Breast augmentation: motives and the role of the family nurse practitioner.

Humans tend to compare themselves to their surrounding culture's idea of beauty. As a result of the influence exerted by the mass media, the American woman's breast is closely linked to womanhood; the fuller the woman's bosom, the sexier and more womanly she feels, or is perceived to be by individuals of both sexes. Because of these cultural expectations, small-breasted women often experience feelings of inadequacy compared with their larger-breasted counterparts, and may seek methods of increasing their breast size, such as breast augmentation. An estimated 5 million to 7 million women have opted to have this elective surgery since its development in 1963. In 2009, nearly 300,000 women chose to undergo breast augmentation--an increase of 36% from 2000, and an impressive 787% since 1992, when the American Society of Plastic Surgeons began formulating yearly national cosmetic surgical statistics. These statistical findings reveal that a significant number of women are interested in this topic, and health care providers need an operational understanding of what is influencing these women's health care decisions. As a result of this need, the motives for breast augmentation have been researched and classified as either internal or external. Internal motives include low levels of self-esteem, body image dissatisfaction, and body dysmorphic disorder, whereas external motives are the desire to attract and retain a romantic partner, pressures from others, and occupational requirements. Understanding these motives allows primary care nurse practitioners to focus their assessments on these areas and to provide the appropriate counseling or referrals as needed.

Psychological considerations in cosmetic breast augmentation.

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.

Women's satisfaction with their breast prosthesis: what determines a quality prosthesis?

The aim of this study is to determine what factors constitute a quality prosthesis and ascertain which factors affect prosthesis satisfaction. Sixty-four women who received full funding for their prosthesis and 38 women who received their hospital's usual funding were recruited. Women rated the information provided about breast prostheses very highly, with 85% reporting that it was "very good" or "excellent." Satisfaction was significantly associated with how well the prosthesis fit (1 week, p = .001; 3 months, p = .01), level of comfort (3 months, p=.005), and appearance of the prosthesis when worn (6 months, p = .001). Quality was significantly associated with how well it fit (1 week, p = .001; 3 months, p = .001), how natural it felt (1 week, p = .001; 6 months, p = .01), the weight of the prosthesis (3 months, p = .003), and appearance when worn (6 months, p = .03). The results will be used to improve women's access to a quality prosthesis.

Breast augmentation & lactation outcome: a case report.

This article contains two case reports that illustrate the difficulty two mothers experienced when they mechanically expressed their milk for their very preterm infants. Each of the mothers was enrolled in a separate research study and had previously undergone surgery for breast augmentation. Neither of the mothers was able to provide an adequate milk supply for her preterm infant. Preoperative counseling and informed consent for breast augmentation is vital if the mother desires to exclusively provide mother's milk for the infant.

Understanding the benefits and risks of breast augmentation.

There are a number of reasons a woman might consider breast augmentation, including cosmetic improvement, reconstruction after a mastectomy, or to address a congenital or developmental abnormality. Nurses should ensure that patients considering breast surgery understand the risks involved. Clearly informed consent is a major issue. For some women, the potential benefits of this surgery will outweigh the risks.

Office education: sharing your knowledge.

The author's passion for plastic surgery nursing emerged from a life-changing experience involving skin grafting and skin reconstruction on her face from basal cell carcinoma. After many more skin cancer excisions, she decided to leave the hospital environment to pursue further study and work in the field of dermatology and wound care. This helped to expand her specialized knowledge of skin anatomy/physiology and prepare for a career in plastic/reconstructive surgery. During her masters degree program, the author developed educational guidelines and materials to facilitate her new role in plastic surgery as a nurse/patient/community educator. She finished her masters degree in nursing education and completed her clinical preceptor/internship with two board certified plastic and reconstructive surgeons in December of 2000.

Transaxillary breast augmentation.

This article will discuss the preoperative, intraoperative, and postoperative nursing interventions specifically related to the patient undergoing transaxillary breast augmentation. Being able to explain the procedure through each of these phases will help to ease a patient's anxiety and, in turn, increase compliance to follow instructions to achieve the best possible result.

Transumbilical breast augmentation.

Surgical augmentation has been performed since 1899, with varying results. Recent developments in endoscopic instrumentation have enabled surgeons to perform many types of procedures through small incisions located at a distance from the surgical site. The transumbilical breast augmentation (TUBA) has advantages over other methods, including a quicker recovery, less pain, and lower chances of complications. This article familiarizes perioperative personnel with TUBA and how to care for the patients who undergo this procedure.

Saline augmentation mammaplasty: nursing implications.

Saline augmentation mammaplasty has dramatically increased in popularity over the past 5 years. Maximizing immediate and long-term results requires skilled perioperative nursing intervention.

The adjustable saline augmentation mammaplasty.

The use of an expander/implant for augmentation mammaplasty allows for increased patient satisfaction in the postoperative period. Surgical time may be shortened as final volume determination is not an intraoperative concern, and secondary surgery for certain complications such as asymmetry, wrinkling, and capsular contracture can often be avoided.

Choosing reconstruction after mastectomy: a qualitative analysis.

PURPOSE/OBJECTIVES: To describe women's perspectives on factors that influenced their decision to have reconstructive surgery after a breast cancer diagnosis. DESIGN: Exploratory, descriptive, qualitative study. SETTING: A comprehensive cancer center in an urban setting. SAMPLE: Eleven women who underwent mastectomy and reconstruction. Six participants had autologous transverse rectus abdominis musculocutaneous-flap reconstruction, four had saline implants, and one had a silicone implant. All but one reconstruction was performed at the time of mastectomy. METHODS: Open-ended, face-to-face interviews using an interview guide were conducted within one month of reconstruction. One to two follow-up interviews were conducted approximately six months later. MAIN RESEARCH VARIABLES: Decision making about reconstruction, perceptions of information needs and sources, sources of support, and factors important to decision making. FINDINGS: The main theme identified was Getting My Life Back. The participants described this in terms of the themes of Information Seeking, Talking It Over, and Seeking Normality. The interactive skills of the healthcare provider played an important role in the women's decision making. CONCLUSIONS: Reconstruction minimized the negative consequences of breast cancer and its treatment for the women in the study. The decision-making process was aimed at getting the person's life back as close to what it was before the diagnosis as possible or improving it. The three themes of decision making are interactive in nature, with participants returning to information Seeking and Talking It Over as necessary to increasing their understanding and clarifying their "normality goals." IMPLICATIONS FOR NURSING PRACTICE: Healthcare professionals should determine how a woman wants to participate in decision making as well as the kind, amount, and sources of information the individual with breast cancer wants to have to make her decisions. Healthcare providers are key sources of information about treatment options, and they are critical to patient satisfaction with the decision-making process and with the final results of the surgical procedure. Family members, friends, and other women with breast cancer play a crucial role in talking it over.