According to at least four studies in recent years, women with breast implants are more likely to commit suicide than women in the general population.

According to a study published by Lykissa and Maharaj:

Pt in urine, brain tissue, and breast milk samples from women exposed to silicone breast implants occurred mainly in the +2 and +4 oxidation states.

The authors list known problems associated with platinum salt exposure:

Pt salt exposure has been associated with positive skin-patch tests, contact dermatitis, asthma, immunogenicity, inhibitory effects on brain enzymes, neurotoxicity, mutagenicity, carcinogenicity, and anaphylactic reactions.

Their research indicates the possible fate of Pt as follows:

migration from silicone implants via the lymphatic and blood systems urine, sebaceous secretions, and breast milk deposition and accumulation in hair and nails

Whilst the Food and Drug Administration does not recognize certain systemic complications occuring with silicone gel-filled breast implants, the agency states:

Persons who are seriously contemplating suicide may:

• Give away prized possessions, make a will, or put affairs in order
  
• Withdraw from others around them
  
• Have a change in sleeping or eating habits
  
• Lose interest in prior activities and relationships
  
• Experience a lift in spirits after being very depressed due to the fact that the person feels a sense of relief thinking that all of her problems will be solved by suicide and the person has the energy to follow through with an attempt
  
• Have a prior suicide attempt
  
• Have a recent loss (i.e. death, divorce, separation, broken relationship, loss of job, money, status, self-confidence, self-esteem, loss of religious faith, and loss of sexual interest)
  
• Have a change in personality
  
• Have menstrual abnormalities (missed periods)
  
• Have a fear of losing control
  
• Have low self-esteem
  
• Feel hopeless
  
• Have difficulty concentrating and a decline in the quality of work
  
• Have a plan to commit suicide
  
• Be unwilling to communicate
  
• Neglect appearance
  
• Be careless
  
• Exhibit hostile behavior
  
• Be late frequently
  

Threats of suicide must be taken seriously. The National Suicide Prevention Lifeline provides aid to individuals in a suicidal crisis by connecting them to the closest suicide prevention and mental health service provider: 1-800-273-TALK (8255). For more information about suicide visit the Suicide Crisis Center Web Site.

Suicide risk is high among breast implant recipients, Canadian study says

 New research pointing to the high risk of suicide among breast augmentation patients is generating debate as Health Canada reviews its restrictions on silicone implants. *

The 49-year-old mother of seven became a sad statistic two months later when she leapt to her death from a five-storey parking garage in Atlanta, Ga. 

Just how significant a statistic became apparent when a new Canadian study published in the latest edition of an American medical journal reported a 73% higher rate of suicide among women with breast implants than the general population.

Although the number of suicides was just a handful from among tens of thousands of subjects, the Canadian research echoes the results of half a dozen recent studies from the United States and Scandinavia. It has experts speculating on the psychological, sociological and physiological explanations for the alarming trend.

The news has reignited a debate about the safety of implants in the midst of a Health Canada review of its restrictions on silicone implants, which were pulled from general use in 1992 amid safety concerns.

Published in the latest issue of the American Journal of Epidemiology, the Canadian study compared mortality rates for 24,558 women in Ontario and Quebec who received breast implants between 1974 and 1989, as well as 15,893 women who had other types of plastic surgery, with those in the general population.

The average age of the subjects was 32, and all the implants were done for cosmetic reasons, as opposed to post-mastectomy reconstruction.

The good news, said Jacques Brisson, a Universite Laval breast cancer specialist and one of the authors of the study, is that women with implants had a 26% lower mortality rate overall. There was also a reduced incidence of breast cancer, he said, likely due to the women having less breast tissue.

The bad news is the elevated suicide risk.

Women with implants were 73% more likely to take their own lives than the general population, while women who underwent liposuction, facelifts or tummy tucks faced a 55% higher risk.

Dr. Brisson pointed out the total number of suicides was quite low -- only 58 women with implants killed themselves, versus 33 who had other types of cosmetic surgery. "It is still a small number, so the risk is still small."

