"Our research shows that between 7% and 15% of those who have plastic surgery have this condition," Sarwer tells WebMD. "These are the patients we need to be concerned about. They generally do not respond well to cosmetic surgery -- 80% or more have no change or even a worsening of psychiatric symptoms after surgery and many become suicidal or take legal action against their surgeon."
Peter B. Fodor, MD, a plastic surgeon in Los Angeles and president-elect of the American Society for Aesthetic Plastic Surgery, says the new Finnish study still doesn't offer any indication that getting breast implants increases a woman's risk of suicide. In March, his association issued a press release criticizing the Swedish study.
"We don't think this or the March study were well-done, and we are in the process of designing one that will be credible and statistically significant," he tells WebMD. "Overall, the longevity of women in the Finnish study who had breast augmentation was the same as those who didn't. So you can't make the correlation that suicide is greater because of the presence of breast implants."
As in the March study, he criticized the researchers for not examining patient histories or lifestyle before breast surgery to determine variables known to be associated with increased risk of suicide, such as panic disorder, depression, and alcoholism.
"People who have body dysmorphic disorders may commit
suicide whether they have surgery or not," says Fodor.
Despite the controversy, the number of women getting breast implants has skyrocketed in the past decade according to the American Society of Plastic Surgeons -- from about 32,000 in 1993 to nearly 237,000 last year.
For anyone considering any type of plastic surgery, here are some warning signs, according to Sarwer, that a person may be getting plastic surgery for the wrong reason:
- Seeing defects that others don't. "The biggest indication is when you're concerned about a feature that others have a difficult time identifying. For instance, you say, 'my breasts are too small' and others say they look fine," Sarwer says.
- The wrong motivation. "Is it an internal motivation that you're trying to improve your self esteem by restoring your breast to the shape that they were before you had children? Or are you looking to please a partner with this or become more popular?" The latter can be a recipe for unhappiness, according to Sarwer.
- Your expectations. It's reasonable if you go into surgery realizing that plastic surgery is unlikely to dramatically change your lot in life. "It's unlikely to get you promoted or save a troubled marriage," he says.