difficult for her not to do this as it would be for me to do it. Although we specifically discussed the fact that I would be looking to make more candid images than the ones that she is used to modelling for, and she fully understood the reasons underlying this, I know for sure (and can sympathise with the fact that) she prefers to be seen at “her best” – and in this sense the images I have made for the series do not “do her justice” and feel – as Larry Sultan expressed it – like something of a betrayal.

My tutor suggested that I go back to the original images to create a new edit that came closer to investigating the emotions and feelings around my sister and her post-breast explant surgery story rather than documenting the literal journey to the clinic. I found this a really helpful suggestion, because I had sensed that I’d focused too closely on documenting the journey itself, but hadn’t been able to pinpoint what the alternative element was. I also now realised that I had been trying to edit the series to fit the brief as closely as possible instead of building the narrative supplied by the images on its own terms.

I now created a new edit from scratch. Nine of the 12 images from the first edit made it through to the second edit, and three new images joined the edit. The first new image is a direct switch of Jane on the train to Birmingham in January 2020 for a similar image from the earlier surgery trip in June 2019.  I had initially rejected the older image because I felt Jane wouldn’t like it, but it hints at an important part of her experience in this story – her fears about the outcome of the surgery and the competence of the surgeon, which meant that she barely slept the night before we travelled to Birmingham and woke up with a migraine. It also illustrates, as my tutor put it, her vulnerability – she is asleep and oblivious as the world rushes by.

The other changes both relate to my now feeling less concerned with the requirements of the brief and more interested in the internal narrative of the series. The reporter on the clinic’s TV screen wears an expression of horror and has her hands cupped close to her breasts in an out-of-control environment. The final new image finds Jane’s surgery-related paraphernalia – the painkillers, antibiotics and dressings – making an incongruous companion to her stylish ankle boots. These changes also reduced the overall problems with noise and insufficiently sharp focus, as these issues occurred mostly with the portrait images.


The first option I explored for presenting the images at assessment was to just send them as prints. I tried out various print settings and found a combination that seemed to work well. Another idea I considered was to incorporate some of the materials I came across while researching the project – FDA press releases, breast implant brochures etc – into my presentation, and for this a book seemed to be an appropriate solution. I created three alternative book drafts – one with minimal accompanying text, which can be viewed here; a second with a strand of text from my research resources running through the book, which can be viewed here; and a third with the text at the end of the book, which can be viewed here.

I soon realised that the version with the strand of text running through the book made it impossible to read the text without feeling that the facing-page image was an illustration of or response to that text, which was not the case and therefore distorted the reading of the images. I was now unsure whether the version with minimal text said that all needed to be said, or whether the text placed the narrative of the images into a broader context, and decided to request my peers’ views via the Critiques forum. The unanimous view from the forum was that the version with minimal text was preferred. One commenter suggested condensing the minimal text still further and placing it all at the front of the book, and also varying the flow of images through the book, and I took both these suggestions on board. The forum comments can be read here.

After making further minor adjustments I had the book printed by Blurb, with the intention of submitting it for assessment. Covid-19 has, however, ruled this out, so instead I have made a short video that shows the physical book and am submitting this alongside the final print pdf and the individual images in a gallery format.