We've Come a Long Way in Breast Implants

Breast augmentation surgery is the most popular cosmetic surgery in the U.S., with about 286,000 people going under the knife in 2014.

(Nose reshaping was a close second with 217,000.) With the ubiquity of celebrities and stories of women looking to add a little extra, it seems that these days breast enhancement is as popular as dying one’s hair or getting a manicure!

And just to be clear, I’m not criticizing this fact. I’m of the opinion that people can do with their bodies whatever they wish, provided they’re fully aware of the potential health risks – and in the case of cosmetic surgeries like breast augmentation, the potential social consequences.

It wasn’t always this simple to alter your body, however. The first true “breast implant” was surgically inserted by Dr. Vincenz Czerny in 1895. Czerny used a patient’s autologous adipose tissue borrowed from a benign lumbar lipoma to fix an asymmetrical breast from which he had removed a tumor. And for a while, surgeons transplanted fat from other parts of the body for breast augmentation, which failed because the fat absorbed back into the body.

However, the implantation method was not the first to be used for breast augmentation. Around 1890 Austrian doctor Robert Gersuny began experimenting with injecting paraffin wax (a combination of petroleum jelly and olive oil) into womens’ chests. While the augmentation looked fine for a while, these injections resulted in the formation of paraffinomas (hard masses of the paraffin) inflammatory reactions, tissue necrosis, and draining sinus tracts. Sometimes the complications included pulmonary embolism and blindness as a result of cerebral embolism. Yikes!

Once it became clear that paraffin wouldn’t work, cosmetic surgeons turned to liquid silicone injections. These didn’t work either – they produced silicone granulomas, and other complications included skin slough, silicone migration, granulomous hepatitis, and embolism. Not altogether surprising when considering silicone injections were never approved by the FDA for breast use.

Jumping ahead just a bit while on the topic of silicone injections – during World War II, Japanese prostitutes purportedly injected themselves to curry favor with American GIs. Quite a tactic!

In the 1940s and 50s the desire for the “Marilyn Monroe” buxom body type created quite a demand for breast implants. To combat the fervor, physicians tested an incredibly disturbing array of materials as breast implant fillers. Here a few of the most unsettling: ivory, glass balls, ground rubber, ox cartilage, wood, and polyester. In the 1950s women began to have many synthetic and polyvinyl sponges implanted, which was the worst idea yet. The sponges shrank after a few months, and led to infections, inflammation, and even cancer.

In 1961, Dow Corning collaborated with two Houston cosmetic surgeons to invent the first silicone breast implant, a rubber sac filled with silicone gel. Silicone implants were particularly desirable (preferred over saline invented in France around the same time) because of their lifelike feel. Silicone breast implants proved to be the first relatively safe method, the design remaining unchanged for 30 years. Their design was modified slightly for safety reasons in 1982, but ten years later, after about 100,000 women had received the modified implants, the FDA announced that the polyurethane in the implants could potentially break down and create a carcinogen.

As a result, surgeons turned back to the safer (but less natural-feeling) saline implants designed in France in the 1960s. However, advances in 3D imaging and increasingly rupture-proof implants are bringing about more natural-looking and safer breast implants all the time!