Introduction to Breast Augmentation

There are three methods in which a breast augmentation procedure can be performed to enhance the size and shape of the breasts.

One of the methods consists of injecting material, such as paraffin and silicone, into the parenchymal tissues of the breasts. The outcome of the procedures was not so satisfactory and a high number of short and long term complications were reported. Inflammatory tumors and growth of granulation tissues, which are called Granumolas, were frequently reported as well. Some even reported disfigurement of breasts caused by scar tissue and skin loss. These complications were too risky and this method was abandoned.

There has been an attempt to inject autogenous tissues into the breasts to enhance their shape and size. Fat, omentum, skin, lipomas, muscle and dermal fat grafts were utilized to be used in the procedure, with not so positive outcome. The results turned out to be unpredictable. Visible scarring and uneven shape of the breasts were some of the minor problems compared to the microcalcifications that would develop in the breasts and would make the early diagnosis of cancer almost impossible.

There were attempts to enhance the shape of the breasts using a suction pump device. Although there were some enlargements, the overall shapes of the breasts were not enhanced in this procedure and the results were not satisfactory.

The preferred method of breast enlargement used these days actually started in the sixties when utilizing of implants started.

Silicone filled implants are one type of these implants that can be used. It has minimum solubility and the high viscosity of it gives a good feel to the breasts. But there still are some disadvantages and using silicone in this procedure is still under investigational approval. If silicone leaches from the implants, it would cause capsular contracture and granumolas to form in the breasts. If silicone reaches the axilla the same complications would arise. In some cases, autoimmune responses have been reported as well, but long-term studies managed to discredit these reports. These studies showed that there are no long term effects caused as a result of this procedure in large number of women who went under breast augmentation with silicone implants.

Although FDA decided to remove the silicone implants because of the increased number of autoimmune responses reported, the number of people interested in using silicone implants for breast augmentation increased when later these reports were discredited.

Another material used for implants is saline. Saline is very safe and is present in the solutions used for intravenous injections. The advantage of saline is that if it leaks from the implants, the material is absorbed into the blood stream without causing any danger. The chance of capsular contracture with saline is much less than silicone.  Saline is less viscose than silicone and a high number of deflations were reported in the beginning. The percentage of deflations decreased significantly due to the researches done to increase the reliability of the implants.

Facts about Implants

Round and tear-drop are the two shapes of implants currently used in breast augmentation procedures. Round implants, that are disc shaped, give an equal fullness to all the areas of the breasts. Tear-drop implants, which are also called anatomic implants, are narrower in the upper part and give less augmentation to the upper part of the breast. They are thicker in the lower part and give more fullness to the lower part of the breasts.

In the seventies polyurethane covered silicone gel implants were introduced for the first time. After some time, decreased capsule formation was reported in many of the patients. In some cases it was claimed that as the scar tissue grows into the polyurethane, the vector force of scar contracture breaks. Although this claim was never proved during the studies that followed, it led to the invention of texture surfaced implants, instead of the smooth ones that were previously used. These implants were removed from the market due to the other problems they caused. Microfragmentation and phagocytosis of polyurethane would cause serious problems. There was also the fear that the polyurethane cover would break down and dissolve between the tissues. If that happened, the patient would develop nucleated cells and macrophages which would lead to intense foreign body reaction.