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The purpose of this study is to compare women with cosmetic breast implants with population controls to examine health-related quality of life. A questionnaire including quality-of-life questions was mailed to 399 Finnish women who had had cosmetic breast implants during the years 1973–2002. The response rate of the study was 85. Results were compared with average Finnish women from a representative population sample. There were no differences in total score of health-related quality of life between women with breast implants and controls. Women with breast implants had lower health-related quality of life in dimensions of distress and sexual activity and partly also in dimensions of sleeping and mental function when compared with controls. On the other hand, operated women reported significantly less discomfort and symptoms than controls. Differences in health-related quality of life between women with breast implants and controls were largest in dimensions of distress, sexual activity, sleeping, and symptoms.