Women looking to enhance their cup size are two to three times more likely to commit suicide according to a study in the Annals of Plastic Surgery.
Finnish researchers monitored the mortality rates of women with cosmetic breast implants between 1970 and 2000 and found suicide was the most common cause of death among these women.
But the link between suicide and breast implants is more complex than cause and effect according to Joseph McLaughlin, the study’s chief researcher.
“I find it hard to believe that a breast implant would force someone to commit suicide,” he said. “Those women who unfortunately did commit suicide had a prior history of psychiatric admissions to hospitals before they ever had their breast implants so that would suggest that they came with the problem. That it was not the implant. It was something that they were not happy with themselves,” said McLaughlin. Low self-esteem, depression or a condition known as body dysmorphic disorder (BDD) may be to blame.
According to a study in the British Medical Journal BDD affects about 6% to 15% of women who undergo cosmetic surgery. BDD, often referred to as 'imagined ugliness,' is marked by a severe obsession with physical appearance to the extent that symptoms impair daily functioning.
The Diagnostic Statistical Manual of Mental Disorders lists the following symptoms of BDD:
Body image specialist Katharine Phillips says, "a significant percentage of patients diagnosed with Body Dysmorphic Disorder (BDD) seek cosmetic surgery."
Phillips believes many patients with the disorder underreport their condition. She says the suicide rate for American women with BDD is about 6 to 23 times higher than in the general population.
"Patients with BDD typically do not disclose their symptoms due to shame and embarrassment," she said.
The tendency to underreport symptoms of BDD is important because the research relies heavily on reviewing patient charts.
And Phillips says researchers could miss the link between cosmetic breast surgery and risk of suicide if the psychiatric condition is not reported on these charts.
London-based psychiatrist Laurence Jerome says psychological screening is an important part of the decision-making process.
"Hence the well recognised need for a careful psychiatric screen of patients undergoing cosmetic surgery," he said. "I suspect in practice this is not always done."
Plastic surgeon Mitchell Brown (left) says psychological screening is not a routine part of his Toronto-based practice.
However, the physician does conduct a thorough thirty minute consultation, he said.
"When a woman comes to see me for consideration of breast implant surgery, I spend a great deal of time trying to understand why they are there, what their individual concerns are, and what are their goals and expectations," he said.
The Study
The study, title Causes of Death Among Finnish Women with Cosmetic Breast Implants was conducted by the International Epidemiology Institute and examined the suicide rate of women who had received cosmetic breast implants in
Researchers compared the expected suicide rate of women who had undergone cosmetic breast implants to those observed in the general population. The study reported 95% confidence intervals.
Updated December 9, 2004
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Dying to be Perfect
Phillips is the director of the 
