Breast Implants Linked to Increased Suicide Rate

Newswise — Women who undergo cosmetic breast implant surgery may have a threefold increase in their risk of suicide, suggests a study authored by a team of Finnish and American researchers that will be published in the October issue of the monthly journal Annals of Plastic Surgery.

The findings highlight the need for plastic surgeons to assess patients' mental health status before performing breast enlargement surgery, according to David B. Sarwer, Ph.D., of the Center for Human Appearance at the University of Pennsylvania School of Medicine. Dr. Sarwer will discuss the new results at the 22nd Annual AMA Science Reporters Conference, to be held September 11 and 12 in Philadelphia.

The team, led by Eero Pukkala, Ph.D. of the Finnish Cancer Registry and Joseph K. McLaughlin, Ph.D., of the International Epidemiology Institute, identified 2,166 women undergoing cosmetic breast implant surgery at hospitals and clinics in Finland from 1970 through 2000. They then compared rates and causes of death for women with breast implants with women in the general population.

Overall risk of death and risk of death from cancer were both no higher than expected for women with breast implants. Their risk of death from diseases of the circulatory system was actually lower than in the general population, possibly reflecting a healthier lifestyle among women who choose to undergo breast implant surgery.

However, women in the breast-implant group had a higher than expected rate of suicide—three times higher than in the general population.

The risk of suicide appeared particularly high in the first few years after implant surgery. Of ten women in the breast implant group who committed suicide, six did so within five years after their operation.

The study is the third in recent years to show an increased suicide risk in women who have undergone breast enlargement surgery, Dr. Sarwer notes in his discussion. Although the studies do not prove any cause-and-effect relationship, they raise concerns that underlying pre-operative psychological problems might lead to an increased rate of suicide among women receiving breast implants. Some reports have suggested increased rates of psychological disorders—including depression and low self-esteem—in this group of patients.

Plastic surgeons should be sure to ask every patient about her mental health history at the first visit, Dr. Sarwer believes. Asking about past and present mental health issues and treatment doesn't mean plastic surgeons are acting as a psychiatrist, any more than asking about patients' history of heart disease means they are acting as a cardiologist.

However, assessing the mental health history may help in deciding whether the patient could benefit from being evaluated by a psychologist or psychiatrist before or after surgery. Dr. Sarwer concludes, "[B]y more thoroughly assessing the psychological status of a prospective patient, the surgeon may be able to decrease the likelihood of an adverse psychological outcome postoperatively."