Women Who Receive Breast Implants More Likely to Commit Suicide
An interesting headline caught my eye yesterday regarding a link between breast implants and suicide. I expected the article to describe some sort of chemical that was leeching from these implants that negatively impacted the brain's ability to regulate mood. Instead, the article suggested that there may be a connection between certain mental health risk factors and women who choose to undergo the most popular form of cosmetic surgery in the U.S.
The results of several different research studies (see list below) suggest that women who receive breast implants are approximately two to three times more likely to commit suicide than women in the general population who don't receive breast implants. Data also suggests that the risk for suicide may be minimal initially (women had no higher risk of suicide in the first 10 years after surgery), and increase across time (4.5 times higher risk 10 to 19 years post-surgery and 6 times higher risk after 20 years). One study also found that women with breast implants had a significantly higher rate of deaths from alcohol or drug dependence than women without the implants.
On to the risk factors: the article I read suggested that some women who get implants have psychological problems (e.g., depression, low self-esteem, etc.) prior to the surgery, and that these issues do not go away afterward. Some of these women may also have body dysmorphic disorder (a disorder where a person is preoccupied with a real or imagined defect in appearance to the point that it interferes with daily functioning). People with body dysmorphic disorder are more prone to suicidal ideation (thoughts), suicide attempts, and completed suicide than people without this disorder. Estimates suggest that between 6% and 15% of patients who have cosmetic surgery also have body dysmorphic disorder, so it would not be surprising that some women who get implants do suffer from this condition.
One thing to keep in mind when thinking about the implications of this study is that this data is correlational. In other words, this research did not follow a tightly controlled protocol where women were randomly assigned to two groups (one who received breast implants and one who did not). Researchers also didn't measure the levels of mental health risk factors present in these women prior to and after surgery. One of the first things that introductory psychology students learn about scientific research is that correlational studies have a very important limitation: they do not identify what causes what. In other words, if two things are related, you do not know whether something else is also going on that might also be related.
Health professionals who have critically reviewed these studies offered another potential explanation for the connection between breast implants and suicide: implant breakage that results in a need to have another surgery. Some women cannot afford the additional expense of having old implants taken out (and new ones put back in), and may experience all sorts of problems (e.g., silicone spreading to other organs, pain or deformities) that can negatively impact their mental health.
Whatever the cause or connection, the research data clearly suggests that there is a need for psychological screening for women seeking breast augmentation. Plastic surgeons (who likely have minimal, if any training in mental health issues and assessment) should receive additional training about how to spot risk factors or "red flags" in women who come to them for consultation. These doctors should also establish a connection with a nearby psychologist or psychiatrist, who can perform mental health assessments for women at risk. Finally, women who have mental health issues should obtain help (e.g., psychotherapy and/or medication) for their psychological problems prior to surgery.