Is bigger better? Breast augmentation surgery linked to boost in self-esteem and sexuality

There's a study in this month's journal Plastic Surgery Nursing from the University of Florida reporting on several indices of patients' self-image improvements after breast augmentation surgery. A WebMD description of it can be read here.

The study included 84 women who were 21 to 57 years old, assessing their perceptions of self-esteem and sexuality before and several months after cosmetic breast augmentation. Responses were recorded with two widely accepted scientific scales to measure self-esteem and sexuality, which assess domains of sexual function, such as sexual arousal, satisfaction, experience and attitudes.

The average self-esteem score increased from 20.7 to 24.9 on a 30-point scale, and their average female sexual function score increased from 27.2 to 31.4 on a 36-point index. Of note, after the procedure, there were substantial increases in ratings of sexual desire (a 78.6 percent increase from initial scores), arousal (81 percent increase) and satisfaction (57 percent increase).

The study's author, Dr. Cynthia Figueroa-Haas CRNP, a clinical assistant professor at the University of Florida's College of Nursing had this to say:

"So much attention is directed to men's sexuality issues; we have all seen countless commercials on drugs and therapy devoted to improving men's sexuality. Unfortunately, very little is discussed regarding women's sexuality issues," Figueroa-Haas said. "I strongly believe that my research shows that interventions such as cosmetic plastic surgery can address these sorts of issues for some women. For example, those women who may have breast changes due to nursing or from the inevitable natural aging process. These women may not feel as attractive, which could ultimately negatively impact their levels of self-esteem and sexuality."

These kind of results really are not anything new though. Similar series of varying quality have been reported in the Plastic Surgery literature for almost 50 years. However, I think it's somewhat redundant to publish such data so early in follow-up which adds nothing much new to what's been published previously. The more important longitudinal findings in these patients need to be followed up years out, not months, to add something to our understanding of psyhcological outcome endpoints. Keep in mind that data presented to the FDA from the clinical trials required on silicone gel implants at 3-4 years out suggested much more conservative attribution of long-term self-esteem or self-identity benefits.

As I do a lot of breast surgery (ranging from mastectomies and reconstruction for cancer, breast reductions for overly-large breasts, breast lifts, and cosmetic surgery involving implants) it's pretty obvious from both my practice and the literature on these diverse patient groups that there is a great deal of psychological benefit from these procedures. I do feel however, that such short-term studies as this one are overstating or over-simplifying things too much.