Cosmetic Breast Surgeries Tied to Increased Suicide Risk

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The excess in risk didn't become significant until 10 years after the implants were placed.

As to why the risk became statistically significant only later on, Lipworth speculated that, "it's possible that some women who may have had psychiatric illness prior to the implant may experience improvement in psychological functioning in the short term [after implant], but it's not sustained. So, 10 or 20 years out, there may be a recurrence or worsening of psychiatric problems."

Lipworth said the five other studies that also found similar trends were done in five different countries: the United States, Sweden, Denmark, Canada and Finland.

Besides the suicide risk, women with enhanced breasts had higher rates of death from psychiatric disorders, including a threefold increase in deaths caused by alcohol or drug dependence. In all, 38 deaths (about a fifth of the total) in the breast implant group were linked with suicide, psychological problems, or drug or alcohol abuse or dependence, Lipworth said.

A spokesperson for the American Society of Plastic Surgeons, Dr. Richard D'Amico, a plastic surgeon in Englewood, N.J., and president-elect of the society, pointed out that "there is no cause-effect relationship between breast implants and suicide" found in the study.

Plastic surgeons are aware, he added, that some potential plastic surgery patients may not be appropriate candidates. "Our members screen for psychological problems as well as medical," he said. If there are any "flags," he added, the plastic surgeon would refer the potential patient to help. That is routine practice among plastic surgeons, D'Amico said.

Another expert, David B. Sarwer, associate professor of psychology at the Center for Human Appearance, University of Pennsylvania School of Medicine, Philadelphia, wrote the "invited discussion" that accompanied the study.

In it, he urged physicians to heed the study results and to assess patients before they undergo cosmetic breast implants and other procedures, in particular looking for psychiatric problems. If a woman is under psychiatric treatment, Sarwer also urged the plastic surgeon to contact her mental health professional to assess whether she is stable enough for the surgery.