Suicide in Breast Implant Patients: ASAPS Commentary on a Swedish Study

According to the American Society for Aesthetic Plastic Surgery (ASAPS), a recent study about suicide in women with breast implants, published in the British Medical Journal, is seriously flawed and, therefore, its conclusions are questionable. The study, entitled "Total and Cause Specific Mortality Among Swedish Women With Cosmetic Breast Implants: Prospective Study," is not a prospective study; it is a retrospective cohort study (1965-1993) that, significantly, does not examine patients' histories before breast surgery to determine the impact of variables known to be associated with increased risk of suicide, such as panic disorder, depression, and alcoholism.

It is noteworthy that the authors of the Swedish study do not conclude that their data show a causal association between implant surgery and suicide - in other words, there is no evidence that having breast implants in any way causes suicide. However, they suggest that an increased incidence of suicide among implant patients in this study and this patient population might reflect a higher incidence of severe psychological disturbance among women seeking cosmetic breast augmentation. No published study has demonstrated this to be so. The validity of this assertion requires much more extensive psychological evaluation than is included in this study.

To examine the issues raised by the Swedish study more scientifically, prospective studies are needed, and these must be designed to control for variables known to be associated with increased risk of suicide. Additionally, these studies would need to examine patients' histories before breast surgery and evaluate them psychologically following surgery.

The American Society for Aesthetic Plastic Surgery (ASAPS) and its foundation, the Aesthetic Surgery Education and Research Foundation (ASERF), have sponsored research on psychological issues, patient satisfaction, and cosmetic surgery. These two organizations continue to educate their members with the goal of better serving the needs of patients.

About ASAPS
The American Society for Aesthetic Plastic Surgery (ASAPS), is recognized as the world’s leading organization devoted entirely to aesthetic plastic surgery and cosmetic medicine of the face and body.  ASAPS is comprised of over 2,600 Plastic Surgeons; active members are certified by the American Board of Plastic Surgery (USA) or by the Royal College of Physicians and Surgeons of Canada and have extensive training in the complete spectrum of surgical and non-surgical aesthetic procedures. International active members are certified by equivalent boards of their respective countries. All members worldwide adhere to a strict Code of Ethics and must meet stringent membership requirements.

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