As a part of the study, lead researcher Dr. Loren Lipworth and colleagues performed an extended follow-up study of 3,527 Swedish women who underwent cosmetic breast implant surgery between 1965 and 1993.
They then used the death certificate data to analyze causes of death among women with breast implants, compared to the general female population.
They found that the long-term risk of suicide is tripled for women who have undergone cosmetic breast implant surgery. The risk was greatest—nearly seven times higher—for women who received their breast implants at age 45 or older. (The average age at breast implant surgery was 32 years.)
Suicide risk was not significantly increased for the first ten years after implant surgery. After that, however, suicide risk increased with time since surgery—risk was 4.5 times higher from 10 to 19 years' follow-up, and six times higher after 20 years.
The researchers also noted that women with breast implants also had higher rates of death from psychiatric disorders, including a three-fold increase in deaths resulting from alcohol and drug dependence.
Several additional deaths, classified as accidents or injuries, might have been suicides or involved psychiatric disorders or drug/alcohol abuse as a contributing cause.
'Thus at least 38 deaths (22 percent of all deaths) in this implant cohort were associated with suicide, psychologic disorders, and/or drug and alcohol abuse/dependence,' the researchers write.
There was no increase in the risk of death from cancer, including breast cancer, among women with breast implants. Several epidemiological studies have found an increased suicide rate among women with cosmetic breast implants.
The current study provides extended follow-up data on a previous nationwide study of Swedish women with breast implants, more than doubling the number of deaths analyzed.
'Nontrivial proportion of women undergoing breast augmentation undergoing cosmetic breast augmentation may bring with them—or develop later—serious long-term psychiatric morbidity and eventually mortality,' said Dr. Lipworth.
The study and its findings appear in the August issue Annals of Plastic Surgery, published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.