Breast Plastic Surgery - Breast Implants
A breast implant is a prosthesis used to enlarge the size of
a woman's breast (known as breast augmentation, breast
enlargement, breast enhancement, mammoplasty
enlargement or augmentation mammoplasty), one
of many types of breast plastic surgery, for cosmetic
reasons; to reconstruct the breast (e.g. after a mastectomy; or
to correct genetic deformities), or as an aspect of
male-to-female sex reassignment surgery. According to the
American Society of Plastic Surgeons, breast augmentation is
the most commonly performed cosmetic surgical procedure in the
United States and therefore the most commonly performed breast
plastic surgery. In 2006, 329,000 breast augmentation
procedures were performed in the U.S.
There are two primary types of breast implants:
saline-filled and silicone-gel-filled implants. Saline implants
have a silicone elastomer shell filled with sterile saline
liquid. Silicone gel implants have a silicone shell filled with
a viscous silicone gel. There have been several alternative
types of breast implants developed, such as polypropylene
string or soy oil, but these are not commonly used, if at
all. The leakage of oil into the body cavity during a
rupture would not be good.
Breast Plastic Surgery - Breast Implants -
History
Implants have been used since 1895 to augment the size or shape
of women's breasts. The earliest known implant was attempted by
Czerny, using a woman's own adipose tissue (from a lipoma, a
benign growth, on her back). Gersuny tried paraffin injections
in 1889, with disastrous results. Subsequently, in the early to
mid-1900s, a number of other substances were tried, including
ivory, glass balls, ground rubber, ox cartilage, Terylene wool,
gutta-percha, Dicora, polyethylene chips, polyvinyl
alcohol-formaldehyde polymer sponge (Ivalon), Ivalon in a
polyethylene sac, polyether foam sponge (Etheron), polyethylene
tape (Polystan) or strips wound into a ball, polyester
(polyurethane foam sponge) Silastic rubber, and teflon-silicone
prostheses. In recent history, various creams and medicaments
have been used in attempts to increase bust size, and Berson in
1945 and Maliniac in 1950 performed a flap-based augmentation
by rotating the patient's chest wall tissue into the breast to
add volume. Various synthetics were used throughout the 1950s
and 1960s, including silicone injections, which an estimated
50,000 women received. Development of silicone granulomas and
hardening of the breasts were in some cases so severe that
women needed to have mastectomies for treatment. Women
sometimes seek medical treatment for complications up to 30
years after receiving this type of injection.
Breast Plastic Surgery - Breast Implants
- Indications
Clinical indications for the use of breast implants are for
breast reconstruction, sex reassignment surgery, and for
abnormalities that affect the shape and size of the breast. In
some countries health insurers will reimburse insertion of
breast implants only for these indications. Non-clinical
indications (the most common reasons) are cosmetic.
Breast Plastic Surgery - Breast Implants - Patient
Characteristics
Patients seeking breast augmentation have been reported as
being usually younger, healthier, from higher socio-economic
status, and more often married with children than the
population at large. Many of these patients have reported
greater distress about their appearance in a variety of
situations, and have endured teasing about their appearance.
Studies have identified a pattern (shared by many cosmetic
surgery procedures) that suggest women who undergo breast
implantation are slightly more likely to have undergone
psychotherapy, have low levels of self-esteem, and have higher
prevalences of depression, suicide attempts, and mental illness
(including body dysmorphia as compared to the general
population. Post-operative surveys on mental health and quality
of life issues have reported improvement on a number of
dimensions including: physical health, physical appearance,
social life, self confidence, self esteem, and sexual function.
Longer term follow-up suggests these improvements may be
transitory, with the exception of body esteem related to sexual
attractiveness.
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