In July of 2007, Sarwer et. al. published a review article in The American Journal of Psychiatry investigating recent research linking surgical breast enhancement and suicide. The studies revealed that the suicide rate of women who received cosmetic breast implants is approximately twice the expected rate based on estimates of the general population.
Growing Popularity of Breast Augmentation
According to the American Society of Plastic Surgeons, 329,396 women underwent cosmetic breast augmentation in the United States in 2006 (ASPS 2007), an increase of 55% since 2000 and more than 300% in the past decade. And since the FDA recently reapproved silicone breast implants, the ranks of American women who undergo cosmetic breast augmentation is expected to increase.
Breast Implants and Higher Rate of Suicide
In a study designed to investigate causes of mortality among women who underwent cosmetic breast augmentation (Brinton 2001) researchers reviewed medial records of nearly 13,500 women who received breast implants for cosmetic purposes and approximately 4,000 women who received other forms of cosmetic surgery.
Women with breast implants were found to have a higher mortality rate than women who received other forms of cosmetic surgery, and suicide victims were more often women who were 40 or older at time of implantation.
The subjects of this study were followed up 5 years later and the researchers found results consistent with their 2001 study; higher suicide rate among women who had breast augmentation, particularly those who had the augmentation when 40 or older.
In 2003, two more studies examining death records of women who had received cosmetic breast implants found a significantly higher number of suicides when this group was compared to women who did not have breast implants (Koot 2003, Pukkala 2003).
Breast Implants and Psychiatric Hospitalization
In 2004 another study was published investigating the overall mortality associated with breast implants and providing information on psychiatric hospitalization (Jacobsen 2004).
Women who underwent cosmetic breast augmentation were found to have an elevated rate of death by suicide. Eight percent of women who underwent cosmetic breast augmentation were found to have a history of psychiatric hospitalizations before surgery, which was higher than the rate of hospitalizations for women who underwent breast reduction (4.7%) or other cosmetic procedures (5.5%).
The Most Recent Study
Villeneuve (2006) examined mortality in 24,558 Canadian women with breast implants, comparing this group to 15,893 women who underwent other cosmetic surgical procedures. They found that 58 deaths among women with breast implants were attributed to suicide, compared to the expected 33.5.
Other cosmetic surgery patients also were found to have a higher rate of suicide (33 deaths). However, in this study, the rate of suicide between women with breast implants and those who underwent other forms of cosmetic surgery was not significantly different.Study Conclusions
With all studies considered together, there have been 126 suicides among women with cosmetic breast implants. The suicide rate is approximately twice that expected from estimates from the general population.
Although there certainly appears to be a relationship between cosmetic breast augmentation and suicide, the specific nature of this relationship is unknown. The authors advise that women interested in breast enhancement who present with a history of psychopathology, or those that the plastic surgeon suspects of having mental health problems, undergo psychological consultation before surgery.
Brinton LA et al. (2001) “Mortality among augmentation mammoplasty patients.” Epidemiology, 12.
Brinton LA et al (2006) “Mortality rates among augmentation mammoplasty patients: an update.” Epidemiology, 17.
Jacobsen PH (2004) “Mortality and suicide among Danish women with cosmetic breast implants.” Arch Intern Med, 164.
Koot VC et al. (2003) “Total and cause specific mortality among Swedish women with cosmetic breast implants: a prospective study.” BMJ 326.
National Plastic Surgery Procedural Statistics, 2006. Arlington Heights, III, American Society of Plastic Surgeons, 2007.
Pukkala E, et al (2003) “Causes of death among Finnish women with cosmetic breast implants, 1971-2001.” Ann Plast Surg, 51.
Sarwer, D. B.; Brown, G. K., and Evans, D. L. (2007) “Cosmetic Breast Augmentation and Suicide.” Am J Psychiatry 164:1006-1013.
Villeneuve PJ et al (2006) “Mortality among Canadian women with cosmetic breast implants.” Am J Epidemiol, 164.