BREAST AUGMENTATION- PAST PRESENT AND FUTURE By Dr. Ajaya Kashyap, MD, FACS
Diplomate American Board – General Surgery
Diplomate American Board – Plastic Surgery
To have shapely breasts have been the desire of all women since before the start of history. The desirable size of the breasts in today’s culture is a C-cup size such that the waist to breast ratio is 0.67. The height and built of the individual are of course important criteria.
Breast augmentation has been attempted with non-surgical means using medications and massages little success. Subsequently other means of breast augmentation were tried including injections of various medications. This also had variable but overall disappointing results. A variety of substances were injected in the breast from foam to paraffin and wool, all with disastrous results. This went on from late nineteenth to early twentieth century . A nother approach that was attempted in the late nineteenth century was use of patient’s own fat and tissue from the chest with somewhat better results although the techniques were rather crude by todays standards. During the mid twentieth century silicone injections were used on over fifty thousand women with disastrous results .
Then in 1961 the first silicone filled breast implants were devised and were used clinically in 1962. In 1964 saline filled breast implants were developed in France which lagged behind in popularity till the controversy in the 1990s Since the development of implants breast augmentation has become the most common cosmetic surgical procedure in the U.S. and many other countries.
In 1990s following a TVshow in the US the controversy started about the linkage of silicone filled breast implants with a variety of medical problems. The silicone filled implants were promptly pulled off the US market. The linkage was never established and in fact the safety of silicone breast implants was subsequently established through extensive studies. This was the time when rapid developments in technology took place. The size, shape and projection of implants evolved , polyurethane coated implants came and went as did soya-been filled implants. Now that the safety of silicone implants is established they are back in almost all the countries. The ne avatar of these implants is the cohesive gel or “gummy bear” implants which do no not flow out even when ruptured. There are many more and safer implant choices that are available today .
There are multiple approaches for breast augmentation . These include putting implants through the armpit, from below the breast fold, through the nipple areola or even through the navel. The first two are the most common approaches for silicone implants. The layer which the implants are put under is also variable , above or below the muscle. There are advantages and disadvantages of both.
In spite of the established safety record of breast implants several concerns remain. If non medical grade silicone is used as in the PRP implants major problems can happen. It is important to use US FDA approved implants which do not have these issues. There is also the possibility of leakage which can occur years after the implant. There is formation of a film of scar tissue around the implant which is called a capsule. The newer techniques and implants have minimized this problem. Further progress is being made in the manufacture of implants as well as techniques used to insert them Cancer screening which was difficult before is becoming easier with MRI technology.
Address:
Diplomate American Board – General Surgery
Diplomate American Board – Plastic Surgery
To have shapely breasts have been the desire of all women since before the start of history. The desirable size of the breasts in today’s culture is a C-cup size such that the waist to breast ratio is 0.67. The height and built of the individual are of course important criteria.
Breast augmentation has been attempted with non-surgical means using medications and massages little success. Subsequently other means of breast augmentation were tried including injections of various medications. This also had variable but overall disappointing results. A variety of substances were injected in the breast from foam to paraffin and wool, all with disastrous results. This went on from late nineteenth to early twentieth century . A nother approach that was attempted in the late nineteenth century was use of patient’s own fat and tissue from the chest with somewhat better results although the techniques were rather crude by todays standards. During the mid twentieth century silicone injections were used on over fifty thousand women with disastrous results .
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Then in 1961 the first silicone filled breast implants were devised and were used clinically in 1962. In 1964 saline filled breast implants were developed in France which lagged behind in popularity till the controversy in the 1990s Since the development of implants breast augmentation has become the most common cosmetic surgical procedure in the U.S. and many other countries.
In 1990s following a TVshow in the US the controversy started about the linkage of silicone filled breast implants with a variety of medical problems. The silicone filled implants were promptly pulled off the US market. The linkage was never established and in fact the safety of silicone breast implants was subsequently established through extensive studies. This was the time when rapid developments in technology took place. The size, shape and projection of implants evolved , polyurethane coated implants came and went as did soya-been filled implants. Now that the safety of silicone implants is established they are back in almost all the countries. The ne avatar of these implants is the cohesive gel or “gummy bear” implants which do no not flow out even when ruptured. There are many more and safer implant choices that are available today .
There are multiple approaches for breast augmentation . These include putting implants through the armpit, from below the breast fold, through the nipple areola or even through the navel. The first two are the most common approaches for silicone implants. The layer which the implants are put under is also variable , above or below the muscle. There are advantages and disadvantages of both.
In spite of the established safety record of breast implants several concerns remain. If non medical grade silicone is used as in the PRP implants major problems can happen. It is important to use US FDA approved implants which do not have these issues. There is also the possibility of leakage which can occur years after the implant. There is formation of a film of scar tissue around the implant which is called a capsule. The newer techniques and implants have minimized this problem. Further progress is being made in the manufacture of implants as well as techniques used to insert them Cancer screening which was difficult before is becoming easier with MRI technology.
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