The History of Silicone Implants
By Sander L. Gilman. Excerpt from the book 'Aesthetic Surgery'
Silicone had first been used in the 1950s in the form of subcutaneous injections for body augmentation. Thus injected into the body, it was soon shown to have the risks of migration and infection. Other problems such as hematoma, visible lines of implantation, and, most frequently, capsule contracture (abnormal firmness of the breast to the touch) also were experienced by women who had had silicone injections. Alternative substances were experimented with: Ivalon, a derivative of poly-vinylic alcohol in 1949, Polistan, a derivative of polyethelene in 1959, Etheron, a derivative of polymethane in 1960s, and Hydron, a derivative of polyglycomethacrylate in 1961. Each had a spongy texture and was advocated for short periods as the ideal substance for breast augmentation. And each had extremely negative outcomes for the health of the patient.
In 1963 a "silastic gel" prosthesis was developed by the Houston surgeons Thomas Cronin and Frank Gerow, which contained saline and provided a preshaped form and size. Gerow came to the idea of a silicone sack filled with liquid by observing a plastic bag filled with blood used for transfusion. He saw in its form the shape of a breast. Thus aesthetic augmentation had its conceptual origin in the context of real surgery. Gerow implanted the first such prosthesis in March, 1962. It broke and released the saline. A week later he implanted a prosthesis filled with silicone gel and this was successful. The result was a patient who "was healed and happy," according to one account. Thus the surgeons neglected to pay much attention to the actual, negative outcomes, such as the fact that some of the breasts with the prosthesis became very hard (contracted capsules). The surgeons relied on initial success, ignoring long-term problems until confronted with them. With insertion of the implant under the muscles of the chest wall (submusclar augmentation mammaplasty) and the introduction of Franklin L. Ashley's silicone-gel implant covered with polyurethane foam in the 1970s, which reduced the risk of contracture, many of the initial problems associated with breast augmentation seemed to have been overcome. While improved saline-filled implants reappeared in the 1970s, they remained less attractive until the attack on the silicone implants two decades later. They were felt to be less natural and did not give the illusion of the breast form and texture that physicians and women wanted. Silicone held its own for augmentation of the breast for all purposes.
In 1990 a House committee chaired by Representative Ted Weiss held its first hearings on the safety of silicone implants and this quickly became a major media event. The claim was that the improved procedures still masked longterm major medical problems. By 1991 the first court case was resolved with findings that the silicone implants had caused immune system illnesses in patients. A $7.3 million damage claim was lodged against Dow Corning, the developer of the gel implant. A number of recipients of silicone breast implants then claimed to have developed a wide and divergent set of symptoms ranging from chronic fatigue, to rheumatoid arthritis (and other inflammatory illness of the joints), lupus, damage to the immune system, and scleroderma (a hardening of the skin and internal organs).
The debate about breast implants came to be one about to what degree the government would permit a woman to pass as whole and, therefore, as healthy. If she was missing a breast, went the argument, she would be "unhappy" about her body and would need augmentation surgery to make her happy. This was worth the risk. If she only wanted to be "happy" without having first suffered cancer that was not worth the risk. The reconstruction of the erotic, female body in the first instance was seen as a goal of reconstructive surgery; the construction of the erotic body in the latter was merely aesthetic surgery and a sign of false vanity.
Silicone had first been used in the 1950s in the form of subcutaneous injections for body augmentation. Thus injected into the body, it was soon shown to have the risks of migration and infection. Other problems such as hematoma, visible lines of implantation, and, most frequently, capsule contracture (abnormal firmness of the breast to the touch) also were experienced by women who had had silicone injections. Alternative substances were experimented with: Ivalon, a derivative of poly-vinylic alcohol in 1949, Polistan, a derivative of polyethelene in 1959, Etheron, a derivative of polymethane in 1960s, and Hydron, a derivative of polyglycomethacrylate in 1961. Each had a spongy texture and was advocated for short periods as the ideal substance for breast augmentation. And each had extremely negative outcomes for the health of the patient.
In 1963 a "silastic gel" prosthesis was developed by the Houston surgeons Thomas Cronin and Frank Gerow, which contained saline and provided a preshaped form and size. Gerow came to the idea of a silicone sack filled with liquid by observing a plastic bag filled with blood used for transfusion. He saw in its form the shape of a breast. Thus aesthetic augmentation had its conceptual origin in the context of real surgery. Gerow implanted the first such prosthesis in March, 1962. It broke and released the saline. A week later he implanted a prosthesis filled with silicone gel and this was successful. The result was a patient who "was healed and happy," according to one account. Thus the surgeons neglected to pay much attention to the actual, negative outcomes, such as the fact that some of the breasts with the prosthesis became very hard (contracted capsules). The surgeons relied on initial success, ignoring long-term problems until confronted with them. With insertion of the implant under the muscles of the chest wall (submusclar augmentation mammaplasty) and the introduction of Franklin L. Ashley's silicone-gel implant covered with polyurethane foam in the 1970s, which reduced the risk of contracture, many of the initial problems associated with breast augmentation seemed to have been overcome. While improved saline-filled implants reappeared in the 1970s, they remained less attractive until the attack on the silicone implants two decades later. They were felt to be less natural and did not give the illusion of the breast form and texture that physicians and women wanted. Silicone held its own for augmentation of the breast for all purposes.
In 1990 a House committee chaired by Representative Ted Weiss held its first hearings on the safety of silicone implants and this quickly became a major media event. The claim was that the improved procedures still masked longterm major medical problems. By 1991 the first court case was resolved with findings that the silicone implants had caused immune system illnesses in patients. A $7.3 million damage claim was lodged against Dow Corning, the developer of the gel implant. A number of recipients of silicone breast implants then claimed to have developed a wide and divergent set of symptoms ranging from chronic fatigue, to rheumatoid arthritis (and other inflammatory illness of the joints), lupus, damage to the immune system, and scleroderma (a hardening of the skin and internal organs).
The debate about breast implants came to be one about to what degree the government would permit a woman to pass as whole and, therefore, as healthy. If she was missing a breast, went the argument, she would be "unhappy" about her body and would need augmentation surgery to make her happy. This was worth the risk. If she only wanted to be "happy" without having first suffered cancer that was not worth the risk. The reconstruction of the erotic, female body in the first instance was seen as a goal of reconstructive surgery; the construction of the erotic body in the latter was merely aesthetic surgery and a sign of false vanity.
Aesthetic Surgery
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Before and after: the quest for perfection
Early illustration of mamma-plasty by Jacques Joseph.
J. Joseph, Nasenplastik und sonstige Gesichtsplastik, Leipzig 1931