Although we may think that the history of breast implants, both for reconstruction and for breast augmentation, is something recent, the reality is that it already has more than a century of life. At the end of the 19th century, specifically in 1895 , we can find the first documented breast augmentation intervention , performed by Czerny , a surgeon from the Czech Republic, from a lipoma or benign tumor of the patient’s back.
Since then, different techniques and materials have been used to perform breast augmentations and reconstructions : different materials have been studied, and research and development has been invested to get us where we are today. This is a brief review on the history of breast implants, with its most important milestones.
The first breast implants: trial, error and success
As we have pointed out, the first mammary implants can be found documented at the end of the 19th century. Around those years they began to try different materials for the manufacture of the implants, not all with the same success : while Czerny’s skin graft was a success, the Robert Gersuny paraffin injections in 1989 were an endless complications in the patients, forcing him to abandon this method.
During the first half of the twentieth century, we continued to experiment with different materials of the most diverse kind: from the aforementioned liquid paraffin and other petroleum-derived substances to polymers made of plastic, cartilage and other synthetic materials.
The aesthetic results offered by these materials were not satisfactory and, more importantly, the complications that appeared in the patients(infections, contractures, migrations of the materials to other tissues) were very numerous.
The success of silicone implants
It was not until the 1960s that silicone implants began to be used , similar to those used today. The American surgeons Croning and Gerow used silicone sheet bags filled with silicone oil for medical use to perform their breast implants.
What is it that makes silicone a good choice for this type of implant? The silicone for medical use has a series of characteristics such as its biocompatibility (does not cause undesirable effects on the patient or implant recipient), its bio durability (does not deteriorate with time), the fact that it is a hydrophobic material (repellent to water), has great chemical and thermal stability and low surface tension.
Silicone for medical use has been maintained as a material for breast implants since the 1960s, and has evolved over time
Thereafter, silicone implants with high molecular weight molecules began to be used, which became very popular in the 1970s because they had a low rupture rate (a common problem in the first implants), although they were susceptible to suffer other complications such as capsular contractures or movement of the implants.
In the 1980s, the use of implants made with heavier molecules and with a polyurethane coating , which significantly reduced the number of complications suffered by patients, became widespread . They stopped being used by an association ( which later proved erroneous ) with the proliferation of tumor lesions.
This led, however, that the research focused on silicone implants coated with silicone elastomer : these implants reduced the risk of capsular contracture while giving a much more natural appearance to the operated chest. During this time, implants filled with saline were also popularized.
21st century: lights and shadows
One of the shadows in the history of breast implants was the scandal of PIP implants , which began to be investigated in the first years of the 21st century and reached the general public around 2010 . It was a very well-known case worldwide: in Spain alone, 18,000 women posed PIP implants.
The French company PIP (Poly Implant Prothèse), the fourth world producer of breast implants, produced for years low cost implants made with a non-approved gel. This caused the prosthesis to break easily and give rise to undesired effects such as inflammatory reactions. Finally, they were banned worldwide in 2010.
The scandal of the PIP prosthesis made the control over the safety of breast implants increase worldwide
Currently the safety of implants used in breast augmentations and breast reconstructions is totally controlled by different agencies. The implants that we can find today are safe, reliable and rupture-proof after passing the necessary controls.
The development and investment in research has made that today we already have fifth-generation silicone implants, which are used both for breast reconstructions after a mastectomy and to make increases in breast size with an exclusively aesthetic purpose. These implants contain a semi-solid silicone gel that significantly reduces leakage problems.
The research around breast implants has led to a greater variety in terms of shapes, textures and sizes , which allow us to choose among many options to find the one that is most appropriate in each case. The help of good medical professionals is invaluable to achieve a satisfactory result.