Study links breast implants, suicide

Women who receive implants for breast enhancement are three times more likely to commit suicide, according to a new report that offers a sobering view of an increasingly popular surgery.

Deaths related to mental disorders, including alcohol or drug dependence, also were three times higher among women who had the cosmetic procedure, researchers said.

The report in the August issue of the Annals of Plastic Surgery was the most recent to detect a higher suicide rate among women who had their breasts enlarged, providing a gloomy counterpoint to other studies that showed women felt better about themselves after getting implants.

While the study did not look at the reasons behind the suicides, senior author Joseph McLaughlin, a professor of medicine at the Vanderbilt University School of Medicine, said he believed many of the women had psychological problems before getting breast implants and their condition did not improve afterward.

Previous studies have shown that up to 15 percent of plastic-surgery patients have body dysmorphic disorder, a psychological condition marked by severe distress over minor physical imperfections.

People with the disorder have a higher rate of suicidal thoughts and rarely improve after plastic surgery.

Breast augmentation is the most popular cosmetic surgery procedure in the United States, followed by liposuction and eyelid surgery. Last year, 315,516 breast enlargements were performed, up 13 percent from 2005, according to the American Society of Plastic Surgeons.

Controversy has long dogged the procedure. Last year, the Food and Drug Administration (FDA) ended a 14-year ban on silicone-filled implants after finding little evidence the devices were unsafe. But the agency required manufacturers to conduct 10-year studies of 10,000 women each to look for long-term health consequences, including possible suicides.

The latest study analyzed data from 3,527 Swedish women who got implants between 1965-93. Breast-cancer patients who received implants as part of breast reconstruction were not included.

Scientists tracked the women for up to 29 years after their implants and found the risk of suicide increased over time. At the average follow-up of nearly 19 years, the suicide rate was three times higher for women with breast implants, compared with the general population, according to a Vanderbilt news release. There was no increased risk during the first 10 years after surgery, researchers said. Suicide risk was four and a half times higher 10 to 19 years after surgery and six times higher after 20 years.

Researchers said the results might have limited applicability to women today because breast augmentation is more socially acceptable than it was 40 years ago.

"You could make an argument that women who sought these procedures 30 to 40 years ago were pretty unique characters," said David Sarwer, a University of Pennsylvania psychologist who wrote a commentary accompanying the report.

McLaughlin said the study underscored the need for psychological screening of women seeking cosmetic breast enhancement.

Allergan, which manufactures the Inamed brand of implants, "is a big advocate" of psychological counseling before surgery, said company spokeswoman Caroline VanHove.