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.