History of Breast Augmentation

A Brief History of Breast Augmentation Surgery

A look at the recent history of cosmetic plastic surgery suggests that the business has gone through a remarkable growth spurt over the last fifteen years. The prestigious American Society of Plastic Surgeons has kept national statistics on their trade since 1992, with specific totals for a wide variety of surgical procedures. There are a few facts that jump off the data sheets.

In 1992 the total number of cosmetic plastic surgery procedures was a little over 413,000. In 2007 that total was 1,837,000. Those figures are somewhat deceptive, because in 2007 plastic surgeons also performed over ten million minimally invasive or non-invasive procedures including Botox and filler injections, laser hair removal, laser skin resurfacing, chemical peels, microdermabrasion, etc. Many of those procedures either didn't exist or were at an infantile stage in 1992.

The Growth of Successful Breast Augmentation

With regard to breast augmentation, in 1992 there was a total of a little over 32,000 procedures for cosmetic purposes. That amounted to less than 8% of the total number of cosmetic plastic surgery procedures. It should also be noted that in 1992, there were over 18,000 breast implant removals. In 2007 there were 347,000 breast augmentation procedures, about 19% of the total number of cosmetic surgical procedures, and over ten times the number of implants done in 1992. Today breast augmentation is the number one cosmetic procedure performed annually. In 1992 it was number six.

Back to the implants: there were 26,000 implant removals in 2007, less than one percent of breast augmentations, compared with the implant removals in 1992 which equaled over half the number of implant procedures done that year. Comparison of those figures speaks volumes about the improvement in breast augmentation over the last fifteen years.

Early Attempts and Early Disasters

Breast implants have never been more popular or more successful. The development of the procedure has not always been so laudable, although the first attempt was for true Hippocratic purposes. That implant was performed by a prominent Austrian physician named Vincenz Czerny, a pioneer in a number of surgical procedures including kidney stone treatments and a new technique for hysterectomies. In 1895 he published an account of his surgical transfer of a benign growth from a woman's back into her breast, in order to avoid asymmetry after removing a tumor from that same breast.

In 1889 an attempt was made with paraffin injections, with the predictable horrific results. In the first half of the twentieth century other experiments or introductory products included ground rubber, ox cartilage, gutta-percha, polyethylene chips, a polyvinyl sponge material, polyurethane sponge, and Teflon-silicon prosthetic implants. In 1945 and 1950 two doctors performed flap procedures by shifting a portion of the patient's chest wall into position behind the breast to add volume.

Moving into the 1960s, silicon injections were used on a fairly widespread basis to disastrous results. Hardening of the breasts was one typical reaction; perhaps worse were the silicon granulomas, which are the development of immune cells surrounding and trying to destroy a foreign substance - in other words, balls of permanent inflammation.

Into the Modern Era

Silicon filled breast implants were introduced in 1961 in the United States. They went through a variety of changes and improvements. The first shells were prone to hardening, so polyurethane shells were introduced. Other combinations included the silicon gel contained inside a saline sac. Problems persisted with the various implants, until 1988 when the FDA declared a moratorium on silicon implants for cosmetic purposes. It is only in the last few years that silicon implants have again become an option.

Today saline implants and silicon implants are the two options open to the potential breast augmentation patient. Saline implants have the advantage of a smaller incision because they can be filled after placement. Silicon implants contain a gel instead of a liquid, and are widely described as feeling more natural once they have settled into position.

Implants have become much less problematic as the technology has improved and as the popularity suggests. They can still leak and that will require revision surgery. In any case they will probably require replacement after a maximum of ten years or so. Nevertheless it is clear that breast augmentation surgery has come of age, adding not only physical dimension but also long-sought self esteem for hundreds of thousands of women annually.

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