Breast implant

A breast implant is a prosthesis used to alter the size, form, and feel of a woman’s breasts in post–mastectomy breast reconstruction; for correcting chest wall congenital deformities; for the aesthetic enhancement of the bust; and as a procedural aspect of male-to-female gender transition surgery. There are three general types of breast implant devices, defined by their filler material: saline, silicone, and composite (alternative composition). The saline implant has an elastomer silicone shell filled with sterile saline solution, the silicone implant has an elastomer silicone shell filled with viscous silicone gel, and the alternative composition implants featured miscellaneous fillers, such as soy oil and polypropylene string, et cetera. The pectoral implant is the male breast implant device for reconstructive and aesthetic enhancement of a man’s chest wall, (see gynecomastia and mastopexy). In breast reconstruction surgery, the breast tissue expander implant is a temporary breast-implant device used in staged breast reconstruction.

Since the late nineteenth century, breast implant devices have been used to surgically augment the size (volume), modify the shape (contour), and enhance the feel (tact) of a woman’s breasts. In 1895, surgeon Vincenz Czerny effected the earliest breast implant emplacement when he used the patient's autologous adipose tissue, harvested from a benign lumbar lipoma, to repair the asymmetry of the breast from which he had removed a tumor.[1] In 1889, surgeon Robert Gersuny experimented with paraffin injections, with disastrous results. From the first half of the twentieth century, physicians used other substances as breast implant fillers — ivory, glass balls, ground rubber, ox cartilage, Terylene wool, gutta-percha, Dicora, polyethylene chips, Ivalon (polyvinyl alcohol – formaldehyde polymer sponge), a polyethylene sac with Ivalon, polyether foam sponge (Etheron), polyethylene tape (Polystan) strips wound into a ball, polyester (polyurethane foam sponge) Silastic rubber, and teflon-silicone prostheses.

In the mid-twentieth century, Morton I. Berson, in 1945, and Jacques Maliniac, in 1950, each performed flap-based breast augmentations by rotating the patient’s chest wall tissue into the breast to increase its volume. Furthermore, throughout the 1950s and the 1960s, plastic surgeons used synthetic fillers — including silicone injections received by some 50,000 women, from which developed silicone granulomas and breast hardening that required treatment by mastectomy.

Types of breast implant device

Breast implant devices filled with saline solution (biological-concentration salt water 0.90% w/v of NaCl, ca. 300 mOsm/L.) were first manufactured by the Laboratoires Arion company, in France, and introduced for medical use in 1964. The surgico–technical application goal was emplacement of the empty implant device via smaller incisions. Contemporary models of saline breast-implant devices are manufactured with thicker, room-temperature vulcanized (RTV) shells made of a silicone elastomer.

During the implantation surgery, after the surgeon has emplaced the empty breast implants to the implant pockets, they are filled with saline solution; because the incisions required are small, the resultant surgical-incision scar will be smaller than the scar usual to the long incision required for inserting pre-filled, silicone gel implants. Historically, a single manufacturer, Poly Implant Prosthesis, France, produced a model of pre-filled saline breast implant that suffered great rates of in vivo failure. By the 1990s, the saline breast implant was the medical device usual for breast augmentation, because of the U.S. FDA importation restriction against silicone breast implants.

In surgical praxis, the saline implant can yield good-to-excellent results, but, when compared to silicone gel implants, saline breast implants are likelier to cause cosmetic problems such as rippling, wrinkling, and being noticeable to the eye and to the touch. Especially for women with very little breast tissue, and for post-mastectomy reconstruction patients, silicone-gel implants are the superior medical device for breast augmentation and breast reconstruction. In women with more breast tissue, for whom submuscular emplacement is the recommended surgical technique, saline breast implants can afford an aesthetic “look” much like that afforded by the silicone gel implant.