Augmentation mammaplasty: neither simple nor safe.

Elective aesthetic cosmetic surgery of the female breast appears not to warrant the same attention to informed consent or authorisation as other surgical procedures. Arguments for benefits do not need to be persuasive since the prospective patient is usually 'sold on the idea'. This paper argues that more rather than less information is necessary where the surgery will not achieve what is claimed for it and where there are significant risks of harm. Evidence is presented to show that augmentation mammaplasty does not provide a solution to problems of body image, self-esteem and sexuality; it may result in considerable pain, suffering, financial and emotional cost, interference with life choices and a loss of trust in health care professionals. In view of the emerging data which points to the doubtful efficacy and safety of the procedure and the prosthetic devices, and since elective cosmetic surgery is said to be a growth industry, checks and balances need to be in place to ensure women are informed participants in decision-making. They require the best possible advice, care and support and nurses could play a more proactive role as patient advocates.