Breast implant psychology: Studies question linkage of implants to overall self-esteem

Dr. McGrath

Atend to be limited to the scope of the surgery itself. Essentially, patients walk away happier with the particular body part they've had enhanced, and that's where the impact of cosmetic surgery seems to end, according to Mary H. McGrath, M.D., M.P.H., professor of surgery, Division of Plastic Surgery, University of California, San Francisco.

Dr. McGrath reviewed literature related to the psychological aspects of breast implants and published a descriptive analysis in the December 2007 issue of Plastic and Reconstructive Surgery.¹ Due to the plethora of contemporary research related to breast implants that culminated in the FDA's decision to permit silicone implants back on the market, she felt it was an ideal time to update cosmetic surgeons on the psychological dimensions of the devices on cosmetic augmentation patients.

OVERBLOWN BELIEFS One of her key findings debunks the pervasive belief, held by doctors and consumers alike, that breast augmentation and other types of cosmetic surgery boost patients' overall self-image and self-esteem and impact their quality of life. "...Some of the older studies said there were remarkable changes in outlook and self-esteem from a psychoanalytic perspective after people have cosmetic surgery," Dr. McGrath says.

But the more recent studies that focused specifically on breast implant patients suggest actual psychological benefits of surgery are specific to the augmented body part.

"When you really start to do very good quality-of-life and psychologic studies, you do find that people find a dramatic improvement in specific measures, such as their perception or sense of satisfaction with a certain body part," Dr. McGrath explains. "But it's not as all-inclusive or all-pervasive for their whole psychologic being as we once thought."

PATIENT POSITIVE While the bulk of studies Dr. McGrath analyzed looked at the psychological impact of breast implant surgery, interestingly, the results were congruent with more general attitudinal research findings about cosmetic surgery patients. No significant mindset differences emerged among types of patients when analyzed by aesthetic procedure elected, and she reports, in general, that "cosmetic surgery patients do not have a poorer overall self-image, nor are they more self-critical and preoccupied with appearance than other individuals. It appears to be a significantly important dissatisfaction with a specific body part that serves as the motivation for surgery — not a poor overall body image."

The belief that patients seeking breast implant surgery in particular might have self-esteem issues might be overblown as well. Researchers in the past decade have not been able to correlate general low self-esteem to the desire to have breast augmentation, she says. In fact, breast augmentation patients seem generally to have a healthy sense of self-image. Indeed, one study Dr. McGrath cites suggests that breast implant patients might even have higher self-esteem than those patients electing to undergo liposuction, abdominoplasty or breast reduction.¹ Rather, their concerns — again — seem more focused on dissatisfaction with a specific body part.