WOMEN CHOOSE PLASTIC SURGERY BREAST PROCEDURES FOR THEMSELVES TO IMPROVE SELF-IMAGE & ELIMINATE PAIN

October 1, 2002

Whether today or 15 years ago, women choose to have breast augmentation, reduction and reconstruction to improve their overall self-image or alleviate painful symptoms, according to an August survey of American Society of Plastic Surgeons (ASPS) members. Responses from almost 800 members across the nation revealed surprising similarities as well as new information about their patient's perceptions of plastic surgery procedures for the breast.

"Patients have always had very definite ideas about their breasts," says Edward Luce, M.D.,Cleveland, ASPS. "Throughout the ages, the female breast has been a symbol of sexuality and maternity regardless of culture. Today is no different and women want to feel good about their own body image."

When asked the primary reason their patients offered for wanting a breast augmentation, it was discovered that not much had changed from 15 years ago. Respondents said 91 percent of today's patients and 90 percent of patients from the mid-eighties both said it was to improve the way they feel about themselves. Respondents said that patients overwhelmingly cite themselves as the primary motivator in their decision to have augmentation (94 percent). Only four percent of respondents said patients cited friends and two percent said they cited husbands or boyfriends.

As for breast reduction, almost 40 percent of respondents said patients cite the desire to eliminate back, neck and shoulder pain as the primary reason for the surgery. When asked the primary motivation for wanting reconstruction, 95 percent of those surveyed said their patients wanted to restore and maintain their self image.

Preferences in cup sizes were also similar - with one important difference. Among today's patients, respondents said cup size "C" was requested by 81 percent of those under age 35 and 85 percent of those over age 35; with a larger cup size "D" as the second most popular choice. In the mid-eighties respondents said, while 70 percent of their patients in both age groups requested "C" cup, approximately 20 percent requested a more conservative "B."

Among the concerns women expressed about breast augmentation 44 percent of respondents said, today's patients cited maintaining a "natural" look and feel. With breast reduction, however, 54 percent of respondents said their patients were concerned about scarring. For breast reconstruction, concerns were similar to those of augmentation; 45 percent said their patients wanted to create a "natural" feeling and looking breast. The second biggest reconstruction concern was complications (24 percent).

The survey results for breast reconstruction, understandably, reflect the more serious nature of the procedure. Half the responding surgeons said, however, that despite their patients' concerns, 76-100 percent of women who seek a consultation for breast reconstruction elect to have the procedure.

A controversial issue surrounding breast reduction is insurance coverage. Plastic surgeons have long observed that reducing breast mass can effectively alleviate the symptoms associated with overly large breasts. However, insurance denials and policy exclusions for the procedure are becoming increasingly common. Among the surgeons surveyed, 18 percent said breast reduction patients receive coverage 1 - 50 percent of the time. Seventy-four percent of respondents said only 1 - 25 percent of the reduction patients who are not covered by their policy elect to have the procedure and pay for it "out of pocket."

In 2001, more than 219,000 women had breast augmentation, more than 99,000 women had breast reduction and almost 82,000 women had breast reconstruction, according to the ASPS. When asked about the future of breast augmentation, reduction and reconstruction, 49 percent of the respondents believed that the number of augmentation procedures would increase between 1 -25 percent, while 22 percent believed it would increase by 26-50 percent. Thirty-six percent of respondents thought that breast reduction would likely increase between 1-25 percent, and 32 percent of respondents said that breast reconstruction would either increase by 1 -25 percent or remain the same.

In conclusion, says Dr. Luce, "While this survey does not reveal every notion women have about these procedures, it is interesting to get an idea of what patients are saying to plastic surgeons about creating or recreating their own body ideal."

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