Plastic Surgery No Substitute for Mental Health Treatment continued...
"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.
"The flip side of this is a number of studies that show improvement in self-esteem and self-worth following breast augmentation. It has that effect, but it is not a substitute for mental health care," Nahai tells WebMD.
Sarwer, associate professor of psychology at the University of Pennsylvania's Center for Human Appearance, says any rise in self-esteem after breast augmentation cannot permanently offset underlying suicidal tendencies.
"I would not want to say breast implants fix this underlying predisposition to suicide," Sarwer says. "We do not say plastic surgery is a treatment for any kind of illness."
Psychological Screening for Women Seeking Breast Implants?
Sarwer has analyzed the research linking breast implants to suicide. He notes that the data come from silicone breast-implant safety studies. At the time researchers designed the studies, they were mainly looking for evidence of cancer and immune dysfunction.
The studies were reassuring about those worries. But when evidence of a suicide link emerged, it left researchers with very little information on the women's mental state and psychiatric history of psychiatric treatment.
What little evidence there is suggests that prior psychiatric hospitalization -- a major risk factor for suicide -- is disproportionately common among women who get cosmetic breast implants.
"Plastic surgeons need to do a better job of screening patients for psychological illnesses," Sarwer says. "My colleagues at the University of Pennsylvania and I have recently reviewed these findings, and we argue that plastic surgeons should evaluate the psychological status of all patients. If they encounter a patient in psychiatric treatment or with a history of psychiatric hospitalization, they should insist that those patients get a mental health consultation prior to surgery."