Despite the claims of plastic surgeons that breast implants improve patients’ self-esteem and quality of life, there is no scientific support for those statements. The only scientific data available are from studies conducted by two breast implant companies: Allergan (formerly Inamed) and Mentor. The two companies were required to conduct the studies and provide the results to the FDA when the companies applied for FDA approval for their silicone gel breast implants. The FDA then reviewed the results and reported them in a summary for each company’s data that is on the agency website.
As part of the studies, women took a set of questionnaires just before they got breast implants, as well as two years later. This allowed researchers to compare how women felt before vs after their implants. The questionnaires included scientifically valid and reliable measures of self-esteem, self-confidence, and other measures of “quality of life,” including physical health, mental health, and social relationships.
Both companies gave these questionnaires to three types of patients: breast augmentation patients, breast reconstruction patients (using implants to replace breasts lost to mastectomy), and revision patients. Revision patients were women who already had breast implants, but their implants needed to be replaced with new ones. This means that they were studied when they had implants that had ruptured or caused other problems and got replacement implants, as well as two years after the implants had been replaced.
This article will explain the results of both companies’ studies, so you can learn about how women felt following their implants.
Inamed’s (Allergan) Studies
Breast implant patients answered a number of questionnaires, including two scales measuring quality of life that asked about general health, social functioning, and mental health. They also answered questionnaires about their “self-concept,” their self-esteem, and their body esteem. For descriptions of the questionnaires used, see the appendix at the bottom of this article. To read the FDA’s full report of the data, click here.
Augmentation Patients
Two years after getting breast implants, augmentation patients reported small but statistically significant changes in how they described themselves on many measures. On measures of how sexually attractive they believed themselves to be and their overall body esteem, augmentation patients reported feeling better two years later. However, they reported feeling worse on many of the other measures, such as physical health, mental health, vitality, and social functioning. For a complete list of measures that showed changes over the two years, see Table 1 below.
Reconstruction Patients
For reconstruction patients, only two scores were significantly different two years after surgery. Reconstruction patients showed improvement in two measures of physical functioning, which probably reflects the fact that many of these women were being treated for breast cancer prior to surgery and their quality of life was better as cancer survivors two years later. For a complete list of what changed and what didn’t change for reconstruction patients, see Table 2 below.
Revision Patients
Revision patients did not show improvement in any of the scales after two years. They did, however, report worse outcomes on many scales such as their general health, mental health, and self-esteem. For a complete list of measures showing how revision patients changed or didn’t change, see Table 3 below.
Mentor’s Studies
The patients in Mentor’s studies completed many of the same questionnaires as the ones used in studies by Inamed (now Allergan). The results were also similar: most women said they felt worse two years after getting implants. The FDA’s information on Mentor’s studies is less detailed than it is for Inamed’s studies, but the FDA’s summary of the data provides information on which measures showed improvement and which measures showed worse feelings after two years. To read the FDA’s summary of the data, click here.
Augmentation Patients
Mentor’s augmentation patients reported worse physical and mental health two years after receiving their breast implants. They did not show a significant difference in body esteem or self-concept, but they did show an improvement in self-esteem. For the list of measures and their outcomes for augmentation patients, see Table 4 below.
Reconstruction Patients
There were no significant changes in any of the measures for reconstruction patients, as shown in Table 5 below.
Revision Patients
For the revision patients, self-concept, physical health, mental health, and body esteem were all lower two years after surgery. However, Mentor’s revision patients had no significant changes in their self-esteem. Table 6 below has the list of measures and their outcomes for revision patients.
The Bottom Line
FDA’s summary of Mentor’s data includes a literature review (provided by Mentor) of the other data available on the relationship between breast implants and quality of life. The FDA notes that “…the literature does not provide strong scientific support that breast implants have measurable psychological and psychosocial benefits for women seeking breast augmentation” (page 70).
In conclusion, there does not appear to be evidence that breast implants improve a woman’s quality of life. Overall, there tended to be statistically significant decreases in well-being over time, such as worse mental health two years after getting implants.
Appendix:
The following are the specific scales used in the studies described above. They are also the scales listed in the tables (below) that summarize the data for each study.
SF-36: The SF-36 is a questionnaire that assesses 8 measures of physical and mental health.
