Women who undergo breast augmentation surgery are nearly three times as likely to commit suicide, according to a study published in the August issue of Annals of Plastic Surgery. This research confirms previously seen links between breast implants and a high risk of suicide, as well as deaths from alcohol or drug dependence.
The study, led by senior author Joseph McLaughlin and Loren Lipworth, both cancer epidemiologists with the Vanderbilt- Ingram Cancer Center, documented the increased suicide risk. This risk suggests plastic surgeons should consider mental health screening and follow-up for women who seek breast implants.
Lipworth and colleagues performed an extended followup study of 3,527 Swedish women who underwent cosmetic breast-implant surgery between 1965 and 1993.
At an average follow-up of nearly 19 years, the suicide rate was three times higher for women with breast implants as compared to the general population (based on 24 deaths). The risk was greatest–nearly seven times higher–for women who received their breast implants at age 45 or older. The average age at the time of surgery was 32 years.
Suicide risk did not increase significantly for the first 10 years after implant surgery.However, the risk increased with time: 4.5 times higher from 10 to 19 years’ follow-up and six times higher after 20 years.
Women with breast implants also had higher rates of death from mental disorders, including a threefold increase in deaths from alcohol and drug dependence. Several additional deaths, classified as accidents or injuries, might have been suicides or involved psychiatric disorders or drug and alcohol abuse as a contributing cause.
“Thus, at least 38 deaths (22 percent of all deaths) in this implant cohort were associated with suicide, psychological disorders, and/or drug and alcohol abuse or dependence,” according to the researchers.
There was no increase in the risk of death from cancer, including breast cancer, among women with breast implants, reports Lipworth. Increases in deaths from lung cancer and respiratory diseases, such as emphysema, likely reflected higher smoking rates among women with breast implants.
Several epidemiological studies have also found an increased suicide rate among women with cosmetic breast implants. The current study provides extended follow-up data on a previous nationwide study of Swedish women with breast implants, more than doubling the number of deaths analyzed.
The increases in suicide and in deaths related to alcohol and drug dependence suggest that a “nontrivial proportion of women undergoing breast augmentation may bring with them–or develop later– serious long-term psychiatric morbidity and eventually mortality,” Lipworth and colleagues write.
Because the study includes only deaths, the true rates of psychological and substanceabuse problems among women with cosmetic implants are likely much higher. The researchers conclude, “Such findings warrant increased screening, counseling, and perhaps post-implant monitoring of women seeking cosmetic breast implants.”
© 2013 Vanderbilt University
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