Zolotykh V G, Gvozdetckii A N, Maevskaya V A, Utekhin V J, Churilov L P, Shoenfeld Y, Yablonskiy P K
St. Petersburg State Budgetary Healthcare Institution "City Hospital No. 40 of the Kurortny district", 9, Borisova ul., St. Petersburg, Russian Federation, 197706.
St. Petersburg State University, 7-9, Universitetskaya nab., St. Petersburg, Russian Federation, 199034.
Langenbecks Arch Surg. 2023 Aug 15;408(1):312. doi: 10.1007/s00423-023-03030-z.
In esthetic surgery, the use of silicone implants is a topic of hot discussion.
An analysis of 119 esthetic surgical interventions on the mammary gland was performed. A study of the immune and endocrine parameters after mammoplasty was carried out.
The phenomenon of an increase in the levels of autoantibodies to the TSH receptor was revealed. The phenomenon of pre-operative growth of prolactin and TSH levels has been confirmed. An increase in thyroid autoimmunity after silicone mammoplasty is interpreted as a result of a silicone adjuvant action. An increase in the incidence of ASIA syndrome in patients who underwent breast surgery was registered. However, it was observed in both patients with silicone and non-silicone breast surgeries and therefore could not be solely explained by the use of silicone. Within 12 months following silicone mammoplasty, the patients with an increase of anti-TSH receptor autoimmunity nevertheless did not show any clinical and laboratory signs of overt thyroid disease, thus staying in a pre-nosological state. PRACTICAL RECOMMENDATIONS: Based on these results, we recommend the following for esthetic surgery: (a) all patients planned for silicone implant surgery should be examined for autoantibodies to the TSH receptor and (b) patients who have undergone breast endoprosthesis, starting 6 months after the operation, need long-term follow-up for thyroid status with mandatory testing for the level of these autoantibodies.
在美容外科手术中，硅胶植入物的使用是一个热门讨论话题。
对119例乳腺美容手术干预进行了分析。对乳房成形术后的免疫和内分泌参数进行了研究。
发现了促甲状腺激素受体自身抗体水平升高的现象。术前催乳素和促甲状腺激素水平升高的现象得到了证实。硅胶隆乳术后甲状腺自身免疫性增加被解释为硅胶佐剂作用的结果。记录了接受乳房手术患者中亚细亚综合征发病率的增加。然而，在接受硅胶和非硅胶乳房手术的患者中均观察到这种情况，因此不能仅用硅胶的使用来解释。在硅胶隆乳术后12个月内，抗促甲状腺激素受体自身免疫性增加的患者仍未表现出任何明显甲状腺疾病的临床和实验室迹象，因此处于疾病前期状态。实用建议：基于这些结果，我们对美容手术提出以下建议：（a）所有计划进行硅胶植入手术的患者应检查促甲状腺激素受体自身抗体；（b）接受乳房假体植入的患者，术后6个月开始，需要对甲状腺状况进行长期随访，并强制检测这些自身抗体的水平。
