Today breast implant surgery is one of the most popular cosmetic procedures. But where did it all start? Where did breast implants come from? It comes as no surprise that altering the body is not a recent invention. Even in ancient times, people sought to alter their appearance using surgical and non-surgical methods. So, what is the history of breast implants? How long have they been around? And, how have they changed? Read on to find out.
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Whilst breast implants were not popular in Australia until the ’90s, the truth of the matter is that breast implants have been around for a lot longer than many people think.
To be fair, many plastic surgical procedures, especially elective ones, have only been approved pretty recently. Plastic surgery has come a long way in the last 30 years. In fact, breast surgeries alone have been improved several times by surgeons all over the world. However, it is interesting to understand where we started and how we got here today.
A Brief Timeline and History of Breast Implants
Early surgeons left no stone unturned in their search for the ideal implant material. In the early stages , a variety of substances were put to the test, including things like glycerine and autologous fat. Some unconventional substances were also put to the test, including things like ox cartilage, silicone oil, and even snake venom. These methods aimed to augment breast size either by attempting to fill the breast tissues inward or by leveraging the inflammation caused by foreign bodies to create the illusion of larger breasts. It’s no surprise that none of these methods were healthy and almost always failed. The result of these early cases often led to infection, disfigurement, or even sepsis and death.1
Whilst some of these did work sometimes, the methods were too primitive to bring consistent results. Autologous fat injections , for example, are still in use today. It’s a technique that involves taking fat tissue from somewhere in your body – thighs, buttocks, belly, and injecting it into the breast tissues.2 This technique is mostly used in filling small depressions. Research to further improve results is ongoing.
First Breast Implants
In 1895, a German surgeon named Vincenz Czerny was the first one to try something similar to advanced implants. He was the first surgeon to think of using natural tissue to use as implants. The first patient who got a successful breast implant was a singer with a tumour in one of her breasts. The removal of the tumour made the breast smaller than before.
In an attempt to correct the uneven appearance, Czerny put benign tumorous tissue from her back into the breast where the initial tumour was taken. The idea was that as the tissue was from her own body, there was a lower risk of rejection. This was a step in the right direction and opened up new paths of possibilities.
The process made by Dr Vincenz Czerny was soon taken up by other surgeons. Everyone was interested in implementing this new method of breast augmentation. Unfortunately, the original surgical procedure proved quite difficult to replicate. This was due to the fact that it was hardly safe to work with tumour tissues. However, it did inspire a rise in research to find the next best thing to use as breast implants.
Different Substances Used for Breast Enlargement
Research led to a lot of trial and error. Whilst searching for a viable option, many different substances were tested, including;
- Glass balls
- Bees wax
- Ground rubber
- Polyurethane
- Sponges
- And even ivory
Regrettably, more often than not, these did not bring good results. In fact, some of these surgeries resulted in necrosis, embolisms as well as other negative results. Furthermore, doctors soon found out that using even soft material like sponges didn’t work, because they are a breeding ground for infection or become hard within a few months.
The creation of the Silicone Breast implant
This wave of research led to the invention of silicone breast implants. In 1964, the first surgery using silicone breast implants was performed by Frank Gerow and Thomas Cronin.
Dr Thomas D. Cronin and Dr Raymond O. Brauer published their research results in 1971 for all to read.3 In this paper, they described the implant as a prosthesis, “consisting of a thin-walled Silastic rubber container in the shape of the breast, and filled with a soft Silastic gel.” The implants had one-inch fibrous mesh in the back to promote healing and attachment to body tissue.
However, this was not the first time silicone had been put to the test. In fact, people in several other countries have used silicone to get larger breasts as well. However, these earlier tests did not confine the silicone in a sphere or bag, so, it did not work. This in turn led to, a horrible epidemic of infection and gangrene broke out, known as “Tijuana silicone rot”. After 1970, countries were forced to ban this procedure because of the large number of cases that led to permanent damage.
Frank Gerow and Thomas Cronin’s work approached the problem in a different way. They decided to use a silicone container to keep the gel inside and away from natural tissue.
The idea of using silicone as an implant material reportedly came to the surgeons when they were working with a fluid-filled bag. The idea to use a thick, viscous fluid material was genius and it paid off. They mimicked the shape and feel of natural breasts or came as close to it as possible at that time. Silicone implants were far better than anything else available on the market. The doctors also took precautions to prevent infections or implant rejections.
