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This is an interesting conglomeration of facts, published onTBO.com (http://www2.tbo.com/content/2010/mar/17/171510/brief-history-breast-implant) on March 17, 2010

Despite its litigious history, breast implant surgery is the most popular surgical cosmetic procedure in the country.

Here are some events that have kept breast augmentation in the news throughout history:

1890s: The first surgical breast augmentation procedure is performed with paraffin wax injections, resulting in infections and lumps. By the 1920s, the practice is discontinued.

1895: German surgeon Vincenz Czerny is known as “the father of cosmetic breast surgery” for reconstructing a woman’s breast by transferring fatty tissue from the belly and buttock areas into the breast. The procedure isn’t very successful because the body quickly reabsorbs most of the fat, leaving the breast lumpy and lopsided.

1940s: During World War II, Japanese prostitutes have silicone liquid injected into their breasts to appear more voluptuous, causing health problems and death. Even so, the procedure catches on and spreads to the United States before the practice is banned.

1950s: Well-endowed Hollywood icons Marilyn Monroe, Ava Gardner and Lana Turner help make the bombshell’s hourglass shape popular, causing many women to turn to padded bras and augmentation to keep up.

1961: Surgeons Frank Gerow and Thomas Cronin develop the first silicone breast implant with the Dow Corning Corp.

1962: Timmie Jean Lindsey, a 30-year-old mother of six, visits a Houston Hospital to have a pair of floral tattoos removed from her breasts and becomes the first woman to get silicone breast implants.

1965: A surgeon develops the first saline-filled breast implants in France.

1977: A woman wins a $170,000 settlement from Dow Corning for pain and suffering after her breast implants rupture.

1980s: Ralph Nader’s Public Citizen Research Group sends out warnings that silicone breast implants cause cancer.

1992: After reports of women claiming implants are hazardous to their health, the FDA stops the cosmetic use of silicone-gel implants.

2000: The FDA approves saline-filled implants, finding them safe and effective for use in breast augmentation and breast reconstructive surgery.

2004: While being photographed at a party, actress Tara Reid accidentally exposes her scarred breast. She later admits to having botched breast surgery.

2006: The FDA approves silicone breast implants again.

2008: Breast augmentation surgery replaces liposuction as the most popular cosmetic surgery in the United States.

2009: Hungary holds a beauty pageant, “Miss Plastic Hungary,” to highlight the positives of plastic surgery.

2010: A Beverly Hills plastic surgeon says breast implants saved the life of one his patients by helping stop a bullet to her chest.

Sources: beyondniptuck.com; pbs.org; breast-plastic-surgery.org, breastimplantsusa.com and ofc.berkeley.edu

Are breast implants permanent?

Breast implants are not permanent devices, but can sometimes last for up to 25 years with no problems.

Can breast implants be removed?

Implants can be removed, but the breast skin and tissue may become stretched over time.  As a result, the breasts may develop redundant skin and a breast lift (mastopexy) may be required after the implant is taken out.

Is breastfeeding possible after breast augmentation?

Breast implants usually do not affect the ability to breastfeed.

Who is eligible to get breast implants?

You are not eligible to get breast implants for cosmetic purposes if you have untreated breast cancer or infection, are under 18 years of age, or are pregnant or nursing.  Silicone implants cannot be placed for cosmetic purposes in patients under 21 years of age.  Breast implants may be placed in younger patients if needed for reconstructive purposes.

Will insurance cover breast augmentation?

Insurance companies do not cover breast implant surgery performed for cosmetic purposes.

What happens if the implant ruptures?

Patients often worry about implant rupture even though it is not a terribly common problem. Within 10 years of surgery, only one in ten implants will rupture.  If a saline implant ruptures, the implant will simply deflate in a few hours and your body will absorb the salt water.  If a silicone implant leaks, it may not become apparent for several years.  For that reason, the FDA recommends that patients get an MRI 3 years after breast augmentation, and then every two years thereafter to assess for rupture.

How will my breasts look and feel after breast augmentation?

