The First Woman Who Received Silicone Breast Implants

In the spring of 1962, Timmie Jean Lindsey from Houston, Texas received the first silicone breast implants and turned her from B to C cup.  Meanwhile, the plastic surgeons who operated on her did not realize that this would be one of the most popular cosmetic surgeries worldwide that in 2010 alone, about 1.5 million women had the procedure.

Today, 80-year-old Lindsey said she has no regrets of having breast implants, which have boosted her self-confidence.  However, what is surprising to know is that she never really intended to have a breast augmentation in the first place.

She was in a hospital for tattoo removal when one doctor came to her and asked if she would consider getting the first silicone breast implants.  At first she was reluctant because what she really wanted was a surgery to pin back her ears.

But because the surgeons Frank Gerow and Thomas Cronin offered her ear pinning surgery at no cost, she immediately volunteered for the first-of-its kind operation.

Gerow first came up with the idea of silicone breast implants when he squeezed a plastic blood bag and realized that has an uncanny resemblance to a woman’s breast.

But before the device was implanted in Lindsey’s chest, Gerow and his team first used a dog named Esmeralda as their guinea pig.  The implant was placed under the skin and stayed there for weeks until the surgeons decided to remove it after the animal incessantly chewed the stitches.

After deeming that silicone breast implants were safe, the surgeons operated on Lindsey and other women followed her footstep.

Lindsey said she experienced pain for three or four days following surgery and described her recovery “as like something had been sitting on her chest.”

At first she had no idea of the full results until she went out in public and men gave her “the look” while others would whistle at her.

While breast augmentation resulted to higher self-confidence, Lindsey said that she never revealed it to her past relationships, and her family and friends became only aware of her operation when she told them about it decades later.

Though she remains delighted with the results, she realized thatsilicone implants would not maker her “breasts forever young” and said that they began to sag over the years.

Currently, breast augmentation is the most popular cosmetic plastic surgery in the US, with about 307,000 procedures performed in 2011 alone. 

Silicone Breast Implants Do Not Increase the Risk of Cancer

In the early 1990s, silicone breast implants were pulled out of the market due to concerns that they might increase the risk of breast cancer and systemic diseases.  But in 2006, the US Food and Drug Administration has lifted the moratorium after extensive studies found no link between using the devices and serious illnesses.

The FDA’s decision to lift the moratorium is supported by many oncologists; in fact, silicone breast implants are increasingly becoming popular among post-cancer patients who have breast deformity following their mastectomy (partial or complete removal of their breasts).

Meanwhile, leading LosAngeles plastic surgeon Dr. Tarick Smaili believes that silicone breast implants are reasonably safe both for cosmetic and reconstructive surgeries.

“Silicone breast implants have been subjected to the most rigorous examinations which have proven that they are reasonably safe.  Another bonus is that they can provide a very natural appearance since they are filled with a cohesive silicone gel that replicates the feel and look of breast tissue and fats,” Smaili said.

Because post-cancer patients who had mastectomy often have a limited amount of tissue, silicone breast implants are usually more ideal than saline implants which have a watery consistent (because it is only filled with a sterile mixture of salt and water).

The mastectomized breast has a very low risk of cancer recurrence so placing implants during reconstructive surgery has become a common practice.

However, Smaili warns that breast implants can make it difficult to conduct mammogram and “physical” breast examinations.

“A breast augmentation patient should go to a technician who has an extensive experience in conducting mammogram screening on women with breast implants.  Also, more views are necessary to get a more accurate and clearer result,” Smaili said.

But despite more difficulty to do mammography, the plastic surgeon advised women with breast implants aged 40 years and older to undergo screening at least every year.

“In this way, their doctors can immediately diagnose any cancerous lumps even before the condition gets worse,” he added.

Meanwhile, mammography is not only performed on older women (with or without implants) but also on younger patients with silicone breast implants that are prone to “silent leak,” a condition in which the cohesive gel drips out of a damaged or ruptured shell without causing any visible signs.

But in the long run, silent leak can lead to inflammation of the tissue, pain, and visible breast deformity.

The FDA recommends mammography every two years for patients with silicone breast implants; on the other hand, this is not a requirement for younger women with saline version because a rupture would immediately show visible signs. 

Preventing Breast Implant Rupture

While there is no guaranty that breast implants will last a lifetime, plastic surgeons have come up with different techniques to at least prolong the devices’ lifespan and lower the risk of implant rupture.

In the event of implant rupture, the only solution is a revision breast augmentation; this procedure may involve replacing the implants with new ones or removing them without any replacement.

Meanwhile, these are some of the basic rules which can help patients prevent or at least lower the risk of implant failure.

* Choosing silicone implants over the saline version

Currently available silicone breast implants are less likely to rupture than saline because they are not prone to sloshing and wrinkling which are known to affect the shell’s stability.  Another advantage is that the silicone gel does not evaporate (unlike the saline) which means the patients can maintain their breast volume unless in the event of rupture.

