The Evolution of Breast Implants
Breast implants have undergone significant transformation since their introduction in the 1960s. Innovations in materials, shape, texture, and surgical technique have improved both safety and aesthetic outcomes. This article explores the history, technological advancements, and current trends in breast implant development.
A Brief History of Breast Implants
1960s: The Birth of Silicone Implants
First silicone implants introduced by American plastic surgeons Thomas Cronin and Frank Gerow in 1962.
Early models had thick silicone shells and gel cores.
1970s–1980s: Popularity and First Concerns
Widespread adoption led to reports of complications: capsular contracture, rupture, and concerns about autoimmune diseases.
Saline implants emerged as an alternative.
1990s: Regulatory Scrutiny and Reform
In 1992, the FDA placed a moratorium on silicone implants for cosmetic use (except in clinical trials).
Rigorous studies led to the reintroduction of improved silicone implants in 2006.
Textured implants introduced to reduce capsular contracture.
2000s–2010s: Anatomical Implants and Cohesive Gel
Fifth-generation "gummy bear" cohesive silicone implants introduced.
Anatomical (teardrop-shaped) implants became more widely used.
Innovation in shell texture and barrier layers to improve durability and reduce silicone bleed.
2020s: Safety, Surveillance, and Customisation
Focus on implant safety following rare cases of BIA-ALCL (Breast Implant-Associated Anaplastic Large Cell Lymphoma).
Shift toward smooth-walled implants and increased informed consent.
3D planning and patient-specific approaches becoming more common.
Silicone Breast Implants
Feature
Filling
Silicone gel
Feel
natural, soft
Rupture Detection
Silent rupture (may require USS or MRI)
Incision Size
Varies depending on product can be as small as 2cm.
Key Innovations in Implant Technology
Cohesive Gel ("Gummy Bear") Implants: Maintain shape, reduce leakage risk.
Textured Shells: Designed to adhere to tissue and reduce movement—less common now due to BIA-ALCL risk.
Smooth Implants: Less tissue interaction; potentially lower risk of BIA-ALCL.
Fat Transfer: Non-implant alternative or adjunct for subtle volume enhancement.
Customised Sizing Tools: 3D imaging, sizers, and digital simulations to aid decision-making.
Implant Placement Options
Subglandular: Above the chest muscle, beneath breast tissue.
Submuscular (Dual Plane): Under the pectoral muscle—more natural contour, better for thin patients.
Subfascial: Less commonly used; between muscle fascia and pectoral muscle.
FAQs: Breast Implants
Q: How long do breast implants last?
A: Implants may not be lifetime devices. On average, they may last 10–20 years, but removal or replacement may be needed sooner due to complications or aesthetic changes.
Q: Are silicone implants safe?
A: Yes. Modern silicone implants are considered safe. Numerous studies have not found a causal link between implants and autoimmune diseases.
Q: What is BIA-ALCL and should I be worried?
A: BIA-ALCL is a rare lymphoma associated mainly with textured implants. It is not breast cancer. Early detection and treatment are effective. Most new implants are smooth or nanotextured to reduce risk.
Q: Can I breastfeed with implants?
A: Most women can breastfeed after implant surgery, particularly if the surgical approach avoids the nipple area.
Q: What happens if an implant ruptures?
A: Saline implant ruptures are noticeable and harmless. Silicone ruptures may be “silent” and are often detected via USS or MRI. Ruptured implants should be removed.
Looking Ahead: The Future of Breast Augmentation
The evolution of breast implants continues toward safer, more personalised outcomes. Trends to watch include:
Biocompatible and hybrid materials
Smart implants with embedded sensors
3D-printed scaffolds and regenerative tissue engineering
As understanding of breast aesthetics and patient safety deepens, breast implant surgery becomes not just about enhancement, but about long-term satisfaction, safety and holistic care.
Seni Mylvaganam
Consultant Oncoplastic, Reconstructive and Cosmetic Breast Surgeon
June 2025