Does having surgically enhanced breasts make women happier? Researchers found that Swedish women who had breast implants were 50% more likely to commit suicide than women without them.

The study showed that deaths of women with breast implants were higher than expected in the categories of suicide and lung cancer due to smoking.

The authors suggested that the extra deaths might be attributable to underlying psychiatric problems—something that plastic surgeons are generally on guard for in patients. Dr. Veronica Koot, one of the study's authors and a clinician at the University Medical Center in Utrecht, the Netherlands, said that "very low self-esteem" might be to blame.

"This is not the, first study to suggest that suicide rates might be higher [in women who have had a breast enlargement]," according to Dr. David L. Feldman, vice president of perioperative services at Maimonides Medical Center in Brooklyn, NewYork. "'Women are deluded into thinking that having larger breasts will change their life. It won't. It'll change their breasts."


Not everyone agrees that the suicides can be linked to the breast implants. "That just doesn't compute with the information that we have in this country," says Dr. James Wells, former president of the American Society of Plastic Surgeons. *We don't know that we have a cause and- effect relationship."

Part of the problem, Wells suggests, is inherent in looking at people from two different societies—in this case, the United States and Sweden.

Wells estimates that US plastic surgeons turn away clients roughly 2% to 5% of the time. "There's an evaluation process by the physicians to try to identify those patients who seem a little unstable. Their job history isn't stable, they're bouncing from relationship to relationship," he says. "'We need to spend time listening to the patient. Surgeons have a responsibility to say no as much as they have a responsibility to say yes."


Koot agreed that different screening procedures could account for a difference in risk, depending on the country.

The typical woman seeking breast augmentation in the US is happily married and has several children, Wells says. "She is looking to reverse what pregnancy did in terms of her breasts and appearance" he says.

Still, identifying the "right" person can be as much art as science. "'We try to avoid operating on somebody who has a propensity for suicide, but this is a tough call and some people will slip through the cracks," Feldman says. "It does point out our obligation to do a full evaluation and not just rush a person off to the operating room."

The American Society of Plastic Surgeons at and The American Society for Aesthetic Plastic Surgery at provide extensive overviews for women thinking about breast enlargement.

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