Some bruising and swelling occurs right after the procedure, but disappears relatively quickly.   Once the swelling is gone, the breasts feel healthier and firmer. Saline breast implants feel a bit firmer (both inside and outside the body), while silicone gel breast implants are softer and more natural feeling.

Will there be scars?

Although scars are a part of the breast augmentation process, Dr. Jejurikar’s goal is to make the scars as aesthetically pleasing as possible.  Dr. Jejurikar places the incisions around the areola, under the arm, or under the breast. Breast augmentation scars, regardless of where they are located, tend to heal extremely well.

When can I return to work and resume normal activities after breast augmentation?

It will take a few days to return to normal activities, and even then, patients often feel fatigued. It is often possible to return to work within one week after breast augmentation surgery. Strenuous physical activity should be avoided for three weeks following surgery.

Breast augmentation is an intensely gratifying procedure for patients, as they see immediate results after the procedure.  Like any surgical procedure, though, patients need to allow some time for recovery.

Recovery is variable from patient to patient. Most patients feel tired and sore after breast augmentation surgery, but this usually passes in a day or two. Many patients return to work within the week.  After a week, most patients have mild fatigue and soreness, but no other significant symptoms.

Surgeons vary in the amount of time they restrict their patients from exercising postoperatively.  I ask my patients to refrain from all vigorous exercise for 2 weeks postoperatively and from all upper body exercises for 4 weeks.  Patients don’t always want to comply with this, as they feel relatively normal well before their postoperative restrictions are lifted.

Scars from breast augmentation incisions will begin to fade in a few weeks and will continue to fade for months or years.

Many of my patients ask how I choose the optimal size for a breast implant. Some women are very concerned about choosing too large of an implant, as they know this can make their breasts look unnatural. Other women are afraid that they won’t choose a large enough implant to see a discernible difference. There are a variety of tools that I use to help my patients select the best breast implant size:

• Photos. Having patients bring photos of breasts they like and breasts they detest help me determine their goals. Some women desire subtle enhancement and others desire much more dramatic enlargement.
• Measurements. The chest wall diameter, breast width and height are all important factors in selecting an appropriate implant. The breast skin envelope is only so large; selecting an implant that is too large invariably means that implant will sit too high, too low, or too lateral.
• Trial sizing. Although it is inexact, having patients try different implants in a bra in the office is a useful exercise. It gives them a crude idea of breast size and shape in clothing and often helps them verbalize their goals.
• Conversation. Different implants have vastly different shapes and profiles. It’s important that patients understand how this differs in appearance from other types of implants, and that can only conveyed adequately in the preoperative consultation.
• Intraoperative sizing. I will often utilize intraoperative trial implants and always sit the patient up during surgery to ensure that the breasts have a pleasing appearance.  This is particularly the case for patients with breast asymmetry, to ensure that the final implants utilized provide the greatest possible symmetry.

Breast augmentation can give women with small or uneven breasts a fuller, better-proportioned look through the placement of saline breast implants or silicone breast implants, dramatically improving self-esteem and confidence. Any operation, though, including breast augmentation, poses some risks that can lead to complications or unfavorable results.

The most common complication is capsular contracture, or hard, firm scar that forms around the implant. Because the breast normally is soft, the development of scar tissue can make the breast feel and look hard, and in severe cases, can cause pain. With older silicone breast implants, capsular contracture was much more common. The frequency of capsular contracture has diminished with currently utilized silicone breast implants, so that the occurrence rate is now similar between silicone and saline breast implants. Mild capsular contracture is hardly perceptible, but severe contractures can be painful and unattractive. Treatment consists of surgery to remove the entire capsule and placement of a new breast implant. Placement of the implant in a pocket below the chest wall muscle results in a lower risk of capsular contracture than placement over the muscle.

Infection, if it occurs, usually does so within a few weeks of surgery. Infection occurs very rarely, but if an infection occurs it often requires antibiotics and the removal of the involved implant for several months.

Some women report that their nipples become oversensitive, undersensitive, or even completely numb. Some women also report small patches of numbness near their incisions. These symptoms usually disappear within time, but may be permanent in up to 15% of patients. If the possibility of having numb nipples is unacceptable to a patient, she should not have breast augmentation, as no plastic surgeon can predict which patients will develop this complication.

