Currently the most widespread cosmetic surgery, breast augmentation has been with us for over a century. Starting off shakily with many a mistake in the late Nineteenth Century, it is now rated as one of the safest and most popular cosmetic enhancement. It seems that women of all ages, shapes and sizes are opting for surgically altering their breasts for aesthetic purposes, improving damaged self-confidence or upsetting body images with pleasing results for most! Although not an answer to all women’s problems, breast augmentation procedures are growing in popularity worldwide.
With currently over ten thousand procedures completed in the United Kingdom per year, it seems almost impossible to believe that the first ever breast augmentation was performed with horrific results back in the year 1890s. Using a paraffin injection into the breast area, the practice left the breasts lumpy, hard and finally led to infection. From then onwards, a series of trial and error procedures were tried and tested throughout the decades. By the early Twentieth Century paraffin injections became redundant due to its unpleasant consequences and were replaced by attempting to transplant fat to the breast from the stomach or buttock region.
With a lumpy and lopsided result due to the quick absorption of the fat into the body, this procedure was discarded and by the 1960’s silicone made its first appearance on the scene. Injected into the breast, the resulting augmentation left breasts with unremitting irritation and swelling, infections and the predictable lumpy quality still proved a problem.
Meanwhile, synthetic sponges began to be implanted into the breasts. Made from polyvinyl and sometimes other synthetic substances, it was thought that the shape of the breast would be maintained better in comparison to injection procedures. The result, however, was no better. The implant shrank and hardened within a year and infection was rife. This procedure has also been linked to cancer.
Silicone reappeared by 1961 when the first silicone breast implant was created. The sack of silicone gel that was implanted into the breast has caused much controversy since it was first implanted in 1962, but its discovery was never-the-less a huge turning point in the history of breast enlargement. For the first time, a natural feel and shape could be created for breasts by silicone and was immensely popular. Formally made with very thick outer casing, silicone implants advanced into being much thinner.
During the following years, the problems surrounding silicone began to surface. Leaking, rupturing and links to cancer and connective tissue diseases are some of the issues silicone implants have brought to light, with several high profile court settlements paid to women with silicone implant complications. For example 1988 saw Dow Corning, one of the leading silicone implant manufacturers, settle a lawsuit for 3.2 billion dollars for approximately one hundred and seventy thousand women.
Since its first development, silicone was used for over two decades before concern for its safety led to the banning of its use in the US in 1992, except for patients undergoing reconstruction or revision surgery or women undergoing clinical trialing. However it is still available in the UK.
Instead of silicone implants, saline-filled implants were introduced as silicone’s replacement. Saline implants consist of a silicone shell that is filled with the required amount of sterile saline solution, or salt water. The volume of saline can be altered to the patients needs and, unlike silicone implants, has the potential to be post-operatively adjusted.
In 1995 a new variety of implant was developed: Soybean Oil implants. Originally thought to be a natural substitute for both saline and silicone implants, they were withdrawn from use by 1999 due to the toxic filler it contained. It was never approved in the US. However by 2006, the FDA re-approved silicone implants for use in the US. Now known as cohesive gel implants or ‘gummy-bear’ implants due to their consistency when sliced (similar to cutting a gummy bear in half) they were designed to maintain their shape and prevent leaks or ruptures as the gel does not move around. They have been used outside of the US for almost a decade and have so far had positive results. Their current down-side is their price, being significantly higher than both saline and silicone implants.
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