Cosmetic Breast Implants and the Risk of Suicide: A Systematic Review and Meta-Analysis
-
Zahra Mousavi
,
Nasrin Abolhasanpour
,
Amirreza Naseri
,
Fatemeh Maghsoudi
,
Azizeh Farshbaf-khalili
,
Kavous Shahsavarinia
,
Ali Mousavi
,
Rasa Beheshti
,
Ali Mostafaei
,
Hanieh Salehi-Pourmehr
Abstract
Objective: Having cosmetic breast implants increases a woman's chance of suicide, which is now a global challenge.
This systematic review evaluated the possible risk of suicide among women who undergo cosmetic breast implants.
Method: This meta-analysis was done based on Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). In the current systematic review and meta-analysis, we systematically searched for all articles written in both English or Persian that estimated the prevalence of suicidal ideation in women who had cosmetic breast implants. We systematically searched different databases, including MEDLINE (PubMed), Web of Science, Embase, Cochrane, Library ProQuest, Scopus, and Google Scholar, from inception to March 2021. There was also a search for references. Suicidal ideation, a suicide plan, or suicide attempts were the outcomes. In order to determine the total pooled prevalence of suicidal ideation, we utilized a random-effects model. To examine the risks of bias in each study, we applied the Joanna Briggs Institute Critical Appraisal method.
Results: We identified 218 citations in our initial search. After omitting duplicated citations and excluding irrelevant studies according to the title and abstract selection, 42 studies were chosen for the full text analysis. Finally, 11 research, examining a total of 324,332 women were incorporated into the systematic review and critical appraisal assessment. Eight of these studies were found to be eligible for meta-analysis. The frequency of suicide in women with cosmetic breast implant was 0.2% (95% CI: 0.1% to 0.4%; P < 0.001) (Q-value: 168.143, I2:95.83). Most of the included studies had moderate quality.
Conclusion: There might be a correlation between cosmetic breast implants and suicide risk, which could be stronger in the presence of a history of mental illnesses. The evidence about the possible effects of breast implants on the risk of suicide is still inconclusive, and there is a need for future well-designed studies on this topic.
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2. Vijayakumar L. Suicide in women. Indian J Psychiatry. 2015;57(Suppl 2):S233-8.
3. Callanan VJ, Davis MS. Gender differences in suicide methods. Soc Psychiatry Psychiatr Epidemiol. 2012;47(6):857-69.
4. Tandon VJ, DeLong MR, Ballard TN, Clemens MW, Brandt KE, Kenkel JM, et al. Evolving Trends in Textured Implant Use for Cosmetic Augmentation in the United States. Plast Reconstr Surg. 2018;142(6):1456-61.
5. Balk EM, Earley A, Avendano EA, Raman G. Long-Term Health Outcomes in Women With Silicone Gel Breast Implants: A Systematic Review. Ann Intern Med. 2016;164(3):164-75.
6. Manoloudakis N, Labiris G, Karakitsou N, Kim JB, Sheena Y, Niakas D. 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. Arch Plast Surg. 2015;42(2):131-42.
7. Lipworth L, McLaughlin JK. Excess suicide risk and other external causes of death among women with cosmetic breast implants: a neglected research priority. Curr Psychiatry Rep. 2010;12(3):234-8.
8. Rohrich RJ, Adams WP, Jr., Potter JK. A review of psychological outcomes and suicide in aesthetic breast augmentation. Plast Reconstr Surg. 2007;119(1):401-8.
9. Crerand CE, Infield AL, Sarwer DB. Psychological considerations in cosmetic breast augmentation. Plast Surg Nurs. 2007;27(3):146-54.
10. Crerand CE, Infield AL, Sarwer DB. Psychological considerations in cosmetic breast augmentation. Plast Surg Nurs. 2009;29(1):49-57; quiz 8-9.
11. Zuckerman DM, Kennedy CE, Terplan M. Breast Implants, Self-Esteem, Quality of Life, and the Risk of Suicide. Womens Health Issues. 2016;26(4):361-5.
