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Breast implants and suicide

August 10th, 2007

Dr Petra

A study recently published in the journal Annals of Plastic Surgery has shown a link between women who’ve had cosmetic surgery (specifically breast implants) and an increase risk of suicide.

Researchers analysed the death certificates of 3,527 Swedish women who’d had breast implants between 1965 and 1993. They found women who had had breast implants were three times more likely to kill themselves compared with women who had not had breast implants

This has led to an absolute frenzy in the media with headlines screaming links between breast implants (or plastic surgery in general) and suicide.

All of which isn’t very responsible reporting. The research and subsequent media coverage both need a critical analysis.

All the hysteria over breast implants assumes that women had the implants for cosmetic reasons, rather than having them as reconstructive surgery post cancer or following an injury to the breast.

The media coverage implies that the researchers followed up a cohort of women over time and assessed how many of them killed themselves, when in fact the researchers simply examined death certificates. Nothing wrong with that methodologically, but it’s not the same as talking to real people about their experiences, you’ve only got a death certificate to go on which can only tell you a small amount of information.

Evidence consistently shows that women who seek cosmetic surgery may well have low self esteem or other psychological problems that lead to their seeking cosmetic surgery and such women may well have multiple cosmetic procedures if their underlying problems are not addressed.

However, this research only looked at the cause of death, and so did not indicate what other factors could be at play. They were able to tell women had had cosmetic surgery, and they had committed suicide. But it may be that women happened to have cosmetic surgery but some other factor caused them to kill themselves. The study only records suicides rather than attempts at suicide or episodes of self harm which may be a more compelling sign of distress in women who’ve had cosmetic surgery.

There’s no doubt if you are depressed or unhappy with your body you may feel surgery could be the answer. Many people claim this is the case. This research, and the hysterical media coverage has unfortunately given the impression that all women who have breast implants are somehow psychologically imbalanced, and in many cases given the incorrect impression that having a boob job will mean you’re going to kill yourself which is bound to cause many women a lot of anxiety.

For the record the research is not claiming there’s anything inherent within breast implants that will lead to people developing suicidal thoughts, it’s claiming that people who seek cosmetic surgery may well already have psychological problems that later lead to suicide.

Although this research can draw practitioners’ attention to the risk of suicide for those with low self esteem/psychological problems who may also be seeking surgery there is another flaw within the study that the media has not noticed.

Most cosmetic surgeons who’re not performing reconstructive breast surgery following an illness or injury are working in private practice. They may already know full well their patients probably have deeper psychological problems, but it’s sadly often not the case that such people are refused procedures. And even if they are there’s always a less ethical practitioner out there happy to take a patient’s money.

We live in a culture where breast implants are now seen as a fashion accessory, as a minor procedure you can get as a coming of age gift or paid for with a bank loan. There are multiple TV programmes extolling the virtues of cosmetic procedures. Celebrities coo over their latest implant, liposuction, botox or boob job. Rather than seeing cosmetic surgery as something that could be masking a deeper psychological problem in some people, the popular view is that if you need ‘improving’ there’s now help available for you. And that’s precisely the message many private cosmetic firms promote.

Care needs to be taken with this research to put it into context. It’s wrong to imply all women who’ve had surgery are victims who don’t know their own minds, or who should all be on suicide watch. It’s wrong to link breast implants themselves as causing suicide. But it’s also wrong not to take a critical look at those promoting surgery – in particular clinicians and the media. Telling us that women who’ve had implants may be three times more likely to kill themselves is meaningless unless the practitioners who’re not turning away those who may well be psychologically vulnerable are placed under stricter scruitiny and control, and the media coverage celebrating surgery is stopped.

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