The Influence of Personality on Health Complaints and Quality of Life in Women With Breast Implants

Abstract

Background: A causal relation between systemic symptoms and breast implants has not been established. Psychological factors, such as personality and psychological distress, are strongly associated with the development of medically unexplained symptoms. It can be hypothesized that psychological factors may be related to the development of breast implant illness (BII).

Objectives: This study was conducted to evaluate the correlation between self-reported health complaints, health- and breast-related quality of life (QoL), and personality, in women with cosmetic breast implants.

Methods: Women who attended the plastic surgery outpatient clinic of Maastricht University Medical Center between October 2020 and October 2021 for reasons related to their implants and women recruited for a BII study at the Center during this period were invited to participate in this study. Only women who underwent cosmetic breast augmentation were eligible. Participants completed a physical complaints score form and the BREAST-Q, SF-36, and EPQ-RSS questionnaires via an online survey.

Results: In total, 201 women completed the questionnaires. Extroversion and social desirability were predominant personality traits in women with breast implants, followed by neuroticism. Relatively high levels of neuroticism were found compared with normative data. Neuroticism correlated significantly with health status and breast-related QoL. Physical and mental health-related QoL had the strongest correlations with neuroticism (β = -3.94, β = -4.86, P < 0.001).

Conclusions: Personality can play a role in the development of complaints. High levels of neuroticism are seen in cosmetic surgery patients and are negatively correlated with subjective health and patient-reported outcomes in women with breast implants. Therefore, neuroticism may be a factor in the development of BII.

Figure 1.

Mean scores of individual health symptoms. The sum of these scores gives the physical complaints score.

Figure 2.

Correlation plots for EPQ domains and all outcomes. The y axis presents all 4 domains of the EPQ questionnaire. (A) Physical complaint score; (B) SF-36 physical component score; (C) SF-36 mental component score; (D) BREAST-Q satisfaction with breast; (E) BREAST-Q psychosocial well-being; (F) BREAST-Q physical well-being; (G) BREAST-Q sexual well-being; (H) BREAST-Q satisfaction with outcome; and (I) BREAST-Q information given by doctor. EPQ, Eysenck Personality Questionnaire; SF-36, Short Form-36.