MOS-20: The Medical Outcomes Study, called the MOS-20, is another scale that measures components of physical and mental health.
Tennessee self-concept scale: This scale, called TSCS for short, measures self-concept, which is related to self-image and self-worth.
Rosenberg self-esteem scale: This scale measures self-esteem, such as self-acceptance.
Body esteem: The body esteem scale measures a few concepts: whether a woman perceives herself to be sexually attractive, whether she has concerns about her weight, and her beliefs about her physical condition.
Table 1: Outcomes for Inamed’s Augmentation Patients
Questionnaire Measure | Outcome after 2 years |
SF-36 Role Emotional | Worse |
SF-36 Role Physical | Worse |
SF-36 General Health | Worse |
SF-36 Pain | No significant change |
SF-36 Social Functioning | Worse |
SF-36 Physical Functioning | No significant change |
SF-36 Vitality | Worse |
SF-36 Mental Health | Worse |
MOS-20 Health Perceptions | Worse |
MOS-20 Physical Functioning | No significant change |
MOS-20 Social Functioning | No significant change |
MOS-20 Mental Health | Worse |
TSCS Physical Self | Worse |
Rosenberg Self-Esteem | No significant change |
Total Body Esteem | Better |
Body Esteem Sexual Attractiveness | Better |
Body Esteem Weight Concern | No significant change |
Body Esteem Physical Condition | Worse |
Table 2: Outcomes for Inamed’s Reconstruction Patients
Questionnaire Measure | Outcome after 2 years |
SF-36 Role Emotional | No significant change |
SF-36 Role Physical | Better |
SF-36 General Health | No significant change |
SF-36 Pain | No significant change |
SF-36 Social Functioning | No significant change |
SF-36 Physical Functioning | No significant change |
SF-36 Vitality | No significant change |
SF-36 Mental Health | No significant change |
MOS-20 Health Perceptions | No significant change |
MOS-20 Physical Functioning | Better |
MOS-20 Social Functioning | No significant change |
MOS-20 Mental Health | No significant change |
TSCS Physical Self | No significant change |
Rosenberg Self-Esteem | No significant change |
Total Body Esteem | No significant change |
Body Esteem Sexual Attractiveness | No significant change |
Body Esteem Weight Concern | No significant change |
Body Esteem Physical Condition | No significant change |
Table 3: Outcomes for Inamed’s Revision Patients
Questionnaire Measure | Outcome after 2 years |
SF-36 Role Emotional | Worse |
SF-36 Role Physical | No significant change |
SF-36 General Health | Worse |
SF-36 Pain | No significant change |
SF-36 Social Functioning | Worse |
SF-36 Physical Functioning | No significant change |
SF-36 Vitality | No significant change |
SF-36 Mental Health | Worse |
MOS-20 Health Perceptions | Worse |
MOS-20 Physical Functioning | No significant change |
MOS-20 Social Functioning | No significant change |
MOS-20 Mental Health | Worse |
TSCS Physical Self | Worse |
Rosenberg Self-Esteem | Worse |
Total Body Esteem | No significant change |
Body Esteem Sexual Attractiveness | No significant change |
Body Esteem Weight Concern | No significant change |
Body Esteem Physical Condition | Worse |
Table 4: Outcomes for Mentor’s Augmentation Patients
Questionnaire Measure | Outcome after 2 years |
SF-36 Physical Component | Worse |
SF-36 Mental Component | Worse |
Tennessee Self-Concept Scale | No significant change |
Rosenberg Self-Esteem | Better |
Body Esteem | No significant change |
Table 5: Outcomes for Mentor’s Reconstruction Patients
Questionnaire Measure | Outcome after 2 years |
SF-36 Physical Component | No significant change |
SF-36 Mental Component | No significant change |
Tennessee Self-Concept Scale | No significant change |
Rosenberg Self-Esteem | No significant change |
Body Esteem | No significant change |
Table 6: Outcomes for Mentor’s Revision Patients
Questionnaire Measure | Outcome after 2 years |
SF-36 Physical Component | Worse |
SF-36 Mental Component | Worse |
Tennessee Self-Concept Scale | Worse |
Rosenberg Self-Esteem | No significant change |
Body Esteem | Worse |