Cosmetic breast surgery experience and a wide range of mental health, psychosocial, and sociodemographic variables were assessed in the population-based Norwegian Mother and Child Cohort Study (N = 78,252). Breast augmentation patients reported elevated mental health problems. Factors in the domains of physical appearance, drug use, relationships, and exposure to abuse were all related to breast augmentation. Adjusting for such factors reduced the relationships between breast augmentation surgery and all mental health problems to non-significance. Results indicate that the increased prevalence of mental health problems among breast augmentation patients has to be understood from multiple perspectives involving several psychosocial domains.