12. Sarwer DB, Brown GK, Evans DL. Cosmetic breast augmentation and suicide. Am J Psychiatry. 2007;164(7):1006-13.
13. Sarwer DB, Brown GK, Evans DL. Cosmetic breast augmentation and suicide. Am J Psychiatry. 2007;164(7):1006-13.
14. McLaughlin JK, Wise TN, Lipworth L. Increased risk of suicide among patients with breast implants: do the epidemiologic data support psychiatric consultation? Psychosomatics. 2004;45(4):277-80.
15. Manoloudakis N, Labiris G, Karakitsou N, Kim JB, Sheena Y, Niakas D. 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. Arch Plast Surg. 2015;42(2):131-42.
16. Porritt K, Gomersall J, Lockwood C. JBI's Systematic Reviews: Study selection and critical appraisal. Am J Nurs. 2014;114(6):47-52.
17. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg (London, England). 2010;8(5):336-41.
18. von Soest T, Kvalem IL, Wichstrøm L. Predictors of cosmetic surgery and its effects on psychological factors and mental health: a population-based follow-up study among Norwegian females. Psychol Med. 2012;42(3):617-26.
19. Brinton LA, Lubin JH, Murray MC, Colton T, Hoover RN. Mortality rates among augmentation mammoplasty patients: an update. Epidemiology. 2006;17(2):162-9.
20. de Paula PR, Fortes de Arruda FC, Prado M, Neves CG. Prevalence of Depressive Symptoms in Patients Requesting Cosmetic Breast Surgery in Midwestern Brazil. Plast Reconstr Surg Glob Open. 2018;6(10):e1899.
21. Coroneos CJ, Selber JC, Offodile AC, 2nd, Butler CE, Clemens MW. US FDA Breast Implant Postapproval Studies: Long-term Outcomes in 99,993 Patients. Ann Surg. 2019;269(1):30-6.
22. Jacobsen PH, Hölmich LR, McLaughlin JK, Johansen C, Olsen JH, Kjøller K, et al. Mortality and suicide among Danish women with cosmetic breast implants. Arch Intern Med. 2004;164(22):2450-5.
23. Lipworth L, Nyren O, Ye W, Fryzek JP, Tarone RE, McLaughlin JK. Excess mortality from suicide and other external causes of death among women with cosmetic breast implants. Ann Plast Surg. 2007;59(2):119-23; discussion 24-5.
24. Pukkala E, Kulmala I, Hovi SL, Hemminki E, Keskimäki I, Pakkanen M, et al. Causes of death among Finnish women with cosmetic breast implants, 1971-2001. Ann Plast Surg. 2003;51(4):339-42; discussion 43-4.
25. Rubin JP, Landfair AS, Shestak K, Lane D, Valoski A, Chang Y, et al. Health characteristics of postmenopausal women with breast implants. Plast Reconstr Surg. 2010;125(3):799-810.
26. Singh N, Picha GJ, Hardas B, Schumacher A, Murphy DK. Five-Year Safety Data for More than 55,000 Subjects following Breast Implantation: Comparison of Rare Adverse Event Rates with Silicone Implants versus National Norms and Saline Implants. Plast Reconstr Surg. 2017;140(4):666-79.
27. Villeneuve PJ, Holowaty EJ, Brisson J, Xie L, Ugnat AM, Latulippe L, et al. Mortality among Canadian women with cosmetic breast implants. Am J Epidemiol. 2006;164(4):334-41.
28. Koot VC, Peeters PH, Granath F, Grobbee DE, Nyren O. Total and cause specific mortality among Swedish women with cosmetic breast implants: prospective study. Bmj. 2003;326(7388):527-8.
29. Heidekrueger PI, Sinno S, Hidalgo DA, Colombo M, Broer PN. Current Trends in Breast Augmentation: An International Analysis. Aesthet Surg J. 2018;38(2):133-48.
