Breast Implants, Self-Esteem, Quality of Life, and the Risk of Suicide

Diana Zuckerman, PhD, National Center for Health Research, Caitlin Kennedy, PhD, Mishka Terplan, MD, MPH, Women’s Health Issues: August 2016

Breast augmentation is one of the most common cosmetic surgery in the United States, and many women are encouraged to undergo breast augmentation to improve their lives, self-esteem, or relationships. It is therefore surprising that studies in the United States and Scandinavian countries have shown that suicide rates are higher for women with breast implants.  These studies raise a key question: Do breast implants increase the risk of suicide or do pre-existing mental health problems increase the likelihood of undergoing breast implant surgery and also increase suicide risk?

This article is the first to take a comprehensive look at implants and suicide, by considering information from studies measuring self-esteem, self-concept, mental health, and quality of life among women before and after getting breast implants.

Our 2016 review of all published studies of breast implants and suicide identified 52 articles, but only 7 studies that provided original data on suicide among women with breast implants. All 7 studies found that women with breast implants had much higher suicide rates when compared to women with similar demographic traits – at least double the rate of suicides.  The greatest increase was among postmenopausal women with breast implants, who were 12 times more likely to commit suicide than postmenopausal women without breast implants.  Mastectomy patients with breast implants, many of whom were also post-menopausal, were 10 times as likely to commit suicide compared to mastectomy patients without breast implants. These differences were statistically significant.

Some plastic surgeons and researchers have hypothesized that patients seeking cosmetic surgery have lower self-esteem or tend to be more depressed than other women before they undergo surgery, and that would explain the higher suicide rate among breast implant recipients. However, our analysis of the 7 studies found that other plastic surgery patients were less likely to commit suicide than breast augmentation patients.  The study also found that females who underwent other types of plastic surgery procedures had lower suicide rates than the general female population, when accounting for age and race.  Studies comparing women’s self-esteem, self-identity, and quality of life before and after getting implants also show that these several of these qualities were higher than average prior to breast implant surgery but lower two years after implant surgery.

In other words, the relatively healthy and confident women who get breast implants tend to be less healthy and less confident afterwards. And, they are more likely to commit suicide.  That is true whether they got implants for augmentation or for reconstruction after a mastectomy.

In conclusion, the scientific evidence suggests that breast implants may have risks to mental health. Although suicide among women with implants was below 1% in each of the 7 studies, the rates ranging from 0.24% to 0.68% are significantly higher statistically and clinically than rates for comparable women without breast implants.  And, with millions of women with breast implants, the consistent evidence that women with breast implants are more likely to commit suicide is reason to be very concerned.  The research suggests that women who feel depressed or have low self-esteem should never be encouraged to get breast implants.

The research illustrates the importance of valid and reliable mental health screening to identify women considering breast augmentation who are vulnerable to depression or suicide.  Breast implant surgery should not be considered a strategy to fix low self-esteem or depression. Long-term studies on breast implant patients and depression, anxiety, and self-esteem are needed to give us a better understanding about the impact of implant surgery on women’s mental health and chances of suicide.

Download the article as a pdf here.
Read the original article here.