But the results have prompted questions about whether some women who opt for breast augmentation may be predisposed to suicide because of underlying emotional problems, or whether the implants themselves are to blame.

Richard Warren, a member of the Canadian Society of Plastic Surgeons and a clinical professor of plastic surgery at the University of British Columbia, said patients seeking nose surgery traditionally have been considered most at risk to suffer mental distress.

"The thing that's different about breast surgery is that it tends to be a slightly younger person [undergoing] it," Dr. Warren said. "There are issues, such as are there other people involved in that person's life who may or may not want them to do this? Are they thinking that having changed a secondary sexual characteristic that their relationships with men will change?"

Plastic surgeons are trained to be on the lookout for psychological troubles, but Dr. Warren says there is currently no formal screening process, adding it all comes down to the doctor-patient relationship.

"My personal experience with sending patients to a psychiatrist for an assessment ... is I have been successful sometimes, but it is quite often taken as an insult," Dr. Warren said. "At that point, you are out of the loop."

Joyce Attis says attributing the suicide rate among breast implant patients to mental deficiency is simply blaming the victim.

"It's very insulting, it's very demeaning," said the president and founder of the Breast Implant Line of Canada and the lead plaintiff in a class-action lawsuit against Health Canada.

To Ms. Attis, who had a silicone prosthetic inserted in 1972 and removed 20 years later, the more likely explanation for the suicides is the despair women feel when their implants ruin their health. Ms. Attis had her right breast done because it had never developed due to a congenital condition.

By the late 1970s, her implanted breast had hardened and was extremely painful and she was experiencing a range of debilitating symptoms that stumped her doctors. One even inserted a steel rod in her spine in an attempt to ease chronic pain in her back and rib cage. But nothing helped and no one could conclusively diagnose her ailments.

When she had her implant removed in 1992, it was discovered to have ruptured earlier, leaking silicone throughout her body.

Today, Ms. Attis suffers from fibromyalgia, lupus syndrome and osteoporosis. She is on heavy pain medication.

"A lot of women are tortured because of the amount of physical pain that they go through," she said. "They're not getting answers, and many women are put off and told there is nothing wrong with them. That, I would say, is the cause for the suicides. And at that point, yes, they are psychologically affected and psychologically dysfunctional."

P.J. Brent is a prime example.

After she jumped to her death on May 29, 2000, an autopsy found platinum, a component of the implants, in her heart, lungs and brain.

Her husband, Ed Brent, remembers the pathologist's words: "He said, 'A woman with that much platinum in her brain could not have been thinking rationally.' "

Mr. Brent said his wife was in despair over the sickness her implants caused herself and her two youngest daughters.

She had her breasts done in 1982 in a futile bid to save her failing first marriage. When she remarried Mr. Brent, she breast-fed two more daughters despite her implants. The health of all three subsequently deteriorated.

On her best mornings, she woke up feeling as if she had the flu. Her joints hurt, her fingers swelled, she had lupus-like symptoms and she was diagnosed with chronic fatigue syndrome.

Her youngest daughters have a disorder that makes swallowing difficult. The eldest of the pair has suffered gastrointestinal ailments, wore leg braces as child and today relies on a wheelchair.

It wasn't low self-esteem that drove Mrs. Brent to take her own life, her husband said. "It was guilt, it was pain, it was looking for a way out."

Anne Rochon Ford, co-ordinator of the Women and Health Protection Group, fears the suicide rate will only go up as younger and younger women opt for surgery - sometimes as soon as they turn 18.

"It's become institutionalized and it's just the norm to think there's nothing wrong, there's nothing harmful about undergoing these procedures," Ms. Rochon Ford said.

"The larger societal issue is, how is it that we're breeding this population of girls and women who are so dissatisfied with how they look?"

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* On Oct 20, 2006, Health Canada lifted the 14-year moratorium on silicone gel-filled breast implants.