Characteristics of women who have had cosmetic breast implants that could be associated with increased suicide risk: a systematic review, proposing a suicide prevention model

Abstract

Literature indicates an increased risk of suicide among women who have had cosmetic breast implants. An explanatory model for this association has not been established. Some studies conclude that women with cosmetic breast implants demonstrate some characteristics that are associated with increased suicide risk while others support that the breast augmentation protects from suicide. A systematic review including data collection from January 1961 up to February 2014 was conducted. The results were incorporated to pre-existing suicide risk models of the general population. A modified suicide risk model was created for the female cosmetic augmentation mammaplasty candidate. A 2-3 times increased suicide risk among women that undergo cosmetic breast augmentation has been identified. Breast augmentation patients show some characteristics that are associated with increased suicide risk. The majority of women reported high postoperative satisfaction. Recent research indicates that the Autoimmune syndrome induced by adjuvants and fibromyalgia syndrome are associated with silicone implantation. A thorough surgical, medical and psycho-social (psychiatric, family, reproductive, and occupational) history should be included in the preoperative assessment of women seeking to undergo cosmetic breast augmentation. Breast augmentation surgery can stimulate a systematic stress response and increase the risk of suicide. Each risk factor of suicide has poor predictive value when considered independently and can result in prediction errors. A clinical management model has been proposed considering the overlapping risk factors of women that undergo cosmetic breast augmentation with suicide.

Keywords: Breast implants; Cosmetic surgery; Mammaplasty; Silicone; Suicide.

Fig. 1. Suicide risk model

(A) Psychological and psychosocial factors i.e.,unrealistic expectations, mood disorders, low self esteem, body image, anxiety, depression, psychiatric unit admission, recent stressful life events, relationship problems, financial issues. (B) Demographic factors and reproductive history i.e.,white, age, education, marital status, infertility, history of terminated pregnancies. (C) Stimuli that can trigger stress response i.e., augmentation mammaplasty operation/postoperative complications, atopy/>10 years of implantation in cosmetic breast augmentation women/hyperimmune state, ASIA, FMS, and low levels of 5-HIAA in CSF. ASIA, autoimmune syndrome induced by adjuvants; FMS, fibromyalgia syndrome; 5-HIAA, 5-hydroxyindoleacetic acid; CSF, cerebrospinal fluid.