Those Hollywood curves may be hazardous.
Women who opt for cosmetic breast implants are three times as likely to commit suicide, according to a study released yesterday by Vanderbilt University Medical Center.
"This long-term study further confirms the link between breast implants and a strikingly high risk of suicide," the study said, noting that there was a "similar increase" in deaths from alcohol or drug abuse and dependence.
Mental anguish related to America's most popular cosmetic procedure — "long-term psychiatric morbidity and eventually mortality" — is a real possibility, the study found.
"Such findings warrant increased screening, counseling and perhaps post-implant monitoring of women seeking cosmetic breast implants," said Dr. Loren Lipworth, an epidemiologist with the Tennessee school who led the research, which was published in Annals of Plastic Surgery.
Potential mood disorders associated with breast implants include depression and body dysmorphic disorder, a condition characterized by an obsession with physical appearance, sometimes accompanied by excessive grooming rituals.
Dr. Lipworth analyzed the medical histories and death certificate data on 3,527 women who had cosmetic breast implant surgery between 1965 and 1993, following them for almost two decades after their surgeries. She found the suicide rate was triple that of women without implants. The risk was greatest — seven times higher — for women who got implants after turning 45.
David Sarwer, a psychologist with the University of Pennsylvania School of Medicine, recommended that plastic surgeons scrutinize the mental state of women who want breast augmentation.
"Until we know more about the relationship between breast implants and suicide, this conservative approach is recommended with both the patient's and surgeon's well-being in mind," he said.
Therapists may have plenty of patients. For the first time on record, breast implants outnumbered any other cosmetic procedure, according to the American Society of Plastic Surgeons (ASPS). Last year, 329,396 women improved their bustlines — more than 2½ times the 1997 number of 122,385.
The numbers are only going to increase. Earlier this year, a ASPS survey of 6,000 doctors found that the majority predicted the number of breast augmentations would increase by at least 25 percent in the next year; and almost three-quarters of the surgeons now perform at least five implant procedures a month.
Some say tastes are changing, and bigger may not be better.
"Women don't want to look 'done,' like they've had surgery. They instead wish to fill out clothing better and feel more comfortable out of clothing," said Dr. Michael Law, a North Carolina-based plastic surgeon. "I rarely have patients requesting large implants anymore."
He still gets occasional queries, though.
"I simply won't perform any aesthetic surgery that doesn't look natural. A woman with very large breast implants that doesn't match her frame looks like a cartoon character," Dr. Law said. "But these patients never have any problem finding someone who will give them the look that they want."