30. Ramachandran K. Breast augmentation. Indian J Plast Surg. 2008;41(Suppl):S41-S7. PubMed PMID: 20174542.
31. Lavigne E, Holowaty EJ, Pan SY, Villeneuve PJ, Johnson KC, Fergusson DA, et al. Breast cancer detection and survival among women with cosmetic breast implants: systematic review and meta-analysis of observational studies. Bmj. 2013;346:f2399.
32. McLaughlin JK, Wise TN, Lipworth L. Increased risk of suicide among patients with breast implants: do the epidemiologic data support psychiatric consultation? Psychosomatics. 2004;45(4):277-80.
33. Kanwar A, Malik S, Prokop LJ, Sim LA, Feldstein D, Wang Z, et al. The association between anxiety disorders and suicidal behaviors: a systematic review and meta-analysis. Depress Anxiety. 2013;30(10):917-29.
34. Hawton K, Casañas ICC, Haw C, Saunders K. Risk factors for suicide in individuals with depression: a systematic review. J Affect Disord. 2013;147(1-3):17-28.
35. Hawton K, Harriss L. The changing gender ratio in occurrence of deliberate self-harm across the lifecycle. Crisis. 2008;29(1):4-10.
36. Qin P, Agerbo E, Westergård-Nielsen N, Eriksson T, Mortensen PB. Gender differences in risk factors for suicide in Denmark. Br J Psychiatry. 2000;177:546-50.
37. Palladino CL, Singh V, Campbell J, Flynn H, Gold KJ. Homicide and suicide during the perinatal period: findings from the National Violent Death Reporting System. Obstet Gynecol. 2011;118(5):1056-63.
38. Samandari G, Martin SL, Kupper LL, Schiro S, Norwood T, Avery M. Are pregnant and postpartum women: at increased risk for violent death? Suicide and homicide findings from North Carolina. Matern Child Health J. 2011;15(5):660-9.
39. Steinberg JR, Becker D, Henderson JT. Does the outcome of a first pregnancy predict depression, suicidal ideation, or lower self-esteem? Data from the National Comorbidity Survey. Am J Orthopsychiatry. 2011;81(2):193-201.
40. Song WJ, Kang SG, Seo BF, Choi NK, Lee JH. A Systematic Review of the National Breast Implant Registry for Application in Korea: Can We Predict "Unpredictable" Complications? Medicina (Kaunas). 2020;56(8).
41. Wurzer P, Hundeshagen G, Cambiaso-Daniel J, Fischer S, Hoflehner H, Spendel S, et al. Lessons Learned From Breast Implant Registries: A Systematic Review. Ann Plast Surg. 2019;83(6):722-5.
2. Vijayakumar L. Suicide in women. Indian J Psychiatry. 2015;57(Suppl 2):S233-8.
3. Callanan VJ, Davis MS. Gender differences in suicide methods. Soc Psychiatry Psychiatr Epidemiol. 2012;47(6):857-69.
4. Tandon VJ, DeLong MR, Ballard TN, Clemens MW, Brandt KE, Kenkel JM, et al. Evolving Trends in Textured Implant Use for Cosmetic Augmentation in the United States. Plast Reconstr Surg. 2018;142(6):1456-61.
5. Balk EM, Earley A, Avendano EA, Raman G. Long-Term Health Outcomes in Women With Silicone Gel Breast Implants: A Systematic Review. Ann Intern Med. 2016;164(3):164-75.
6. Manoloudakis N, Labiris G, Karakitsou N, Kim JB, Sheena Y, Niakas D. 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. Arch Plast Surg. 2015;42(2):131-42.
7. Lipworth L, McLaughlin JK. Excess suicide risk and other external causes of death among women with cosmetic breast implants: a neglected research priority. Curr Psychiatry Rep. 2010;12(3):234-8.
