On August 11, 2019, an autopsy was performed.[283] The preliminary result of the autopsy found that Epstein sustained multiple breaks in his neck bones. Among the bones broken in Epstein's neck was the hyoid bone. Such breaks of the hyoid bone can occur from those who hang themselves, but they are more common in victims of homicide by strangulation. A 2010 study found broken hyoids in one-fourth of cases of hangings, and a larger study conducted from 2010 to 2016 found hyoid damage in just 16 of 264 cases, or six percent of cases of hangings. Hyoid bone breaks are more common in older individuals, as the bones become more brittle upon reaching middle age.[284] Forensic pathologist Cyril Wecht noted that hanging by leaning forward would not result in broken cervical bones.[285]