Loren Lipworth, ScD, Joseph K. McLaughlin, PhD, and colleagues analyzed data on 3,527 Swedish women. The women had voluntary cosmetic silicone breast-implant surgery an average of 19 years earlier.
"It appeared there was no excess risk of suicide in the first 10 years after receiving a breast implant," Lipworth tells WebMD. "But after that, the risk went up and continued to go up. There was a 4.5-fold risk for 10 years after surgery and a sixfold risk for 20 or more years."
The women also had a threefold higher risk of alcohol or drug dependence and an excess of drug/alcohol-related deaths from accident or injury.
Nobody is saying that silicon breast implants themselves make women commit suicide, although scientists cannot yet totally rule out that remote possibility, says Louise A. Brinton, PhD, MPH, chief of the hormonal and reproductive epidemiology branch of the U.S. National Cancer Institute.
"Probably this is not related to silicone toxicity, but we cannot entirely rule that out. It probably is more likely that it is an underlying psychological predisposition," Brinton tells WebMD.
Lipworth, along with every expert contacted by WebMD, agrees that the most likely explanation is that a small but substantial proportion of women seeking cosmetic breast implants have deep-seated psychological problems.
"What our data suggests to us is there is a subset of women choosing to get cosmetic breast implants who have psychiatric illness prior to implantation. This results in high risk of unnatural cause of death -- suicide and deaths related to alcohol dependence and drug abuse," says Lipworth, an assistant professor of medicine at Vanderbilt University, Nashville, Tenn.
The findings appear in the August issue of Annals of Plastic Surgery.
Plastic Surgery No Substitute for Mental Health Treatment
The current study isn't the first to find an increased risk of suicide after cosmetic breast augmentation surgery. Other studies too, show a link between breast implants and suicide.
Brinton led the first study to detect an increased risk of suicide in breast-implant patients.
"There could be a host of explanations," Brinton tells WebMD. "It could be these women have unrealistic expectations about how implants are going to change their lives. There could be complications of breast implants that affect quality of life. Or there could be underlying personality predispositions that lead both to seeking implants and to suicide. We can't tell which, although anecdotal evidence points to the third possibility."
Despite this link, it's clear that breast augmentation results in improved self-esteem for many women, notes Atlanta plastic surgeon Foad Nahai, MD, president of the American Society for Aesthetic Plastic Surgery.