Comments on the article by V. C. M. Kuck-Koot et al (see record 2003-01986-001) which assessed total and cause specific mortality among Swedish women aged 15-69 years old with breast implants. Koot et al reported an increased risk of suicide among patients who had received cosmetic breast implants. It is argued that cosmetic surgeons should seek psychiatric consultations preoperatively for the purpose of ruling out body dysmorphic disorder and have it treated if present. Perhaps only then can the elevated suicide rate associated with breast implants be diminished.