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by Jaime Ahmed, staff writer

Breast augmentation has become the most common plastic surgery procedure in the United States. According to the American Society of Plastic Surgeons (ASPS), 329,396 breast augmentations were performed in 2006, an increase of 55 percent since 2000 and more than 300 percent since the past decade.

According to medicinenet.com, augmentation of the breast is the insertion of a silicone bag (prosthesis) under the breast (sub-mammary) or under the breast and chest muscle (sub-pectoral). Once inserted, the bag is filled with saline (salt water) or, since the 2006 FDA approval, silicone gel. The prosthesis expands the breast area to give a fuller breast (increased cup size), provide better contour, and enhance cleavage.

This year, breast augmentations have already increased 13 percent over last year, and silicone gel-filled implants have increased 18 percent.

Reasons why women may consider this procedure:

-They may have had breasts that have never matured.
-They may have lost breast volume from weight loss
-They may have had part of a breast removed due to cancer.
-They may lack self-esteem, or confidence.

The last motive is troubling. Plastic surgery might not be the answer for women with emotional problems such as low self-esteem, depression, and lack of confidence. In fact plastic surgery may sometimes worsen the problem and may lead to suicide. In the American Journal of Psychiatry July 2007, an article by Drs. David B. Sarwer Gregory Brown, and Dwight Evans called “Cosmetic Breast Augmentation and Suicide” stated that the suicide rate of women who received cosmetic breast implants is approximately twice the expected rate, based on estimates of the general population. This suggests that plastic surgery may not be the answer to all one’s problems.

The article lists some possible correlations between cosmetic breast implants and suicide and examines the role of preoperative personality characteristics and psychopathology, motivations and expectations for surgery, and the impact of postoperative complications.

Illustration by Jaime AhmedThe stereotypical breast augmentation patient is believed to be a single Caucasian woman in her early to mid-20s who is interested in the surgery as a way to facilitate the development of a romantic relationship.

Researchers from the National Cancer Institute reviewed the medical records of 13,488 women who received breast implants for cosmetic purposes. These reviews suggest a different profile. The typical patient is most often Caucasian, but she differs from this stereotype by being in her late 20s or early 30s, married, with children. Furthermore, the range of patients included women from their late teens to mid-40s of varying ethnic backgrounds and relationship status. And several epidemiological studies found that women age 40 and older who undergo breast augmentation appear to be at increased risk of suicide.

Studies in the American Journal of Psychiatry found that women who receive breast implants differ from other women in a variety of unique characteristics. Women who receive breast implants are more likely to have had more sexual partners, report a greater use of oral contraceptives, are younger at their first pregnancy, and have a history of terminated pregnancies compared to women who have not had breast implants. They have also been found to be more frequent users of alcohol and tobacco and have a higher divorce rate. These women have also been found to have a below average body weight, leading to concern that some may be experiencing eating disorders. Finally they have been found to report more frequent use of psychotherapy than physically similar women not interested in breast augmentation, and they have been found to have a history of more psychiatric hospitalizations than other plastic surgery patients.

According to The National Women’s Health Information Center, psychological problems are not always solved by surgery, and a woman who has the procedure may still feel the same or worse, especially if she is suffering from body dysmorphic disorder (BDD), which is another characteristic that appears to distinguish women with breast implants.

BDD is a serious illness in which a person is preoccupied with minor or imaginary physical flaws, usually of the skin, hair, and nose. A person with BDD who seeks cosmetic surgery may never be happy with the outcome, even if the surgeries are successful.

Some people with mild symptoms of BDD can function well, despite the stress they feel. For others, the illness can become so serious that they may be unable to work, socialize, or leave their homes. They worry that they look ugly, or that people will laugh at them. Eventually this illness could lead to suicide.

According to Sarwer, et. al., between 3 and 15 percent of cosmetic surgery patients have been found to have some form of the disorder. Retrospective studies of cosmetic treatment use among persons with BDD found that more than 90 percent experienced either no relief from their symptoms following these treatments, or an actual worsening of their BDD symptoms. The study concluded that BDD contraindicates cosmetic surgery.

Not all women who seek breast implants suffer from BDD, and many women who receive them report improved quality of life, body image, and self-esteem as well as increased marital and sexual satisfaction. According to Sarwer et. al., women’s postoperative expectations are surgical, psychological, and social. Surgical expectations include their specific concerns about what they will look like after the operation. Psychological expectations include emotional satisfaction occur after surgery. Social expectations include the potential social benefits of cosmetic surgery. Many women think that implants will make them more attractive to current or potential romantic partners. When these expectations are not met, they may become despondent, depressed, and potentially suicidal.
Sarwer et. al. quote clinical reports that suggest that the majority of women are satisfied after their breast augmentations and experience improvements in body image. These benefits, however, may be tempered by the experience of a postoperative complication. Up to 25 percent of women are reported to experience surgical or implant-related complication. The most common complications are implant leakage or rupture/deflation, capsular contracture, discomfort or pain, breast asymmetry, scarring, loss of nipple sensation, and breast-feeding difficulties. The experience of a complication is negatively related to postoperative satisfaction and to less favorable changes in body image. The negative experience could cause depressed mood, increased anxiety, and a decline in quality of life, which may lead to subsequent suicide.

One of the most famous cases of postoperative complications is that of actress Tara Reid. She had pain and scarring that was so bad she turned to high-tech oxygen treatments for healing in a hyperbaric chamber where gas is pumped in to help her blemishes disappear and scarring heal (Hollywoodgossip.com).

According to HPU junior business major Holly Cabatbat, “A woman needs to love herself regardless of her breast size.” She believes that a woman who is satisfied with her own breasts would not have this surgery because she wouldn’t feel the need too.

Women are aware of the risks of going through this procedure, but as freshman international relations major Chelsie Kappius said, “If I were insecure and had severe depression problems, I’d consider breast implants.”





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