History of Breast Augmentation
The history of breast augmentation began as early as 1895 when Vincenz Czerny attempted breast augmentation using a woman’s own fat tissue taken from a lipoma or fatty tissue removed from her back. Gersuny attempted to increase breast size by the injection of paraffin in 1889 with horrible complications. From the early to mid 1900s many substances including rubber, glass balls, polyvinyl sponges and polyethylene chips were used. The materials were many and varied but they all had one thing in common: Results were terrible and unpredictable.
Grafts of a combination of dermis and fat were attempted by Berson in 1945 and Bames in 1950. Along similar lines, Longacre reported on his 10 years experience with dermis fat flaps in 1959. These methods never became popular because of donor scars, unpredictable results due to fat absorption and the possibility of fat necrosis with chronic drainage.
Numerous investigators used Ivalon or polyvinyl sponge and Etheron or polyether sponge in the 1950s but these techniques fell into disuse with the development of silicone gel and saline implants in the 1960s. The age of breast augmentation really began with the introduction of silicone gel breast implants by Cronin and Gerow in 1964. This was followed by a similar implant coated with a layer of polyurethane by Ashley in 1970. These were intended to increase fixation as were the patches applied to the back of implants by Cronin. These gel implants were widely used due to the fact that they retained their size, remained soft with minimal tissue reaction and a low incidence of infection. Jenny in 1969 developed the saline inflatable implant, which is similar to the implant in use today.
Capsular contracture or breast hardness remained a problem and modifications have been attempted to decrease this type of tissue reaction. Dempsey in 1969 described the technique of placing implants underneath the pectoral muscle. Although not realized until many years later, this approach has been shown to reduce the incidence of breast hardness compared to placement on top of the muscle. The polyurethane implant underwent further modifications and seemed at first to have a beneficial effect on breast hardness. However breast augmentation surgery aroused extreme controversy following a highly inflammatory news profile by Connie Chung in 1990. In 1992 The U.S. Food and Drug administration bowed to public hysteria and banned silicone gel implants in this country for all but reconstruction and revision patients. Billion dollar law suits followed against the implant manufacturers with the eventual bankruptcy of Dow Corning. Finally in 2006 after exhaustive investigation, the FDA returned silicone gel implants for all women over 22 finding no evidence that they caused disease or were dangerous to a woman’s health.
Since their removal and return to the US market, Inamed and Mentor corporations along with numerous board certified plastic surgeons, have thoroughly investigated these medical devices. Implant silicone gel has been modified to be more viscous and cohesive greatly decreasing the chance of migration. The silastic shell of silicone gel breast implants now prevents gel bleed or migration of small microscopic quantities of gel across the shell membrane.
Dr. Linderman with over 30 years of experience with both saline and silicone gel implants has participated in trial studies helping to return gel implants to the US market. He is board certified by the American Board of Plastic Surgery and a member of both the American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgeons. He is extremely qualified to help you make the choice of breast augmentation surgery and which implant is best for you.By Dr. Richard Linderman