There is no evidence to indicate that breast implants will affect fertility, pregnancy, or the ability to breastfeed. If, however, a patient has nursed a baby within a year before breast augmentation, she may produce milk for a few days after surgery. This may cause some discomfort, which usually resolves within a few days. For women who get pregnant after having breast implants placed, in most cases, breast implants will not affect the fate of the breasts. After the breast tissue shrinks after pregnancy and breastfeeding, the breast skin may or may not shrink. If the skin does not shrink, the breasts will likely droop. Whether or not the skin shrinks is controlled by factors other than the presence or absence of breast implants.

Breast implants may break or leak. Most often, breast implant rupture is the result of normal wear and tear on the breast implant shell. If a saline-filled implant breaks, the implant will deflate within a few days and the salt water will be harmlessly absorbed by the body. To restore volume, another implant needs to be placed. If a break occurs in a silicone breast implant, silicone gel may move into surrounding tissue, provoking an inflammatory reaction which can lead to a severe capsular contracture. There may be a change in the shape of the breast, and the breast may become hard and painful. This will require a second operation to remove the breast implant shell and to replace the leaking implant.

No data exists suggesting that breast implants cause breast cancer. Silicone and saline breast implants, however, can alter surveillance for breast cancer. Breast implants can alter the amount of breast tissue visualized on a mammogram. When placed below the chest wall muscle, greater than 90% of breast tissue can be seen well on mammogram. When placed above the muscle, only about 75% can be visualized. Breast implants do not interfere with the ability to detect masses with self breast examination, regardless of position relative to the chest wall muscle. Self exam is the most successful way to discover new breast masses. Implants also do not interfere with ultrasound or MRI scans, which are helpful in the evaluation of breast masses.

Breast implants can move out of position anytime after breast augmentation surgery. If they move a lot, surgery may be needed them back into position. The larger the implant, the more likely it will displace downward.

Rippling or wrinkling of the implant is much more common with saline breast implants compared to silicone breast implants and in thin patients. The visualized wrinkles are the folds of the breast implant shell. Ripples can be particularly disconcerting if they occur on the upper pole of the breasts.

Because breast implants are manmade, mechanical devices, they are prone to problems over time. All women who undergo breast augmentation surgery should assume that, at some point in their lives, they will require a secondary procedure, whether it’s for capsular contracture, rupture, displacement, etc. Some women may never have problems, but it’s impossible to predict which patients will fall into this category.

Many patients want to know, “What’s better - silicone or saline?”  The answer is that it depends.  Both silicone and saline implants have pros and cons.  It’s important that the educated patient understands these differences before making an informed decision.  Before delving into these differences, though, it’s important to state unequivocally that currently utilized silicone breast implants are safe.  Over the past 15 years, many large and rigorous studies have been performed investigating whether silicone breast implants are associated with autoimmune diseases or any types of cancer.  All studies performed reached the same conclusion; there is no conclusive data supporting any link between silicone implants and these diseases.  Only after carefully considering these scientific studies did the U.S. Food and Drug Administration approve the use of silicone breast implants in all women for breast reconstruction and in women over the age of 22 years for cosmetic breast augmentation.

Some good things about silicone breast implants; breast implants filled with silicone gel look and feel more like natural breast tissue.  Also, particularly in thin patients, silicone breast implants tend to have fewer problems with visible rippling than saline breast implants.

Some bad things about silicone breast implants; breast implants filled with silicone are more expensive.  Silicone breast implants are approximately twice the cost of saline breast implants, which is factored into the price of surgery.  Also, a breast implant rupture is easy to detect when the implant is filled with saline; the breast tends to deflate rapidly, in the span of a few days.  A silicone breast implant ruptures is much more subtle to detect.  For that reason, the Food and Drug Administration recommends an MRI to monitor for rupture, the first one 3 years after surgery, and then every 2 years thereafter.  This test is expensive and most likely will not be covered by third-party insurers.  Lastly, capsular contracture rates, or pathologic scarring around the implant, traditionally were much higher with the older generation of silicone breast implants.  This does not seem to be the case with the newer generation of silicone breast implants used, which is largely attributable to a thicker implant shell and thicker, more viscous silicone gel within the implant.

