Health-related quality of life issues after cosmetic breast implant surgery in Finland.

The purpose of this study is to compare women with cosmetic breast implants with population controls to examine health-related quality of life. A questionnaire including quality-of-life questions was mailed to 399 Finnish women who had had cosmetic breast implants during the years 1973-2002. The response rate of the study was 85. Results were compared with average Finnish women from a representative population sample. There were no differences in total score of health-related quality of life between women with breast implants and controls. Women with breast implants had lower health-related quality of life in dimensions of distress and sexual activity and partly also in dimensions of sleeping and mental function when compared with controls. On the other hand, operated women reported significantly less discomfort and symptoms than controls. Differences in health-related quality of life between women with breast implants and controls were largest in dimensions of distress, sexual activity, sleeping, and symptoms.

A feasibility study of magnetic resonance imaging of silicone breast implants in Finland.

Cosmetic breast implants have become increasingly popular throughout the world. However, there is insufficient knowledge about the frequency and severity of local complications such as rupture and capsular contracture. A pilot study of 25 Finnish women with 50 cosmetic breast implants was organized to determine the feasibility of conducting a magnetic resonance imaging (MRI)-based study of rupture incidence. The pilot investigation included a clinical examination by a plastic surgeon, MRI scan, and self-administered questionnaire. The participation rate was 100%. Implants in our study represented a cross-section of the different generations of implants in Finland, with implant ages varying from 4 months to 20 years. The average implant size was 215 mL, typical in Finnish cosmetic surgery. MR images were evaluated by two independent readers. The first reader diagnosed six implants with intracapsular rupture, while the other diagnosed all implants as intact. The procedures of the feasibility study proved successful, and the results demonstrate the importance of a rigid image evaluation protocol with employment of well-defined rupture criteria, as well as the benefits of several image readers.

Local complications after cosmetic breast implant surgery in Finland.

Concerns regarding potential health effects of silicone breast implants have recently shifted from long-term illnesses to postoperative local complications. In this study, occurrence of local complications and treatment procedures were evaluated in a population of 685 Finnish women who received cosmetic silicone breast implants between 1968 and 2002. Patient records were abstracted, and additional information was gathered using a structured questionnaire that was mailed to 470 of the women in the cohort. Overall, 36% of the women had 1 or more diagnoses of postoperative complications in their medical records. The most common complication was capsular contracture, occurring in 17.7% of women and 15.4% of implantations. Other complications were more rare. The majority of women (74%) needed no postoperative treatment. However, 22% of women required 1 or more surgical procedures after the primary implantation. Most of the women were satisfied with the implantation, but only 40% considered the preoperative information on possible risks related to implantation as sufficient. With respect to the occurrence of local complications following cosmetic breast implantation, the findings of this study are consistent with previous studies. Frequencies of complications were remarkably similar in medical records and self-reports.

Causes of death among Finnish women with cosmetic breast implants, 1971-2001.

Mortality patterns among women with cosmetic breast implants have not been well characterized. We examined cause-specific mortality among women who underwent cosmetic breast implantation at major public hospitals and private clinics in Finland from 1970 through 2000. Causes of death through 2001 were identified through the national mortality register. Expected numbers of deaths were calculated on the basis of mortality rates in the general female population, and standardized mortality ratios (SMR), i.e. ratios of observed to expected deaths, and 95% confidence intervals (CI) were calculated. Among the 2166 women with cosmetic breast implants, we observed 31 deaths versus 32.1 expected. Overall disease mortality was below expectation, mainly due to low mortality from diseases of the circulatory system (SMR, 0.28; 95% CI, 0.03-1.02). Mortality from cancer was close to expectation. There was a statistically significant excess of suicide, based on 10 deaths, which was most pronounced during the first 5 years of follow-up (SMR, 4.26; 95% CI, 1.56-9.26). In conclusion, although based on small numbers, women with cosmetic breast implants did not experience higher mortality overall than women in the general population. The high suicide risk supports other studies and warrants further detailed investigation.