8. Rohrich RJ, Adams WP, Jr., Potter JK. A review of psychological outcomes and suicide in aesthetic breast augmentation. Plast Reconstr Surg. 2007;119(1):401-8.
9. Crerand CE, Infield AL, Sarwer DB. Psychological considerations in cosmetic breast augmentation. Plast Surg Nurs. 2007;27(3):146-54.
10. Crerand CE, Infield AL, Sarwer DB. Psychological considerations in cosmetic breast augmentation. Plast Surg Nurs. 2009;29(1):49-57; quiz 8-9.
11. Zuckerman DM, Kennedy CE, Terplan M. Breast Implants, Self-Esteem, Quality of Life, and the Risk of Suicide. Womens Health Issues. 2016;26(4):361-5.
12. Sarwer DB, Brown GK, Evans DL. Cosmetic breast augmentation and suicide. Am J Psychiatry. 2007;164(7):1006-13.
13. Sarwer DB, Brown GK, Evans DL. Cosmetic breast augmentation and suicide. Am J Psychiatry. 2007;164(7):1006-13.
14. McLaughlin JK, Wise TN, Lipworth L. Increased risk of suicide among patients with breast implants: do the epidemiologic data support psychiatric consultation? Psychosomatics. 2004;45(4):277-80.
15. Manoloudakis N, Labiris G, Karakitsou N, Kim JB, Sheena Y, Niakas D. 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. Arch Plast Surg. 2015;42(2):131-42.
16. Porritt K, Gomersall J, Lockwood C. JBI's Systematic Reviews: Study selection and critical appraisal. Am J Nurs. 2014;114(6):47-52.
17. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg (London, England). 2010;8(5):336-41.
18. von Soest T, Kvalem IL, Wichstrøm L. Predictors of cosmetic surgery and its effects on psychological factors and mental health: a population-based follow-up study among Norwegian females. Psychol Med. 2012;42(3):617-26.
19. Brinton LA, Lubin JH, Murray MC, Colton T, Hoover RN. Mortality rates among augmentation mammoplasty patients: an update. Epidemiology. 2006;17(2):162-9.
20. de Paula PR, Fortes de Arruda FC, Prado M, Neves CG. Prevalence of Depressive Symptoms in Patients Requesting Cosmetic Breast Surgery in Midwestern Brazil. Plast Reconstr Surg Glob Open. 2018;6(10):e1899.
21. Coroneos CJ, Selber JC, Offodile AC, 2nd, Butler CE, Clemens MW. US FDA Breast Implant Postapproval Studies: Long-term Outcomes in 99,993 Patients. Ann Surg. 2019;269(1):30-6.
22. Jacobsen PH, Hölmich LR, McLaughlin JK, Johansen C, Olsen JH, Kjøller K, et al. Mortality and suicide among Danish women with cosmetic breast implants. Arch Intern Med. 2004;164(22):2450-5.
23. Lipworth L, Nyren O, Ye W, Fryzek JP, Tarone RE, McLaughlin JK. Excess mortality from suicide and other external causes of death among women with cosmetic breast implants. Ann Plast Surg. 2007;59(2):119-23; discussion 24-5.
24. Pukkala E, Kulmala I, Hovi SL, Hemminki E, Keskimäki I, Pakkanen M, et al. Causes of death among Finnish women with cosmetic breast implants, 1971-2001. Ann Plast Surg. 2003;51(4):339-42; discussion 43-4.
25. Rubin JP, Landfair AS, Shestak K, Lane D, Valoski A, Chang Y, et al. Health characteristics of postmenopausal women with breast implants. Plast Reconstr Surg. 2010;125(3):799-810.
26. Singh N, Picha GJ, Hardas B, Schumacher A, Murphy DK. Five-Year Safety Data for More than 55,000 Subjects following Breast Implantation: Comparison of Rare Adverse Event Rates with Silicone Implants versus National Norms and Saline Implants. Plast Reconstr Surg. 2017;140(4):666-79.
