Silicone Gel Breast Implants: Past, Present, and Future.

The authors have provided an in-depth review of the history of saline and silicone gel-filled breast implants. In the history of medicine, no devices have been more scrutinized and thoroughly studied than breast implants. Although we as plastic surgeons recognize and appreciate the benefits that our patients derive from these devices, society as a whole continues to remain skeptical. The reasons for this are complex and multifactorial but appear to be fueled by the media, oppositional organizations, and several trial lawyers. Prior to 1990, when the silicone gel implant controversy began, there were only eight indexed publications that dealt with the issue of silicone gel breast implants. Since 1990, there have been more than 500 indexed publications dealing with silicone gel implants. At the time of the moratorium in 1992, we as plastic surgeons did not have a leg to stand on because there was a paucity of scientific evidence to support our observations that silicone breast implants were safe and effective devices.

The evolution of breast implants.

Female glandular hypomastia is a frequently encountered entity that occurs either developmentally or by postpartum involution. Historically, women have long sought breast enlargement to improve physical proportions, to foster a more feminine appearance, or to enhance self-image. This article explores the evolution of breast implants.

History of breast implants and the food and drug administration.

Over the past 30 years, silicone-gel breast implants and their manufacturers have experienced a tumultuous relationship with the FDA and the public, which has changed the modern climate of industry oversight and the field of plastic surgery. We present an account of the events leading up to and resulting from the 1992 FDA moratorium on silicone implants. We highlight the involvement of the manufacturers, the scientific and legal communities, regulators, the plastic surgery community, and others as they strive to come to terms with a fearful public opinion shaped by the influence of the media. Finally, we describe how these past events will help the field of plastic surgery grow and continue to push the bounds of medicine.

Breast implant research: where we have been, where we are, where we need to go.

This article summarizes the current state and future needs of research into saline-filled and silicone gel breast implants. The authors describe recent investigations into possible causes and potential risk factors for silicone gel and saline implant failure. Also discussed are local complications of breast implantation and the need for revisional operations in augmentation and reconstruction patients. In addition, the effects that surgical, implant, and patient variables have on the aesthetic outcome of surgery are addressed. The last portion of the article lays out future research needs, such as determining the incidence rate of implant failure, reducing the frequency of revisional surgery, and the difficulty of designing better breast implants in the current strict regulatory climate.

History of breast prostheses.

What material was available for breast augmentation 25 to 75 years ago? How has the development of today's breast implants evolved? These and other related issues are discussed in this article on the history of breast prostheses.