Depression Disorder & Body Image
Women with Breast Implants More Likely to Commit Suicide
In recent years there have been six studies investigating the relationship between cosmetic breast augmentation and suicide. What's the connection?
In July of 2007, Sarwer et al. published a review article in The American Journal of Psychiatry investigating recent research linking breast augmentation and suicide. The studies revealed that the suicide rate of women who received cosmetic breast implants is approximately twice the expected rate based on estimates of the general population.
What’s the Relationship?
There are several possible explanations for the correlation between breast implants, including:
- personality characteristics and psychopathology
- psychiatric hospitalization
- patients’ motivations and expectations
Personality Characteristics and Psychopathology
Characteristics of Those Who Get Cosmetic Breast Implants
Several studies have found that women who receive breast implants differ from other women on a variety of characteristics. They are more likely to:
- more frequently use alcohol and tobacco
- have a higher divorce rate
- have had more sexual partners
- report higher use of oral contraceptives
- be younger at first pregnancy
- have had an abortion
- have a below average body weight, leading to concern that some may be experiencing eating disorders
- have a history of psychiatric hospitalizations
Some of these characteristics have been found to be risk factors for suicide, including:
- previous psychiatric hospitalization
- alcohol consumption and tobacco
- eating disorders
Body Image Dissatisfaction and Body Dysmorphic Disorder.
Another characteristic by which women with breast implants differ from other women is their dissatisfaction with their body, and body image dissatisfaction may be the primary motivational factor in the pursuit of cosmetic surgery.
Several empirical studies have found that cosmetic surgery patients report dissatisfaction with their body image before surgery which improves postoperatively (Sarwer 2004).
Cosmetic Surgery and Body Dysmorphic Disorder
Between 3% and 15% of cosmetic surgery and dermatology patients have been found to have Body Dysmorphic Disorder (BDD), and 90% of this population experienced either no change or a worsening in their disorder following surgery (Crerand 2005).
The emotional suffering associated with Body Dysmorphic Disorder may lead some to contemplate or attempt suicide. The mean annual suicidal ideation rate among persons with BDD is 57.8%, and the mean annual suicide attempt rate is 2.6% (Phillips 2006).
Psychiatric Hospitalization
Jacobsen (2004) investigated psychiatric history of their cosmetic breast augmentation patients and found a higher rate of previous psychiatric hospitalizations among women with breast implants compared to both women who underwent other cosmetic procedures.
Among women in the general population, a history of psychiatric hospitalizations has been shown to be a strong predictor of suicide (Qin 2003).
Patients’ Motivations and Expectations
Several studies have suggested that patients report improvements in body image and quality of life and decreased anxiety and depressive symptoms following surgery. However there is presently no evidence indicating that patients' social relationships improve after surgery, and Honigman (2004) concluded that unrealistic expectations are associated with poor postoperative outcomes.
Some women may enter into breast augmentation surgery with unrealistic expectations about the effect that breast augmentation will have on their lives. When these expectations are not met, they may experience depression and potentially become suicidal.
Conclusions
Although there certainly appears to be a relationship between cosmetic breast augmentation and suicide, the specific nature of this relationship is unknown. The authors advise that women interested in breast enhancement who present with a history of psychopathology or who the plastic surgeon thinks may have problems with mental health should undergo psychological consultation before surgery.
More Information from this Study
To find additional information on Psychology in general, see the excellent website Psychology Prof Online. For more information on the studies of cosmetic breast implants and suicide, see the continued exploration of this study in the Suite101 article Breast Augmentation & Suicide.
This is a summary of one article describing the possible link between breast augmentation and suicide. It is not meant to take the place of medical or psychiatric care.
Sources
Crerand CE, Phillips KA, Menard W, Fay C: (2005) Non psychiatric medical treatment of body dysmorphic disorder. Psychosomatics 2005, 46.
Honigman R, Phillips KA, Castle DJ (2004) A review of psychosocial outcomes for patients seeking cosmetic surgery. Plast Reconstr Surg, 113.
National Plastic Surgery Procedural Statistics, 2006. Arlington Heights, III, American Society of Plastic Surgeons, 2007
Phillips KA, Menard W (2006) Suicidality in body dysmorphic disorder: a prospective study. Am J Psychiatry, 163.
Qin P, Agerbo E, Mortensen PB (2003) Suicide risk in relation to socioeconomic, demographic, psychiatric, and familial factors: a national register-based study of all suicides in Denmark, 1981-1997. Am J Psychiatry, 160.
Sarwer DB (2004) Discussion of causes of death among Finnish women with cosmetic breast implants, 1971-2001. Ann Plast Surg, 51.