The latest version of silicone implants—which have a more cohesive silicone gel than the one currently used—is almost immune to implant failure.  However, these breast implants, called the gummy bear implants, are not yet approved in the US although these are already used in Europe and Canada.

* When using salinei mplants

Rippling, which can compromise the shell’s stability, can be prevented in saline implants by slightly overfilling them.  However, this should be carefully done because too much filler can cause abnormal pressure on the device.

On the other hand, underfilling saline implants only has negative results because it can cause creases, leading to weak areas in the shell.

* Avoiding high trauma to the breast

Modern breast implants are very strong although they are still subjected to the effects of physical force.  Impact from car collision, sports injuries, and accidental falls may compromise the shell’s stability or may even lead to rupture.

* Consider the implant placement

Some doctors say that submuscular implant placement (placing the device under the pec muscle) poses a slightly higher chance of shell damage than the subglandular technique (positioning the implants over the muscle).  A good compromise might be the subpectoral placement.

* Use of Keller Funnel technique

In this technique, plastic surgeons place the breastimplants in a cone-shaped device and then squeeze it so the implants are transferred into the breast pockets.  Doctors use less force in this method than if they push the devices using their fingers.

Can Silicone Breast Implants Correct Mild Drooping?

Silicone breast implants are increasingly becoming popular these days as they provide a more natural result than saline implants.  This is not surprising because they are filled with a cohesive silicone gel designed to replicate the “feel” and move of glandular tissue and fats; another bonus is that the filling does not evaporate—unlike the saline solution—which means the patients can maintain their breast volume unless in the event of leak or rupture.

The good news is that breast implants—particularly the silicone-filled versions—can correct mild or pseudo ptosis (sagging) which is caused by breastfeeding.  It happens when the mammary glands put pressure on some glandular fats, but after the enlargement resolves, the breasts somewhat “deflate.”

On the other hand, true ptosis is caused by stretched and damaged suspensory ligaments in the breasts.  Oftentimes, the problems can only be addressed by mastopexy or more commonly referred to as breast lift; this can be performed as a standalone procedure or as a complementary to breast implantsurgery.

To correct mild or pseudo ptosis, it is highly recommend to use small implants (300 to 350 cubic centimeters would be the right range) because introducing large ones can aggravate the problem as the tissue is forced to carry the extra weight.  And over time, the stretched tissues will worsen.

By using large implants, there is a higher chance that the patients will need breast lift sooner rather than later.

It is important to note that even small implants can provide upper pole fullness in the breast, the area which is often affected by childbirth and breastfeeding.  But as mentioned earlier, silicone implants are better than the saline versions because they do not have a natural deflation rate.

By contrast, saline implants have been found to lose about 10 percent of their volume after a decade because of evaporation and other factors.  This simply means that patients with these devices are more likely to need revisions sooner than those who have silicone implants.

Meanwhile, there is still a debate whether the subglandular or submuscular implant placement provides more lift.

In the subglandular implant placement, the device is positioned above the muscle which is believed to provide a more lifting effect.  But one downside is that only the tissue and skin support the implant, something which may aggravate the ongoing ptosis.

On the other hand, the submuscular implant placement is said to prevent future ptosis because the device, which is positioned under the pec muscle, is being supported not only by the tissue and skin but also by a thick amount of muscle.

Too Young for Breast Augmentation?

In the US, the legal age requirement for breast implant surgery is 18—and that is if you are going to have saline implants which are filled with a sterile saline (saltwater solution).  But if you want to use the silicone implants, you should be at least 22 years old.

The main reason why silicone breast implants require a higher age limit is that they pose risk in the event of rupture or leak.  For this reason, you have to undergo regular MRI screening to detect any “silent leak.”

By contrast, the examination is not necessary if you will choose the saline implants because in the event of implant failure, your breasts will deflate within hours after the rupture, thus allowing you to seek revisions right away.

Generally speaking, female patients under the age of 18 cannot have breast augmentation surgery unless there is an issue of breast deformity.  The problem with younger people is that their body is still maturing and they may not yet fully understand the ramifications of cosmetic plasticsurgery.

It is important to note that even if you are flat-chested at the age of 15, there is still a chance that your breasts will enlarge as years pass by.  And with large implants and ongoing breast development, you may end up having oversized busts that look unnatural and asymmetric to the rest of your body.

Another concern is that patients below the age of 18 are not emotionally mature.  In fact, a study has suggested that teenagers see cosmetic surgery as a way to fit into their crowd.  By contrast, adults seek the procedure to stand out from the rest.

As mentioned earlier, your plastic surgeon may allow you to have breast augmentation at a younger age if you are suffering from certain types of deformity including tuberous breasts in which they appear too pointy because of the unusual structure of their base.

Breast augmentation performed at a younger age may also be necessary if you develop a very large breast on one side while the other is too small or even “absent.”  In general, age is not an issue in reconstructive plastic surgery.

While the US is quite strict when it comes to cosmetic breast augmentation, certain countries allow the procedure on patients as young as 16.  This lower age limit is not acceptable to many American surgeons who believe that the body should be allowed to mature first before any aesthetic or elective surgery is conducted.