Exploiting Body Dysmorphic Disorder: The Business of Breast Augmentation

Asahi Shimbun Morning Edition – September 25, 1999

I am fed up with magazine advertisements featuring "large breasts" that catch my eye on trains, whether I like it or not. Late-night television programs frequently showcase "F-cup" models. At the same time, advertisements for diets and beauty treatments that promote a slim, model-like figure are also widespread.

From time to time, patients who are obsessed with the idea that their appearance is ugly visit psychiatric clinics.

There was a female patient who, despite being undeniably beautiful, underwent surgery at a cosmetic clinic to remove a small mole. Afterward, she sued the doctor, claiming that the scar made her appearance even worse. When another surgeon was shown before-and-after photos, he confirmed that the procedure had been flawless, and to an untrained eye, there was no visible trace of the mole at all.

This is a type of delusion known as dysmorphophobia or body dysmorphic disorder.

In developed countries, while an increasing number of young women develop anorexia or bulimia due to dieting, many others seek breast augmentation surgery.

I watched a television movie called Breast Men (1997) on video. The subtitle, "Cosmetic Surgeons," made me feel a little uneasy when renting it.

The movie tells the story of two American doctors who, during the early days of cosmetic surgery in the 1960s, developed the technique of enlarging breasts by inserting silicone implants. They made a huge profit and became ecstatic, believing they had "relieved women's stress." One of them eventually escalated breast augmentation surgeries according to patients' desires, creating increasingly larger busts.

However, both doctors were ultimately sued for medical malpractice by women whose implants leaked, deforming their breasts, or who suffered other health complications. One lawsuit after another ended in their defeat.

There is a clear distinction between reconstructive surgery—helping breast cancer patients regain confidence and reduce feelings of shame after a mastectomy—and the desire of healthy women to enlarge what they already have.

While the distinction between cosmetic procedures (paid for privately) and medical treatments (covered by insurance) is, of course, necessary, I cannot help but question the act of surgically altering the body for reasons unrelated to treating illness.