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Breast implants boost self-esteem for many women, but some feel let down.

How Will Breast Implants Change Your Life?

Deciding About Breast Implants: An Emotional Journey continued...

Over the years, Rod J. Rohrich, MD, chairman of plastic surgery at the University of Texas Southwestern Medical Center in Dallas, has come to recognize the patient with unrealistic expectations. "I want to do it if the patient is doing it for themselves -- not for their new boyfriend, or to save their marriage."

He won't treat patients who are going through major life changes -- divorce, death in the family, he tells WebMD. "I tell them up front it won't change your life, won't get you a new job, won't get you more dates. But it can make you feel better about who you are."

When Breast Implants Mask a Bigger Problem

When self-esteem and sense of self are more fragile, that's when people tend to have unrealistic expectations of breast implant surgery, explains Wellisch. "They are seeking transformation of sense of self. The gap between their ideal self and real self -- or the way they see themselves -- is greater than for the other group."

For these women, breast implant surgery is a band-aid approach to a bigger problem, he says. "They do feel better after this kind of surgery. I've seen it in my practice. But the surgery cannot transform a fragile or extremely vulnerable sense of self."

It's no surprise to Wellisch that studies show an increased risk of suicide among some women with implants, often 20 years later. Some women may hope that breast implants are a quick fix for mental health problems.

"It could be that the women have a psychiatric illness, then they feel better after the implants," says Loren Lipworth, ScD, an assistant professor of preventive medicine at Vanderbilt University, Nashville, Tenn., who worked on some of the studies. "Studies have certainly shown high levels of satisfaction and improved quality of life after this surgery."

But a decade later, the satisfaction fades for some reason, Lipworth says. "It may be that the psychiatric illness gets worse later on, or that it may develop later on. We don't know for sure."

Bottom line: Women need to be aware of this risk, she says. "A woman knows if she has a history of depression. She should be aware that depression can return.”

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