o even worse problems because many of those performing the augmentation were not doctors and they were not using medical grade silicone. Additives and impurities in the silicone these non-medical practitioners used caused complications from extensive inflammation and granulation reactions to the material. Some early medical practitioners used autologous fat transplants into the breast, but because of liquefaction and reabsorption of the fat by the patientÆs body, the results were asymmetric breasts, internal scarring and calcifications, and residual scarring in the area the fat was taken from (usually the abdomen and/or buttocks).
In the 1950s, the Mayo Clinic introduced a polyvinyl sponge (Ivalon) for breast augmentation3. Although it showed promise at first, infections, capsular contractures, contraction of the sponge causing a decrease in breast volume, tissue reactions, a possibility of the risk of cancer, and other tissue growths became problematic, not only in themselves, but also in that they made removal of the sponge implants difficult. A later version of the Ivalon sponge was a custom-tailored version, cut and shaped to size, with the center removed. The cut-out center was sealed in an airtight polyethylene sac and reinserted into the shell and the opening sealed. In this way, it was hoped to stop body fluids from accumulating in the sponge and reduce the possibility of infection. Variations on this theme continued into the 1960s.
The 1960s saw the development of the first silicone gel prosthesis by Dow Corning Company4. In 1962, the first Silastic implant was used - a silicone rubber shell filled with silicone gel. The product was refined over the years with reduction of the shell thickness, Dacron patches to fix the implant to the tissue, elimination of seams on the implant, less viscous gels, and then removal of the adhesive patches. However, late complications developed in patients with displacement of i...