The First Silicone Implant Surgery
The first successful surgery was done on Timmie Jean Lindsey. After this point, the popularity of silicone breast implants grew. Moreover, research into creating new and better procedures kept going. This continuation of research and inspiration from silicone implants led to the invention of saline implants. However, the lower viscosity of saline created problems like sounds, movements, etc.
Most surgeons continued using silicone implants because it was thought relatively safe to do so. However, these early silicone implants were far from being perfect. According to research, despite the notable absence of data until 1992, the estimation is that several thousands of implant surgeries were carried out.4
During this time, the procedure was still relatively new and results were heavily dependent on the quality of implants from the manufacturers. Because of this, it was still a risky surgery. Unfortunately, there were complications despite efforts to reduce them.
However, the media and general population soon became concerned about silicone-associated diseases. This was especially true in the US, where hundreds of complaints were filed. The situation got so out of hand that in 1992, the FDA issued a moratorium that required the cessation of silicone breast implant use. However, recent research shows that most of them had no foundation and were in fact the result of misunderstanding in the process.
Making Silicone
The process of silicone making is complex. Silicones are made biochemically by attaching oxygen molecules to silicon. The making of this material requires chemical reactions between toxic agents. Although the end results are safe for humans, the process is still a source of concern for many patients. Nevertheless, the need for silicone implants grew and better technology made it possible to improve the existing designs. In 2006, the FDA approved silicone breast implants.
Evolution of Silicone Implants
Silicone implants started small but they soon became popular. Their soft feel and natural teardrop shape only added to their appeal. The truth is that silicone implants currently in use in Australia are very different from the original designs.
Since approval from the FDA, there have been numerous upgrades to the silicone material. There is evidence that modern silicone implants have little to no reaction with the body. On top of this, they also last for a long time.
At first, polyurethane foam was used to cover the surface of the anatomically shaped implants. These worked really well in preventing capsular contraction. So much so that a company in Brazil started producing polyurethane implants. They soon became popular as there were surprisingly fewer degrees of capsular contraction. Studies suggested the reduced incidence of capsular contracture was a result of the polyurethane bit integration. The characteristic lattice created by the polyurethane prevents the collagen fibres from creating a mesh of their own and as a result, prevents contractures.5
Textured Implants
After numerous alterations, in 2006, the FDA approved the use of silicone breast implants . With this came the newer surface-textured implants.
The hope was that by creating texture on the surface of the implants cases of capsular contractions would reduce. To create a rougher outer silicone shell texturing different manufacturers used altering methods. Some embedded salt crystals in the silicone shell, and some took the negative imprint of the polyurethane foam layer. These upgrades were done in hopes of mimicking the surface lattice of polyurethane that prevents capsular contractions.
Currently, breast implants primarily consist of silicone. There have been numerous additions and changes to the design, but the supple feel of silicone implants has stayed the same.
A few of the new attributes of 21st-century breast implants are:
- Ergonomic:
- Recently, there has been emphasis put on creating implants that look and feel like natural breasts.
- Ergonomic implants follow the shape of natural breasts and move with you.
- It will gently slope down when standing and become a bit flattened when lying back just like natural tissue while retaining the upper pole fullness.
- Smooth surface implants:
- Although textured surfaces were introduced to reduce breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), some studies claim that they increased them instead.6
- Hence, most newer silicone implants do not have a textured surface.
- Smaller scars:
- Modern surgeons like to leave a smaller scar.
Like most medical procedures, breast augmentation is a continuously evolving field. To get the best possible care, you will need to choose a surgeon who is both qualified and experienced.
References
- Firstly, All That’s Interesting. The bizarre and painful history of breast implants. https://allthatsinteresting.com/weird-history-of-breast-implants
- Fontes, T., Brandão, I., Negrão, R., Martins, M. J., & Monteiro, R. (2018). Autologous fat grafting: Harvesting techniques. Annals of medicine and surgery , 36 , 212-218.
- Cronin, T. D., & Brauer, R. O. (1971). Augmentation Mammaplasty. Surgical Clinics of North America, 51(2), 441–452. doi:10.1016/s0039-6109(16)39388-4
- Perry, D., & Frame, J. (2020). The history and development of breast implants. The Annals of The Royal College of Surgeons of England, 1–5.
- Handel, N. (2006). Long-term safety and efficacy of polyurethane foam-covered breast implants. Aesthetic Surgery Journal , 26 (3), 265-274.
Lastly, Mempin, M., Hu, H., Chowdhury, D., Deva, A., & Vickery, K. (2018). The A, B and C’s of silicone breast implants: anaplastic large cell lymphoma, biofilm and capsular contracture. Materials , 11 (12), 2393.
