Breast implants

Breast augmentation is one of the most common wishes of female patients of all ages worldwide.

Plastic surgery and in particular its sub-area, aesthetic surgery, is a young branch of medicine. While certain surgical procedures were carried out more than 120 years ago, it is only in the last 40-50 years that medicine and surgery have begun to focus on body modification and aesthetics. In the course of human history, the ideals of beauty have changed again and again. Everyone has seen a painting by Mahler Rubens in which women with large hips and small breasts express the ideal of beauty at the time. An early 17th century painter portrayed an image of a woman that is now more than 300 years old. Although the beauty ideal of large breasts is not that old, it dates back to the early days of aesthetic surgery. Since its beginnings, it has therefore been concerned with the question of how the female breast can be enlarged and beautifully shaped.

Thanks to the rapid development of surgery in the last century, it was soon possible to perform major operations under sterile conditions and to protect patients from infection through hygienic measures. The use of foreign bodies such as screws and plates in the treatment of bone fractures also soon became possible. This also enabled the development of breast implants. As these needed to be soft in order to resemble the natural breast as closely as possible, the search was on for a material that was similar to human tissue and could be tolerated by the body during implantation. It had long been known that silicone has these properties. It hardly causes any reactions from the human immune system. The term ‘inert’ is used to describe substances that can remain in the body and have the property of not activating the immune system, or only activating it to a small extent.
The increasing demand for beautiful, voluminous and well-formed breasts on the one hand and the technical development of hygiene, surgical techniques and implants on the other made it possible to use breast implants for the first time in the second half of the last century.

Of course, today's modern breast implants differ from those of the early days. Back then, liquid silicone or saline solution was used as a filling, which was surrounded by a simple silicone shell. There were and still are saline-filled implants today. These are mainly used overseas as they are much cheaper but have many medical disadvantages.
Over the years, the structure of the shell of breast implants was improved and experiments with different surfaces of the shell began. The aim was to develop breast implants that would interact as little as possible with the body, as irritation of the body by the implant can quickly lead to a reaction from the immune system. This can favour a hardening of the capsule, known as capsular fibrosis.
Roughened surfaces have been developed that feel like fine sandpaper. They were designed to enable better integration into the body structure. Later, implants with foam surfaces were also introduced.
However, research was not only carried out on the surfaces, but also on the filling of the breast implants. The originally quite liquid silicone, which could leak into the body in the event of a defect in the shell, was gradually replaced. It was replaced by a so-called cross-linked silicone, which resembles the inner structure of a gummy bear. This meant that the silicone was no longer liquid and could no longer leak out even if the shell was defective. This internal structure has survived to this day and is still used in a further developed form as the filling for modern implants.

SCANDALS SURROUNDING BREAST IMPLANTS

Time and again, there have also been undesirable developments or unwelcome findings that have led to the manufacturing processes for implants being adapted. In one major scandal, a French company filled the implants not with the complex and cross-linked silicone intended for this purpose, but with inferior silicone. This criminal act initially went unnoticed as the filling is not visible during use. These implants were marketed under the name PIP Breast Implants. Fortunately, the fraud was soon discovered and the criminal company owner was prosecuted. The victims were the women who had to have the defective implants replaced. 

Another revealing change concerned the structure of the shell: as already described, the companies experimented with foam-like and rough surfaces, which proved to be statistically unfavourable. In some women who received these implants, altered cells were found on the implant capsules that had the characteristics of cancer cells. The disease became known as ALCL, and again many women who had received these implants had to have them replaced.
All in all, one must of course consider the enormous number of women worldwide who have received implants in recent decades and have been able to fulfil their desire for breast augmentation. This large number illustrates the safety of modern breast implants for many millions of women. However, the cases also show that modern science and research can always go in the wrong direction and that although implants have become better and better in recent decades, they are still perceived by the human body as foreign bodies.
At the Am Rosengarten Clinic, where breast implants have also been used for many years, neither the faulty PIP breast implants nor the particularly risky ALCL implants have been used. We have always favoured established brands from European companies in our clinic and have therefore always been spared these situations.

CHARACTERISTICS OF MODERN BREAST IMPLANTS

Inside modern breast implants is cross-linked silicone. In terms of its structure, this is similar to solid pudding or the inside of a gummy bear and is not (or no longer) liquid. If there is an injury to the shell, which is very rare or no longer the case, this filling does not leak out and therefore does not spread throughout the body. This is the first major innovative step in recent years.
The shell itself no longer consists of just one layer, but of several layers that distribute the forces evenly so that you can, for example, hit an implant several times with your fist without damaging it. The shell of breast implants has therefore become much more stable, which is a second key safety factor when using such implants.
The surface structure of modern implants is very finely textured, almost like fine sandpaper. These tiny bumps on the surface allow the body to make good contact with the implant, hold it in position and prevent it from twisting or slipping.

THE MOST IMPORTANT RESULTS ON BREAST IMPLANTS
TO SUMMARISE, IT CAN BE SAID THAT THE DESIRE FOR A VOLUMINOUS BREAST HAS ACCOMPANIED WOMEN FOR AROUND 100 YEARS. WHILE SMOOTH IMPLANTS AND LIQUID FILLERS WERE INITIALLY USED, IN RECENT YEARS DEVELOPMENT HAS FOCUSSED ON CROSS-LINKED SILICONE AS A FILLER AND A STABLE CAVITY STRUCTURE. STATISTICALLY SPEAKING, BREAST IMPLANTS ARE THEREFORE MUCH SAFER TODAY THAN THEY WERE 30 YEARS AGO. IT IS NOT CONCEIVABLE THAT SUCH IMPLANTS COULD BURST EITHER WHEN DIVING OR FLYING, AND IF THE SHELL WERE TO OPEN DUE TO AN INJURY, THE SILICONE WOULD NOT ESCAPE.

If you have any questions on this topic, please contact us. We will be happy to advise you.