4 octobre 2005 03:11

These go with the citiations I sent you there the articles printed out

Mortality and Suicide Among Danish Women With Cosmetic Breast Implants

Arch Intern Med. 2004;164:2450-2455.
Background Epidemiologic studies indicate that women with cosmetic breast implants have a significantly increased risk of suicide. Our objectives were to examine mortality among Danish women who underwent cosmetic breast implant surgery and to evaluate the baseline prevalence of psychopathological disorders as measured by admission to a psychiatric hospital among women seeking cosmetic surgery.

Methods Cohort study of 2761 women who underwent cosmetic breast implant surgery at private clinics of plastic surgery or public hospitals, 7071 women who underwent breast reduction surgery at public hospitals, and 1736 women who attended private clinics for cosmetic surgery other than breast implantation, between 1973 and 1995. Causes of death through 1999 were identified through the Danish Mortality Files. Information on admission to psychiatric hospitals prior to cosmetic surgery was obtained from the Danish Psychiatric Central Register.

Results Women with cosmetic breast implants had significantly elevated standardized mortality ratios (SMRs) for death overall (SMR, 1.4; 95% confidence interval [CI], 1.1-1.7), nonmalignant lung disease (3.4; 95% CI, 1.4-6.9), and suicide (SMR, 3.1; 95% CI, 1.7-5.2). Women who underwent breast reduction exhibited low SMRs for death overall (0.7; 95% CI, 0.7-0.8) and several specific causes, including breast cancer (0.4; 95% CI, 0.2-0.6), whereas death from suicide was moderately above expectation (SMR, 1.6; 95% CI, 1.0-2.5). The prevalence of psychiatric admission prior to cosmetic surgery was higher among women who underwent cosmetic breast implant surgery (8.0%; 95% CI, 7.0%-9.0%) than among women who underwent breast reduction (4.7%; 95% CI, 4.2%-5.2%) or other cosmetic procedures (5.5%; 95% CI, 4.5%-6.7%). When compared with all control groups, women with cosmetic implants had an odds ratio for prior psychiatric admission of 1.7 (95% CI, 1.4-2.0).

Conclusions Danish women with cosmetic breast implants experienced higher overall mortality compared with women in the general population owing in part to a 3-fold increase in suicide. Women with breast reduction had a low total and cause-specific mortality but a moderate excess risk of suicide. For the first time, to our knowledge, we found evidence of an increased prevalence of mental illness as measured by admission to a psychiatric hospital prior to implant surgery among women receiving cosmetic breast implants. Studies are needed to clarify the underlying reasons for the consistently reported 2- to 3-fold excess of suicide among women with cosmetic breast implants.

Author Affiliations: Department of Plastic Surgery, Private Hospital Hamlet, Copenhagen, and Department of Plastic and Reconstructive Surgery, Odense University Hospital, Odense, Denmark (Dr Jacobsen); Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen (Drs Hölmich, Johansen, Olsen, Kjøller, and Friis); Department of Plastic and Reconstructive Surgery, Herlev University Hospital, Herlev, Denmark (Dr Hölmich); International Epidemiology Institute, Rockville, Md (Dr McLaughlin); and Department of Medicine, Vanderbilt University Medical Center, Vanderbilt-Ingram Comprehensive Cancer Center, Nashville, Tenn (Drs McLaughlin and Olsen).

Arch Intern Med. 2001;161:973-979.
Objective To examine the occurrence of connective tissue diseases (CTDs) as well as ill-defined and other rheumatic conditions among Danish women with cosmetic silicone breast implants.

