Breast augmentation is the process by which the size, feel or form of a woman’s breast is surgically altered. The procedure is called Augmentation Mammoplasty and is used to correct chest-wall congenital abnormalities, post-mastectomy breast reconstruction and for aesthetic purposes. It is also part of the process of male-to-female gender transition surgery. Breast augmentation generally involves one of three types of breast implant devices: Saline, Silicone or Composite. The devices are defined by the composition of the filler inside the implants.
Composite Implants: composite implants were made of alternative materials, rather than saline or silicone implants. No longer manufactured at all, they consisted of various miscellaneous fillers, such as soy oil, polypropylene string and other things.
Saline Implants: The first breast implants filled with saline solution of biological concentration were manufactured by the Laboratoires Arion company in France and introduced for medical use in 1964. The goal was to produce a product that could be surgically implanted using smaller incisions than the previous used prosthetic devices. Contemporary models of saline breast-implant devices are comprised of thicker, room-temperature vulcanized (RTV) shells made of silicone elastomer. They are implanted during surgery, deflated and then filled with saline solution after placement. This allows even smaller incisions and significantly reduces scaring for the patient. In the 1990’s, saline implants were the most common device used for implant surgery in the United States. Saline implants certainly provided good results but when compared to silicone gel implants, they are more likely to cause cosmetic problems. Wrinkling, rippling and being obvious to the eye and touch are a few of those problems.
Silicone Gel Implants: The first silicone breast implantation surgery was performed in 1962, using the model developed by Thomas Cronin and Frank Gerow in 1961. There are five device generations, as described below:
Cronin-Gerow Implant, prosthesis model 1963 was a silicone rubber envelope filled with viscous silicone-gel in the shape of a tear-drop. The back of the device shell was affixed with a fastener patch of Darcon (Polyethylene Terephthalate) in an effort to minimize device rotation on the chest wall of the patient.
The devices born in the 1970’s were developed with the intent to provide softer, more life-like prosthesis. Second generation models were made of thinner silicone shells and were filled with a less cohesive filler. As a result, the second generation models of silicone implants tended to be associated with higher incidences of “silicone gel bleed”, rupture and capsular contracture. Despite those troubles, a positive technological development did occur and that was the double lumen design. Though no longer used in quite the same way as it was in the 1970’s, the concept paved the way for contemporary models that are used today primarily for breast-reconstruction. Original concepts featured a silicone filled inner layer enclosed within a saline filled out layer and, unfortunately, had a higher fail incident than single lumen designs. However, the technology was promising and in 1984, today’s contemporary model was born.
Introduced in the mid 1980’s, the third and fourth generation models of silicone breast implants featured elastomer coated shells and thicker fillers. The shells were more durable and the thicker gel filler reduced the incidence of gel bleed. These models featured both anatomic shapes and round and tapered models, giving surgeons and clients more options for optimal surgical benefits.
Current models, which began in the mid 1990’s, are of a semi-solid gel that mostly eliminates all concern of filler leakage (now called silicone migration). The contemporary designs seem to have reduced the incidence of capsular contracture and have improved the overall safety and efficacy of augmentation mammoplasty.
Augmentation Mammoplasty is relatively safe, yet complications can and do occur. As with any other surgery, adverse reactions to anesthesia and risk of hematoma (post-operative bleeding), fluid accumulation and infection are all risks to be considered. Pain, altered sensation, impeded breast-feeding, visible wrinkling, thinning of the breast tissue, and symmastia are all possible complications unique to mammoplasty. Capsular contracture, while not as common as it once was, is still a risk and if occur, will need to be corrected, causing more possible scarring. Breast augmentation can have significant, long term benefits for patients and for many, the benefits far outweigh these potential risks.
Mental health and sexual function can all be restored or significantly enhanced thanks to technology that has made augmentation mammoplasty safe and effective.