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Whether for augmentation or reconstruction purposes, breast implants are only used when a woman chooses them. Even when they are prescribed to improve the proportion of a woman’s figure, to reconstruct a breast, or to achieve symmetry between a breast that has been reconstructed and a natural breast, there is no reason a woman must undergo surgery to place breast implants. Breast implants can have an immensely positive influence on a woman’s self-esteem and self-image. But breast implants do not treat disease, nor are they essential to a woman’s health or treatment outcomes. Therefore, the placement of breast implants in your body is entirely by choice, even when implants are part of a prescribed breast reconstruction. You may be supported and encouraged by those whom you love, by your cosmetic surgeon, and other physicians in your consideration of breast implants. But the bottom line is that choosing breast implants is a decision you must make for yourself, by yourself.
There are alternatives to breast implants. In the case of augmentation, a woman may choose to wear padded bras, she may choose to pad her bra with external prosthetic enhancements, or she may choose to simply accept her breasts as they are. In some cases of breast reconstruction, specialized plastic surgery techniques that rebuild a woman’s breast using her own muscle and/or fat and skin may be an alternative to the use of breast implants. A woman may choose to wear prosthetic bras or pad her bra with external prosthesis, or she may choose to accept her condition and live with the absence or deformity of her breast. But these alternatives are not right for everyone. Prosthetic solutions have their limitations in fashion choices and to a woman’s self-image. The only true fulfillment you may feel is through seeing yourself as you feel your breasts and your body should be. If that is the case, the choice for breast implants must be your decision.
With rare exception, implants should not be placed into a woman’s body if she is pregnant or nursing, if she has an active infection or critical illness present anywhere in the body, or if she has an existing malignant or pre-malignant breast cancer that is not being treated. An exception is infection surrounding an existing breast implant, in which case the course of treatment may include removing or occasionally replacing an implant. In addition, women with certain medical conditions that may impair healing may be advised not to consider breast implants. The U.S. FDA has only approved breast implants strictly for augmentation purposes (to cosmetically enhance size) for women age 18 or older. Augmentation candidates who have emotional or psychological conditions such as body dysmorphic disorder (BDD) will likely be referred for counseling prior to breast implant surgery. Body dysmorphic disorder is a very serious psychological condition noted to be similar to obsessivecompulsive disorder. It is a preoccupation with an imagined physical defect or a vastly exaggerated concern about a minimal defect. Individuals with BDD are so troubled by the perceived defect that they obsess over it for more than one hour per day. BDD should only be diagnosed by a licensed and appropriately trained psychologist or psychiatrist; it should not be a label used by opponents of plastic surgery or breast implants.
In fact, in a study conducted by the American Society for Aesthetic Plastic Surgery in 2003, their members report less than 2% of patients who consult with them exhibit symptoms of BDD. ASAPS members and cosmetic surgeons in the study also responded that 84% refused to perform surgery on patients who displayed symptoms of BDD and the majority referred these patients for counseling. There have been external medical devices, exercises, herbal supplements, and creams touted to increase breast size. In fact, these substances may be harmful to a woman’s health as they are not reviewed or approved by the FDA. However, nothing has the proven satisfaction and outcomes of breast implants in breast augmentation. The use of breast implants in augmentation surgeries, as reported by the American Society of Plastic Surgeons in 2003, was just over 250,000 cases (not implants). This is a greater than 600% increase in the use of breast implants for augmentation purposes since 1992.