Cosmetic breast augmentation surgery: a critical overview

Despite the ban on silicone gel breast implants in 1992, the last decade witnessed a dramatic increase in the number of cosmetic breast augmentation procedures performed in the United States. According to the American Society of Plastic Surgeons, over 132,000 women in this country underwent the procedure in 1998. This is an underestimate of the actual number of breast augmentations performed annually, as increasing numbers of nonsurgeon physicians are now performing cosmetic surgery. Given the rising number of women who now seek cosmetic breast augmentation surgery, it is likely that women's healthcare providers will be asked by their patients about breast augmentation. This review is designed to provide an overview of the medical and psychological literature on cosmetic breast augmentation. We begin with a history of breast augmentation, including an overview of the controversy of silicone breast implants and the Institute of Medicine's report on their safety published in 1999. We also discuss the psychological characteristics of breast augmentation patients, reviewing both preoperative and postoperative studies. We conclude with suggestions for future research as well as a discussion of the clinical relevance of this area for women's healthcare professionals.