Over the years, various surgical procedures were attempted to augment breasts in women with small or absent breasts. However, due to the prominent scars left by these interventions, the search for alternative application methods began.
In light of the idea that breast augmentation might be possible by adding foreign substances to the chest area, various materials were tested. Unfortunately, all these attempts resulted in failure.
Despite encountering numerous problems, from deformities to complications, in 1961, Dr. Gerow, a plastic surgeon and faculty member at Baylor College, part of the university where I was located in the USA, developed a special prosthesis design to enlarge breasts. After Dr. Gerow’s design was approved by his mentor, Dr. Cronin, the Dowcorning company produced silicone prostheses for the first time to be tested on dogs.
These initial silicone prostheses, which were gel-filled silicone bags, yielded successful results in dogs after one year of research. Consequently, the production of silicone prostheses for human use began. In 1962, a patient in Houston received a silicone prosthesis for the first time. Following this historically successful case, millions of individuals have undergone silicone prosthesis implantation.
This rosy period continued uninterrupted until 12 years ago when a fashion model sued the manufacturing brand. The reason for the lawsuit was that silicone prostheses were allegedly concealing cancer. As a result of this situation, which turned into a commercial industry with lawyers in the USA agreeing to a 50-50 split and individually contacting patients, numerous lawsuits were filed, leading the manufacturing company to declare bankruptcy under the heavy burden of compensation.
During this period, silicone prostheses were subjected to many unfounded accusations, leading universities to re-examine them. The American Food and Drug Administration (FDA), wary of media attention, did not participate in these scientific studies involving many different universities, choosing instead to conduct its own independent research. The results of all these independent studies unequivocally revealed that silicone prostheses pose no harm to the human body. With experimental and clinical research supporting each other, it was announced to all physicians that silicones, whose name had been cleared, were harmless.
The biggest advantage of this challenging period was that the American Food and Drug Administration (FDA) asserted its authority, ensuring that silicone prostheses would be manufactured to an even higher quality. As a result of this era, which saw significant advancements in silicone quality, the cohesive gels used in silicone prostheses became larger in particle size. This led to the production of silicones where gel leakage would not occur even if the prosthesis was cut. Since there would be no leakage problem with such a silicone, the only remaining issue, the risk of hardening (capsule formation), was also reduced. The quality of silicone also gained importance, and FDA-approved silicones became preferred.
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There are three types of breast implants:
- Gel-filled silicone implants
- Saline-filled silicone implants
- Empty silicone implants, inflated later
These types of silicone implants are further divided into two categories: textured and smooth.
Polyurethane-coated silicones have the lowest risk of breast hardening, also known as capsule formation. Only one in one hundred or two hundred patients experiences capsular contracture, whereas this risk can be as high as 10% with other types of silicones. These are, without a doubt, high-quality silicones. These silicones are shaped like a normal female breast and are completely round. The second type, anatomical silicones, have a flatter upper part and a more prominent lower section. Although these silicones are commercially referred to as ‘teardrop implants,’ there is essentially no such substance as a teardrop silicone. The type of silicone to be used is decided based on the patient’s breast structure and the type of aesthetic surgery.
Anatomical implants are used for two reasons:
- To prevent a large bulge in the upper border of the breast on the chest wall when placed under the muscle
- To achieve a smoother appearance by applying a thinner implant to the upper part of the chest wall if there is a protrusion in that area
How long do silicone implants last in the body?
My Chief, Dr. Spira, from Houston Baylor University, gave a conference in Istanbul in 2011 and shared with us the outcome for the patient who received the first silicone implant in 1962. Despite the many years that had passed, the patient had lived a healthy life with her implants and showed us slides demonstrating that her breasts still looked very beautiful.
A few articles claiming that silicones degrade within 5-10 years were later accompanied by several response articles asserting the opposite. However, the fact that many people have lived comfortably and healthily with their implants for a long time suggests that we should all feel at ease. Unless there is excessive capsule formation or any pathology detected in radiological examinations, there is no need to replace the implants.
Do silicone breast prostheses affect breastfeeding?
Silicone prostheses, which have no negative effect on milk secretion or breastfeeding, are placed beneath the mammary gland and have no connection with the milk ducts.
IMPORTANT NOTE: The production of PIP (Poly Implant Prothese) implants has been halted in France.
No doctor in our clinic has ever used this brand of prosthesis. We have had patients come to our clinic to have these prostheses removed after having them implanted elsewhere, and these prostheses have been removed. It has been observed that this prosthesis spread unhealthily within the breast and caused reactions.
Post-Operative Care Information
For the first two days after surgery, you should move your arms as little as possible.
For the first two weeks after surgery, you should sleep on your back.
During the first week, minimize arm movement, avoid heavy lifting, and refrain from driving.
Generally, do not wet your chest area until your bandages are removed by the nurse on the 6th or 7th day.
You may experience pain and swelling in your breasts, and sometimes bruising may also be observed. Additionally, numbness in the breasts in the early stage is not an abnormal condition.
Use painkillers only when you feel discomfort, and be sure to take your antibiotics regularly for the first week. Continue to use the medication that reduces swelling for one month, and do not stop taking any medication without consulting your physician.
Absolutely do not use aspirin or aspirin-containing medications for 1.5 months.
Do not forget to make appointments for dressings and check-ups.
Three weeks after surgery, start taking 1000 IU of Vitamin E. After 6 months of regular use, take a one-month break, then resume with 400 IU for another 6 months, and continue this cycle with a one-month break every 6 months.
Start the massages you learned from your physician from the 21st day. After 3 weeks, consult your doctor to learn the new type of massage and begin applying it.
You can watch Prof. Dr. Onur Erol's speech on Breast Aesthetics and Implants in the video.
Prof. Dr. Onur EROL's Training at the International Society of Aesthetic Plastic Surgery (ISAPS) Congress in Xi'an, China
At the congress, he gave lectures on the following topics related to breast aesthetic surgery. All his lectures were followed with great interest by 625 Chinese aesthetic plastic surgeons.
A 30-minute lecture on “Scarless correction of breast (chest) ptosis with the Onur Erol method in aesthetic surgery”
A 30-minute lecture on “Aesthetic breast reconstruction for patients who have undergone mastectomy after cancer”
