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Title: Negotiating present and future selves : women's decision-making to pursue breast augmentation surgery on the NHS
Author: Hansen, Esther
ISNI:       0000 0004 2698 4538
Awarding Body: University of East London
Current Institution: University of East London
Date of Award: 2004
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A material-discursive framework was used in this qualitative study of eight women's decision-making for breast augmentation surgery on the NHS, using pre-surgery interviews. The NHS offers cosmetic breast augmentation surgery in "exceptional circumstances". An interpretative phenomenological analysis was carried out to consider how women conceptualised the process of deciding to pursue this surgery, which included their reasons for pursuing surgery and their perceptions of the risks involved. The women described how they viewed their breasts as "abnormal" and "unfeminine", which impacted on how they perceived themselves. The consequent distress led them to seek breast augmentation surgery, which they anticipated would lessen their distress and produce positive feelings. The women also explained how the anticipated changes rendered the medical and psychosocial risks negligible. The women's accounts of their decision to have breast surgery revealed the dynamic nature of decision-making, evident through continuing risk-to-benefit appraisals, ambivalence and the accumulation of supporting evidence. This would indicate that breast surgery was a satisfactory rather than optimal choice. Subsequently, the Foucauldian discourse analysis focused on the discursive constructions of 'small breasts' and 'breast augmentation surgery'. It revealed how discourses which perpetuate the notions of self-improvement and bodily interventions as acceptable, positively framed the women's decision to have surgery. The women's construction of bodily appearance as central to self-identity and self-worth supported their evaluation of their breasts as making them feel "unfeminine" and their choice of surgery as a means of producing a feminine identity. The women's perception of surgery as a process of psychological change suggests that service provision should involve psychologists. The process of obtaining breast augmentation surgery on the NHS also reinforces women's perceptions of their breasts as "abnormal". Current pathways should be reconsidered and it may be helpful for primary care interventions to promote solutions other than BAS.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psych.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available