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The prosthesis to enlarge the size of the women's breast for cosmetic
or reconstruction reasons is called a breast implant. It is also known as breast augmentation.
This is the third most commonly performed cosmetic surgical procedure in the United States.
In 2005, 291,000 breast augmentation procedures were performed.
There are two types of breast implants.
1. Saline filled implants: they have a silicone
elastomer shell filled with sterile saline liquid.
2. Silicone gel filled implants: these have a
silicone shell filled with a viscous silicone gel.
History:
Since 1895 implantation has been going on to augment the size and the
shape of the women's breast. The first attempt was done by Czerny. Then
Berson and Maliniac performed a flap based augmentation by rotating the
patient's chest wall tissue into the breast to add volume.
Indications used in breast implantations:
Patient characteristics:
1. younger
2. women who have breast fed their children
3. higher socio economic status
4. greater distress about their appearance
5. Endured more teasing about their appearance.
6. low self-esteem
Types of Breast Implant:
1. Saline Implants:
They were introduced by Arion in France in the year 1964.
2. Silicone Gel Implants:
Thomas Cronin and Frank Gerow, plastic surgeons developed
the first silicon breastprosthesis with the Dow Corning Corporation in 1961.
First woman was implanted in 1962.
Silicone implant generations:
Silicone breast implants are best described in five generations. We
discuss the common characteristics of manufacturing techniques.
1. first generation:
the Cronin-Gerow implants were made of a silicone rubber envelop and
filled with a thick viscous silicone gel with a Dacron patch on the
posterior shell. They had a ?teardrop? anatomic shape and were firm.
2. second generation:
the breast implants were redesigned with thinner gel and thinner shells
in 1970's. There was also the development of polyurethane foam
coating which was effective in diminishing capsular contracture by
causing an inflammatory reaction that discouraged formation of fibrous
tissue around the capsule. The second generation implants also included
various ?double lumen? designs.
3. third and fourth generation
The principle of the third
generation was to elastomer-coated to decrease gel
bleed, and filled with
thicker, more cohesive gel. The gel filler reduces leakage of the
gel compared to earlier devices. Anatomic
shaped implants are uniformly textured to reduce rotation, while round
devices are available in smooth or textured surfaces.
4. fifth generation:
In the United States of America in the preliminary stages the
form-stable of implants were ?gummy-bear? or high-cohesive. When there
is a high degree of gel cohesion it will significantly reduce the
possibility of silicone migration.
Breast Implant placement techniques:
There are many kinds of implant placement techniques such as
? Inframammary.
? Periareolar.
? Transaxillary.
? Transumbilical.
? Transabdominoplasty.
Breast Implant pocket placement:
The placement of implants is described in relation to the pectoralis
major muscle.
? Subglandular
? Subfascial
? Subpectoral
? Submuscular
Complications:
There are always negative points whenever you get a
surgery done. Some of the risks of breast implant surgery are:
? Post-operative bleeding
? Fluid collections
? Surgical site infection
? Breast pain
? Alterations in nipple sensation
? Interference with breast feeding
? Visible wrinkling
? Asymmetric appearance
? Wound dehiscence
? Thinning of the breast tissue
? Synmastia
There are also some very common reasons which ask for a re-operation
after the breast implantation is done
1. rupture
? saline implant rupture
? silicone implant rupture
? capsular contracture
? systematic reviews on claims of systemic illness
? platinum
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