Patients and Methods A total of 2761 women with breast implants and 8807 control subjects were identified from plastic surgery private clinics and from public hospital plastic surgery departments. Women operated on at plastic surgery private clinics were identified through the files of each clinic, while women operated on at public hospitals were identified using the nationwide Danish National Registry of Patients. The control group consisted of women who underwent cosmetic surgery other than breast implantation or who only had a consultation. All women were followed up from January 1, 1977, through December 31, 1996, through the Danish National Registry of Patients for the occurrence of CTD as well as ill-defined and other rheumatic conditions. For the study period January 1, 1977, through December 31, 1994, the Danish National Registry of Patients contains information on hospitalization only, whereas data on outpatient visits are included from 1995 on, thus improving the sensitivity of the data. The implant and control groups were compared with the Danish population rates for CTD and ill-defined and other rheumatic conditions, and a direct comparison between the implant and control groups was also performed.

Results When compared with rates from the general population, no excess of definite CTD was observed in the implant cohorts. For ill-defined and other rheumatic conditions, statistically significant excesses of unspecified rheumatism were observed in both the implant and control cohorts when compared with national rates. A direct comparison between the implant and control cohorts found no material differences between the groups.

Conclusions The findings of this study support previous investigations and independent review panel conclusions that an association between silicone breast implants and definite CTDs is unlikely. The observation of an excess of unspecified rheumatism among women with implants and among control women suggests that women undergoing cosmetic plastic surgery have hospitalization rates for this condition in excess of those from the general population.

From the Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark (Drs Kjøller, Friis, Olsen, Mellemkær, and Winther); the International Epidemiology Institute, Rockville, Md (Drs McLaughlin, Lipworth, Blot, and Fryzek); and Vanderbilt University Medical Center, Vanderbilt-Ingram Cancer Center, Nashville, Tenn (Drs McLaughlin, Lipworth, Blot, and Fryzek).

Arch Surg. 2003;138:801-806.
Hypothesis The incidence of silicone breast implant rupture varies with implantation time and type of implant.

Objective To measure the incidence of implant rupture by repeated magnetic resonance imaging (MRI) among women with silicone breast implants.

Design, Setting, and Participants In 1999, 271 women who had received breast implants at least 3 years before, and who were randomly chosen from a larger cohort of women with cosmetic breast implants, underwent a baseline MRI. A second MRI was performed in 2001; 317 silicone implants (in 186 women) that were intact at the baseline MRI (n = 280) or were intact at baseline but removed before the second MRI (n = 37) were included in the rupture incidence analyses.

Main Outcome Measures Implants were diagnosed with definite or possible rupture. Crude and implant age–adjusted incidence rates were calculated, and implant survival was estimated based on the observed rupture rates.

Results We found 33 definite ruptures (10%) and 23 possible ruptures (7%) during the 2-year period. The overall rupture incidence rate for definite ruptures was 5.3 ruptures/100 implants per year (95% confidence interval, 4.0-7.0). The rupture rate increased significantly with increasing implant age. Double-lumen implants were associated with substantially lower rupture risk than single-lumen implants. For modern implants intact 3 years after implantation, we estimated rupture-free survival of 98% at 5 years and 83% to 85% at 10 years.

Conclusions The risk of implant rupture increases with implant age. A minimum of 15% of modern implants can be expected to rupture between the third and tenth year after implantation.

From the Institute of Cancer Epidemiology, Danish Cancer Society (Drs Hölmich, Friis, Kjøller, and Olsen), and the Department of Radiology, Rigshospitalet (Dr Vejborg), Copenhagen, Denmark; the Departments of Plastic and Reconstructive Surgery (Dr Hölmich) and Radiology (Dr Sletting), Herlev University Hospital, Herlev, Denmark; the International Epidemiology Institute, Rockville, Md (Drs Fryzek and McLaughlin); the Department of Medicine and Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tenn (Drs Fryzek, McLaughlin, and Olsen); and the Department of Radiology, Hjørring Hospital, Hjørring, Denmark (Dr Conrad).

you can download these if you follow exactly how I've gotten into jama without

being a Dr; hit the link with a check mark an it will allow you to down load the

entire article so we'll have them.. if I don't fall a sleep I'll grab some more.