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Psychological Considerations in Cosmetic Breast Augmentation

Crerand, Canice E. PhD; Infield, Alison L. BA; Sarwer, David B. PhD

doi: 10.1097/01.PSN.0000347725.13404.5f
ARTICLE: CONTINUING EDUCATION
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Within the past decade, the popularity of cosmetic breast augmentation has surged and, with it, the interest in the psychological aspects of the procedure. Investigations of women who seek cosmetic breast augmentation have examined both their psychosocial characteristics and their motivations for surgery. Dissatisfaction both with body image and with breast size and/or shape are thought to be primary motivators for surgery. It is common for women seeking cosmetic breast augmentation to have some body image dissatisfaction. However, a considerable minority may suffer from excessive dissatisfaction consistent with the psychiatric diagnosis of body dysmorphic disorder, which is believed to contraindicate cosmetic surgery. Following breast augmentation, most women report satisfaction with the aesthetic result and improvements in body image. The impact of the procedure on other areas of functioning, such as self-esteem and quality of life, is less clear. These positive outcomes have been tempered by recent epidemiological studies that have identified a relationship between cosmetic breast implants and suicide. This article reviews this literature and provides recommendations to plastic surgical nurses regarding the psychological assessment and management of patients seeking breast augmentation.

Canice E. Crerand, PhD, is a psychologist in the Division of Plastic Surgery, Department of Psychology, Children's Hospital of Philadelphia. She is also a consultant to the Edwin and Fannie Gray Hall Center for Human Appearance, University of Pennsylvania School of Medicine, Philadelphia, PA.

Alison L. Infield, BA, is a research assistant in the Department of Psychiatry at the Center for Weight and Eating Disorders, University of Pennsylvania School of Medicine, Philadelphia, PA.

David B. Sarwer, PhD, is Associate Professor of Psychology in the Departments of Psychiatry and Surgery, University of Pennsylvania School of Medicine. He is also a consultant to the Edwin and Fannie Gray Hall Center for Human Appearance and Director of Clinical Services at the Center for Weight and Eating Disorders, University of Pennsylvania School of Medicine, Philadelphia, PA.

Address correspondence to David B. Sarwer, PhD, University of Pennsylvania Medical Center, The Edwin and Fannie Gray Hall Center for Human Appearance, 10 Perm Tower, 3400 Spruce Street, Philadelphia, PA 19104 (e-mail: dsarwer@mail.med.upenn.edu).

Conflicts of Interest: Drs. Sarwer and Crerand are consultants for Allergan. Dr. Sarwer receives grant support from the National Institute of Diabetes and Digestive and Kidney Diseases (Grant #s R03-DK067885 and R01-DK072452) as well as the American Society of Plastic Surgeons/Plastic Surgery Educational Foundation (Grant #s DR03-05 and DR06-04).

This article is from Plastic Surgical Nursing 2007, 27(3):146–154. Reprinted with permission.

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Copyright © 2009 by American Society of Plastic Surgical Nurses