A brief history of breast augmentation Implants

Plastic surgery that includes breast augmentation is a medical science. There are many people who are curious about medical science, however, this field of study is very professional therefore, if someone who is not a professional, delivers undetailed information, that information may be wrong.

I have written a lot of contents in my blog and I have a lot of readers, however, I feel that those patients that visit me at the clinic get wrong information online.

Poly-dimethyl-siloxane (PDMS)

Media is a source that provides wrong information to people. Non-specialists such as reporters and PDs from newspaper, TV, internet gather superficial information, make an attractive headline and report it. This kind of scares me.

Such articles with wrong information existed long before the introduction of the internet, but it still occurs frequently.

If you know the history of breast augmentation, implant, water drop type augmentation and its implant, you would be able to understanding the overall procedure better.

There are few reasons on why I would like to write contents on the history of the implants today,

First, breast augmentation is a once in a life time activity therefore, the patient needs to know what is being put inside one’s body and plan on the surgery with the correct knowledge.

Second, implant and the surgery method should be decided under the academically and logical reasoning recommendation from the doctor, and not just by getting internet knowledge.

In one sentence, the history of breast implant was centered on the shape and marketability, however, the focus changed to safety after the recommendation from US FDA.

We will skip the details of the early ages and focus on the modern age where the silicone gel breast implant was introduced in 1963.

At the time, many surgeons used smooth type silicone gel implant and put it above the pectoralis muscle with inflammatory line incision. The incidence rate of capsular contracture was very high at the time at about 10 ~ 15%. However, the patients thought the breast augmentation was worth doing with such incidence rate.




The substance insider the silicone implant continually changed to provide better feel and natural shape by making the implant with smooth exterior until the mid-70’s.

If the patient needed reconstruction due to the implant collapse, the leaked substance would be gathered around the space near the capsula. There weren’t much data on what would happen to the body if the substance was absorbed, therefore, there were a lot of social issue regarding the side effect of silicone liquid in US.

Since then, the manufacturers focused on making not liquid but something sticky. In the 80’s, Mentor and McGhan competed in the implant market with the focus in avoiding any damage to the implant making the exterior thicker.

If you see an advertising statement on the internet that reads “new cohesive gel implant has a good feel”, this is false. Cohesive silicone gel was produced 20 years ago by a US company, McGhan, and this does not have a better feel than the liquid silicone charged implant which was used in the 1960’s.
Also, the correct name for the cohesive gel is ‘Silicone gel changed artificial breast implant’.

There were many implants introduced between the 1970’s and 80’s. There were implants with glue at the bottom so when the implant goes into the breast; the position gets fixed below the pectoralis major muscle. This was made under the concern that as a person ages, the breast might sag down with the implant but in reality, the original breast sagged but the implant did not making the shape look weird. Nobody used this implant with glue anymore.

There was an implant called double lumen with silicone gel on the inside and saline solution charged on the outside.

Silicone gel implants with polyurethane exterior was introduced during the 80’s. Since then, the incidence rated of capsular contracture decreased dramatically. Polyurethane exterior on the implant sticks completely with the skin. However, there were news that the polyurethane when exposed leads to high possibility of cancer, therefore, the sale distribution stopped in US. (It is still used in Europe)

Textured implant started on the basis of polyurethane exterior. But this textured implant does not stick completely to the surrounding skin and its substance is completely different from polyurethane.

PVP (Poly vinyl pyrrolidone) was made in the 90’s. There was a problem with it getting bigger once it gets in the body, so the doctors and the patients could not use the product.

Anyway, there were such variety of products in US and Europe, and in 1992, there was a big happening that influenced the manufacturers, hospitals, doctors, and even the surgery procedure.

In 1991, US FDA gathered PMA (Production and Marketing administration) to check and gather the information regarding the safety of the implants. At the time, the examining department in FDA temporarily seized all sales of silicone gel implants in US.
This examining department was headed not by plastic surgery specialist but by pediatrician. There were no medical record that supported this seize. There was no evidence that this silicone gel implant when absorbed by the body caused any harmful effect.

The moratorium went on for 14 years until 2006 and in that time, the doctors and the manufacturers all gathered data related to surgery, results, side effects, reconstruction rate, in order to submit to the FDA.

When McGhan made water drop type cohesive gel implant in 1991, its sales was stopped in US right away. The patients could only use the saline solution bag type implants so the purchasing power of the patients were hurt with having not much choice.

Anyway, after the introduction of the moratorium, many doctors in US gathered millions of data and published a book called ‘Safety of silicone gel implants’ in 1999. The conclusion was that the silicone gel inside the body did not cause any type of physical harm or illness.

This showed that the usage ban was under the social pressure and not by any medical reasoning.

US has a reputation of being very strict on the implant that is used inside the body. There are also many lawyers who earn much money from medical lawsuits. Our country does not allow what US FDA does not, and allows what US FDA does. However, in US the doctors, under their judgement, can use any type of implants for reconstruction and ribcage problem; however the Korean government restricts the import of the implants. Korean patients have very small variety of products to choose from. Our neighboring country, Japan, can select implants as those in US do, and it has 7 manufacturers that produce the implants.




This is a simple summary on the history of the implants.

Today, there are patients who require:
-       Please use the new cohesive gel, the one with a good feel
-       I want the textured 275, the one that does not cause the capsular contracture

The implant may be the cause of the side effects, but the side effects are caused due to the epidemiologic relationship between the human body and the implant. The core problem is how well the implant stays inside the body.

If the implant has some type of aggressive effect on the body, this leads to capsular contracture, and if there is no proper physiological and safe desquamation, then this leads to infection and inflammation.

If the body cannot take the large sized implant, there would be problems such as implant collapse, leakage, rippling, and unnatural feel.

Before 1992, the core issue with the implant was whether it collapses easily or leaks easily, and if the leaked substance harms the body. But this is all old news now. Today, the implants do not collapse easily. Also there are evidences that the silicone gel is not related to any type of physical illness and breast cancer. (This was proven 13 years ago)
The PIP news from France is a real fraud. This company’s sales activity was seized two years ago however they sold their products illegally and the news was just shared.

Such product was never imported to our country and it was the first time that I have heard of this. The news did not have any relation with us but there was a big fuss about it.


- Mentor breast implant, US
- Allergan breast implant, US
- Polytech breast implant, Germany
- Silimed breast implant, Brasil
- Sebbin breast implant, France

These are the products that can be used in our country. These implants have been proven that they do not cause harm to the body, but the most important thing is to find a clinic that has a doctor who can select an appropriate implant for the patient and give a proper explanation on the expected or not expected side effects and illness that may be caused.


 This is all for today. Thank you very much.