Sarwer David B
Philadelphia, Pa. From the Departments of Psychiatry and Surgery and The Edwin and Fannie Gray Hall Center for Human Appearance, and the Center for Weight and Eating Disorders, University of Pennsylvania School of Medicine.
Plast Reconstr Surg. 2007 Dec;120(7 Suppl 1):110S-117S. doi: 10.1097/01.prs.0000286591.05612.72.
The psychological aspects of cosmetic breast augmentation have been the focus of a great deal of empiric study over the past 40 years.
Studies investigating the preoperative characteristics and psychosocial status of women interested in breast augmentation are reviewed. Investigations of postoperative satisfaction and psychosocial changes are discussed. The results of the seven epidemiologic studies that have identified a relationship between cosmetic breast augmentation and suicide are detailed.
Methodologic limitations of the studies investigating the preoperative psychosocial status of breast augmentation candidates make it difficult to draw firm conclusions about the potential psychological differences between these women and those not interested in breast augmentation. Postoperative satisfaction rates are high, and several studies suggest that patients experience improvements in body image following surgery. The effects of breast augmentation on other areas of psychological functioning are less clear. Based on the seven epidemiologic studies published to date, the suicide rate among women with cosmetic breast implants is two to three times the expected rate.
The literature in this area should be used to guide the psychosocial assessment and management of cosmetic breast augmentation patients. There currently is little evidence to support a recommendation that all women who present for cosmetic breast augmentation be required to undergo a psychiatric evaluation before surgery. Given the relationship between breast implants and suicide, however, it is recommended that women with a history of psychopathology who present for breast augmentation, or those who are suspected by the plastic surgeon of having some form of psychopathologic abnormality, should undergo a mental health consultation before surgery.
在过去40年里，隆胸手术的心理层面一直是大量实证研究的焦点。
回顾了有关对隆胸感兴趣女性的术前特征及社会心理状况的研究。讨论了术后满意度及社会心理变化的调查。详细阐述了七项已确定隆胸手术与自杀之间存在关联的流行病学研究结果。
调查隆胸手术候选人术前社会心理状况的研究存在方法学上的局限性，这使得难以就这些女性与对隆胸不感兴趣的女性之间潜在的心理差异得出确凿结论。术后满意度较高，多项研究表明患者术后身体形象有所改善。隆胸对心理功能其他方面的影响尚不清楚。根据迄今发表的七项流行病学研究，接受隆胸植入物的女性自杀率是预期自杀率的两到三倍。
该领域的文献应用于指导隆胸手术患者的社会心理评估与管理。目前几乎没有证据支持建议所有寻求隆胸手术的女性在手术前都需接受精神科评估。然而，鉴于隆胸植入物与自杀之间的关联，建议有精神病理学病史且前来隆胸的女性，或被整形外科医生怀疑存在某种形式精神病理异常的女性，在手术前应接受心理健康咨询。