So, what’s better?  To repeat, silicone breast implants look and feel much more natural, but it comes at a higher financial cost, the recommendation for MRI monitoring to detect for rupture, and a larger incision.  Despite this, with each passing year, more and more patients are opting for silicone breast implants.

This is taken directly from a press release from the American Society for Aesthetic Plastic Surgery

New York, NY and Arlington Heights, IL – What people find beautiful about themselves may be different than what they find appealing in another person. That’s just one finding from a recent consumer survey conducted on the BeautyforLife website (a joint venture of the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery.) Visitors were asked “What aspect of physical beauty do you find most appealing in another person?” In their 20s, 30s, and 40s, respondents look for a fit, well proportioned body; youthful skin ranked at the top for respondents in the 50s and 60s. When considering “Which part of your body are you most concerned about?” respondents ranked their abdomen/hips number one in their 30s. But surprisingly, respondents listed the face, not their body, as the most popular choice in the 20s, 40s, 50s and 60s.

“It is always important to understand what our patients are most concerned about at different stages of their lives. We want to be equipped to help our patients make the right decisions to maintain their beauty at every age—no matter which type of cosmetic medical procedure they are interested in.” said ASAPS President Renato Saltz, MD.

Additional results were revealed when answering “Which part of your body are you most concerned about?” While respondents primarily chose their face, significantly more respondents are concerned about their abdomen/hips than their breasts (chest)—with the disparity increasing throughout the decades:

1. 30s - 37% chose abdomen/hips as their top concern while only 18% chose breasts
2. 40s - 32% selected abdomen/hips and only 10% breast
3. 50s - 25% chose abdomen/hips compared to 7% breast
4. 60s - 23% indicated concern about their abdomen/hips, while only 7% selected breast

Community members were also asked to consider “The most important reason to maintain your physical appearance.” “To boost self-confidence” was the top choice across all decades, with “To attract potential partners” a close second for the 20s. In the 30s and 40s, the second-most popular choice shifted to “To increase professional opportunities,” which remained the number two choice in the 50s, but by a much smaller percentage. In the 60s, increasing professional opportunities fell to third behind “To help make friends.”

“The survey on the BeautyforLife website has provided interesting data about patients’ attitudes, motivation and perception. Our goal is to provide useful tools for prospective patients to help them first decide if a cosmetic medicine procedure is right for them and then to provide information on how to choose an appropriate provider,” said Dr. Richard D’Amico, past president of ASPS.

Another question asked members to contemplate “The most important factor in maintaining beauty.” While adherence to a healthy diet, regular exercise and skin care were popular choices, approximately one in five members felt that a cosmetic medical procedure was most important in the 50s and 60s.

This survey was conducted by The American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery, via their Beauty for Life program—a series of patient education tools.

About ASPS
The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. Representing more than 6,700 physician members, the Society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. For more information, please visit the ASPS website at www.plasticsurgery.org.

Having a child usually is the one of the most magical and emotionally-fulfilling experiences of a woman’s life.  Unfortunately, the physical toll that pregnancy, childbirth and breastfeeding can have on a woman’s body often is devastating. Even with proper diet and exercise, it usually is nearly impossible to restore a youthful, pre-pregnancy body.

Women come in with a litany of complaints, including loosening and bulging of the abdominal wall muscles, stretching and loosening of the skin of the breasts, thighs, and abdomen, and extra fat of the belly, back and thighs.  For those women out there who want a firmer, tighter body, even after childbirth, there is the Mommy Makeover. This cosmetic procedure is individualized for each patient.  One patient may need a breast lift and a tummy tuck; another may opt for liposuction and breast augmentation.  No two patients are the same, so the mommy makeover combines the best of several popular procedures to restore a youthful, pre-pregnancy body.

Through the end of October 2009, we are offering 10% of all surgeon’s fees on breast and body contouring surgery.  Call today (214-827-2814) to schedule a consultation!