Saline breast implants ... among women with breast implants the suicide rate was 73 per cent higher than in the general population.

Credit: U.S. Food and Drug Administration

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QUEBEC CITY, Canada: Women who have breast implants have a much lower rate of breast cancer but a far higher suicide rate than the general population, a new Canadian study shows.

The study, conducted among 24,600 women, concludes that having breast implants does not increase mortality risk. However the suicide rate among women with breast implants is 73 per cent higher than in the general population. These findings are published in a recent issue of the American Journal of Epidemiology.

Led by Jacques Brisson and Louis Latulippe of Université Laval in Québec, a team of researchers collected information on 17,400 women from the province of Québec and 7,200 from Ontario who had received breast implants for cosmetic purposes between 1974 and 1989. These women, who had undergone the surgery at an average age of 32, were the subject of regular follow-ups during a 15 year period.

A total of 480 women with breast implants died during the period of the study, and cross-referencing with the Canadian Vital Statistic Database was performed to determine the cause of death. There was no increase in mortality rate of women with breast implants. In fact, that rate was 26 per cent lower than in the control group. Fewer deaths from cancer - notably breast cancer - and heart disease accounted for most of the discrepancy.

According to the researchers, this lower mortality rate is not the result of breast augmentation, but rather of bias in the type of women electing to have surgery. "First, a woman must be in relatively good health to undergo breast implant surgery," said Brisson. "Also, women who receive breast implants tend to be of higher-than-average socioeconomic status. Thus, women who undergo breast augmentation surgery are more likely to be in better health than the general population."

To put this explanation to the test, the research team analysed a group of 16,000 women who had undergone plastic surgery procedures other than breast augmentation. As in the breast implant group, the mortality rate was lower (by 32 per cent) and the suicide rate higher (by 55 per cent) compared with the general population.

Previous studies have observed that the psychological profile of women who receive breast implants is characterised by low self-esteem, lack of self-confidence, and more frequent mental illnesses such as depression. According to Brisson, surgeons ahould pay particular attention to the reasons why women want to undergo breast augmentation. "If this reveals problems that cannot be treated with plastic surgery, doctors should refer these patients to mental health professionals," he said.

However the debate over breast implant safety is far from being settled, warned Brisson. "Our study shows that there is no relation between breast implants and mortality rate. It also demonstrates that the risk of cancer - particularly breast cancer - is not higher in women with breast implants. But our study does not assess the impact of breast implants on other aspects of women's health," he said.

"We know there are local complications due to implant degradation, which can sometimes lead to implant replacement. Women must take those facts into consideration when determining whether or not they want to receive breast implants," he added.