Surgeons performed 383,886 breast augmentation procedures in the United States in 2006, up from slightly more than 100,000 procedures 10 years earlier [source: American Society for Aesthetic Plastic Surgery]. Breast augmentation remains the second most popular surgical cosmetic procedure next to liposuction, 403,684 of which were performed in the U.S. in 2006 [source: American Society for Aesthetic Plastic Surgery]. There are many known risks associated with breast implant surgery and considerable controversy over silicone implants, which were allowed back onto the U.S. market in November 2006 after a 14-year ban. But now there's a new risk factor: suicide. Several studies, including one published in the August 2007 issue of "Annals of Plastic Surgery," have found a link between breast implants and an increased suicide rate among women.
The August 2007 study looked at 3,527 Swedish women who had breast enhancement procedures between 1965 and 1993. The researchers considered women who got implants for purely cosmetic reasons -- not as part of a reconstructive procedure. Some of the women were part of a study performed by the researchers eight years earlier, and many were tracked for at least a decade. Of these 3,527 women, 24 committed suicide, representing a suicide rate three times higher than among the general population.
The researchers wrote that the "increased risk of suicide was not apparent until 10 years after implantation" [source: Annals of Plastic Surgery]. Ten to 19 years after surgery, the suicide rate became 4.5 times that of women in the general population. Twenty years or more after surgery, it was six times higher [source: Annals of Plastic Surgery]. The suicide rate was also higher for women 45 years or older, and on average the suicides occurred 19 years after surgery.
Besides the increased suicide rate, 14 women in the study died from drugs or alcohol abuse, which constitutes a death rate three times higher than average [source: Yahoo News]. The researchers also found higher incidences of injuries and accidents caused by drugs and alcohol [source: Annals of Plastic Surgery].
The study showed no increase in breast cancer deaths, but the researchers pointed out in their report that breast implants can interfere with mammograms and other breast cancer detection methods. The researchers also found an increase in deaths from "lung cancer and other smoking-related diseases," yet a 2006 Canadian study found lower incidences of cancer [source: Annals of Plastic Surgery]. The researchers behind the Swedish study attributed the elevated levels of smoking-related illnesses to the findings of past studies that Danish and Swedish women with breast implants were more likely to be regular smokers.
On the next page, we'll look at what the results of these studies mean about the possible link between implants and suicide and at what doctors and scientists are trying to do to change it.
Conclusions about Breast Implant/Suicide Studies
Besides the study published in August 2007, five other studies have examined the relationship between breast implants and suicide. Three of these studies took place in Scandinavian countries. All of these studies revealed that women with breast implants were two to three times more likely to commit suicide [source: Annals of Plastic Surgery]. Besides the higher suicide risk, researchers found that women with breast implants more often had problems with alcohol and drugs and were more likely to be divorced, all of which are risk factors for suicide. Compared to women who get other cosmetic procedures, women who receive breast implants are almost twice as likely to have been admitted to a psychiatric hospital [source: Annals of Plastic Surgery].
These studies reflect a frequently discussed concern that people who receive cosmetic surgery also suffer from mental health problems and body image issues. While most studies on the connection between breast implants and suicide haven't closely investigated the reasons for these suicides, the apparent correlation has raised the need for further scrutiny.
Up to 15 percent of people who get elective plastic surgery suffer from body dysmorphic disorder (BDD), which causes people to obsess over small or even nonexistent imperfections [source: Los Angeles Times]. People with BDD can think they're ugly or disfigured even when they're not. The condition can cause major disruptions in patients' lives, and cosmetic surgery often doesn't fix the perceived issues. BDD patients are two to 12 times more likely to commit suicide [source: Annals of Plastic Surgery]. For those who seek treatment, a combination of medication and psychotherapy is most often prescribed.
Both David B. Sarwer, a psychologist invited to comment on the Swedish study, and the researchers propose that pre-existing psychological conditions likely form the connection between breast implants and suicide. Sarwer and the other researchers propose that breast implants provide temporary psychological relief to patients suffering from body image issues. However, those feelings of relief and satisfaction fade over time, accounting for the increase in suicides 10 years or more after surgery. The report on the Swedish study states that the high level of drug and alcohol abuse -- both before and after implantation -- indicates a need for pre-surgery screening and ongoing, post-surgery observation [source: Annals of Plastic Surgery].
A spokeswoman for a manufacturer of breast implants told the Los Angeles Times that her company was a "big advocate" of requiring patients seeking breast implants to undergo counseling prior to the procedure [source: Los Angeles Times]. In his accompanying report, Sarwer wrote that while surgeons generally screen patients for psychological disorders or body image issues, these studies indicate that screenings should be more rigorous and that surgeons should ask about any psychiatric treatment or hospitalization the patient has experienced. Until more is known, he said, surgeons should be as careful and thorough as possible when screening patients for breast implant surgery.
More Great Links
- "Body dysmorphic disorder." Mayo Clinic. Oct. 30, 2006. http://www.mayoclinic.com/health/body-dysmorphic-disorder/DS00559
- "Statistics 2006." The American Society for Aesthetic Plastic Surgery. http://www.surgery.org/press/statistics-2006.php
- Fox, Maggie. "Breast implants linked with suicide in study." Reuters. Yahoo News. Aug. 8, 2007. http://news.yahoo.com/s/nm/20070808/hl_nm/implants_suicide_dc;_ylt=Ag79THhc_Q8hJBcf464srAnVJRIF
- Gellene, Denise. "Breast implants linked to suicide risk." Los Angeles Times. Aug. 8, 2007. http://www.latimes.com/news/science/la-sci-implants8aug08,1,3168948.story?ctrack=1&cset=true
- Lipworth, Loren, Nyren, Olof, Ye, Weimin, Fryzek, Jon P., Tarone, Robert E. and McLaughlin, Joseph K. "Excess Mortality From Suicide and Other External Causes of Death Among Women With Cosmetic Breast Implants." Annals of Plastic Surgery. Aug. 2007. http://www.annalsplasticsurgery.com/pt/re/annps/abstract.00000637-200708000-00001.htm;jsessionid= GB1GLMkcZDGn5TsvTlLDPCPjmnvmsGht1fh7JnpfSGpYtJSwY7J0!1152499061!181195629!8091!-1
- Sarwer, David B. "Invited Discussion: Excess Mortality From Suicide and Other External Causes of Death Among Women With Cosmetic Breast Implants." Annals of Plastic Surgery. Aug. 2007. http://www.annalsplasticsurgery.com/pt/re/annps/fulltext.00000637-200708000-00002.htm;jsessionid= GB1GLMkcZDGn5TsvTlLDPCPjmnvmsGht1fh7JnpfSGpYtJSwY7J0!1152499061!181195629!8091!-1