Breast Augmentation

Excerpt

Breast augmentation is a surgical procedure where the breast size is enhanced. Augmentation can be from the placement of an implant, or less commonly, through fat transfer. Breast augmentation is one of the most commonly performed plastic surgery procedures in the United States. The FDA put a restriction on silicone-filled implants for cosmetic enhancement starting in 1992. However, most reconstructive patients continued to receive silicone implants post-mastectomy. This ban was put in place following concern over the risks of silicone implants. Extensive research and clinical trials did not confirm those fears of silicone. After many studies had failed to show silicone linked to diseases, the FDA, in 2006, again allowed silicone-filled implants to be used by any patient without requiring them to be enrolled in a clinical study. In 2017, the majority of patients undergoing breast augmentation received cohesive gel silicone implants. The FDA also recommends MRI screening every 2 years in patients with silicone implants to detect subclinical implant leaks. However, patients and their physicians do not always adhere to this recommendation, and MRI scans can also have false-positive readings. The gel in current implants is more cohesive than previous implants and even shaped, or form-stable implants have been increasing in use. These may have lower complication rates, but further evaluation is ongoing. Recently, implant makers have been introducing different levels of cohesive gel in their products. The higher or more cohesive the gel, the more firm or "gummy" the implant will be. This may lead to lower rupture rates of implants. But eventually, all implants will likely eventually rupture or break.