27. Villeneuve PJ, Holowaty EJ, Brisson J, Xie L, Ugnat AM, Latulippe L, et al. Mortality among Canadian women with cosmetic breast implants. Am J Epidemiol. 2006;164(4):334-41.
28. Koot VC, Peeters PH, Granath F, Grobbee DE, Nyren O. Total and cause specific mortality among Swedish women with cosmetic breast implants: prospective study. Bmj. 2003;326(7388):527-8.
29. Heidekrueger PI, Sinno S, Hidalgo DA, Colombo M, Broer PN. Current Trends in Breast Augmentation: An International Analysis. Aesthet Surg J. 2018;38(2):133-48.
30. Ramachandran K. Breast augmentation. Indian J Plast Surg. 2008;41(Suppl):S41-S7. PubMed PMID: 20174542.
31. Lavigne E, Holowaty EJ, Pan SY, Villeneuve PJ, Johnson KC, Fergusson DA, et al. Breast cancer detection and survival among women with cosmetic breast implants: systematic review and meta-analysis of observational studies. Bmj. 2013;346:f2399.
32. McLaughlin JK, Wise TN, Lipworth L. Increased risk of suicide among patients with breast implants: do the epidemiologic data support psychiatric consultation? Psychosomatics. 2004;45(4):277-80.
33. Kanwar A, Malik S, Prokop LJ, Sim LA, Feldstein D, Wang Z, et al. The association between anxiety disorders and suicidal behaviors: a systematic review and meta-analysis. Depress Anxiety. 2013;30(10):917-29.
34. Hawton K, Casañas ICC, Haw C, Saunders K. Risk factors for suicide in individuals with depression: a systematic review. J Affect Disord. 2013;147(1-3):17-28.
35. Hawton K, Harriss L. The changing gender ratio in occurrence of deliberate self-harm across the lifecycle. Crisis. 2008;29(1):4-10.
36. Qin P, Agerbo E, Westergård-Nielsen N, Eriksson T, Mortensen PB. Gender differences in risk factors for suicide in Denmark. Br J Psychiatry. 2000;177:546-50.
37. Palladino CL, Singh V, Campbell J, Flynn H, Gold KJ. Homicide and suicide during the perinatal period: findings from the National Violent Death Reporting System. Obstet Gynecol. 2011;118(5):1056-63.
38. Samandari G, Martin SL, Kupper LL, Schiro S, Norwood T, Avery M. Are pregnant and postpartum women: at increased risk for violent death? Suicide and homicide findings from North Carolina. Matern Child Health J. 2011;15(5):660-9.
39. Steinberg JR, Becker D, Henderson JT. Does the outcome of a first pregnancy predict depression, suicidal ideation, or lower self-esteem? Data from the National Comorbidity Survey. Am J Orthopsychiatry. 2011;81(2):193-201.
40. Song WJ, Kang SG, Seo BF, Choi NK, Lee JH. A Systematic Review of the National Breast Implant Registry for Application in Korea: Can We Predict "Unpredictable" Complications? Medicina (Kaunas). 2020;56(8).
41. Wurzer P, Hundeshagen G, Cambiaso-Daniel J, Fischer S, Hoflehner H, Spendel S, et al. Lessons Learned From Breast Implant Registries: A Systematic Review. Ann Plast Surg. 2019;83(6):722-5.
| Files | ||
| Issue | Vol 18 No 3 (2023) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijps.v18i3.13008 | |
| Keywords | ||
| Breast Implants Cosmetic Surgery Suicide Systematic Review | ||
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How to Cite
1.
Mousavi Z, Abolhasanpour N, Naseri A, Maghsoudi F, Farshbaf-khalili A, Shahsavarinia K, Mousavi A, Beheshti R, Mostafaei A, Salehi-Pourmehr H. Cosmetic Breast Implants and the Risk of Suicide: A Systematic Review and Meta-Analysis. Iran J Psychiatry. 2023;18(3):319-331.
