Breast implant: The prosthesis to enlarge the size of the women's breast for cosmetic or reconstruction reasons is called a breast implant. It is also known as breast augmentation. This is the third most commonly performed cosmetic surgical procedure in the United States. In 2005, 291,000 breast augmentation procedures were performed. There are two types of breast implants. 1. Saline filled implants: they have a silicone elastomer shell filled with sterile saline liquid. 2. Silicone gel filled implants: these have a silicone shell filled with a viscous silicone gel. History: Since 1895 implantation has been going on to augment the size and the shape of the women's breast. The first attempt was done by Czerny. Then Berson and Maliniac performed a flap based augmentation by rotating the patient's chest wall tissue into the breast to add volume. Indications used in breast implantations: Patient characteristics: 1. younger 2. women who have breast fed their children 3. higher socio economic status 4. greater distress about their appearance 5. Endured more teasing about their appearance. 6. low self-esteem Types of Breast Implant: 1. Saline Implants: They were introduced by Arion in France in the year 1964. 2. Silicone Gel Implants: Thomas Cronin and Frank Gerow, plastic surgeons developed the first silicon breastprosthesis with the Dow Corning Corporation in 1961. First woman was implanted in 1962. Silicone implant generations: Silicone breast implants are best described in five generations. We discuss the common characteristics of manufacturing techniques. 1. first generation: the Cronin-Gerow implants were made of a silicone rubber envelop and filled with a thick viscous silicone gel with a Dacron patch on the posterior shell. They had a teardrop" anatomic shape and were firm. 2. second generation: the breast implants were redesigned with thinner gel and thinner shells in 1970's. There was also the development of polyurethane foam coating which was effective in diminishing capsular contracture by causing an inflammatory reaction that discouraged formation of fibrous tissue around the capsule. The second generation implants also included various double lumen" designs. 3. third and fourth generation The principle of the third generation was to elastomer-coated to decrease gel bleed, and filled with thicker, more cohesive gel. The gel filler reduces leakage of the gel compared to earlier devices. Anatomic shaped implants are uniformly textured to reduce rotation, while round devices are available in smooth or textured surfaces. 4. fifth generation: In the United States of America in the preliminary stages the form-stable of implants were gummy-bear" or high-cohesive. When there is a high degree of gel cohesion it will significantly reduce the possibility of silicone migration. Breast Implant placement techniques: There are many kinds of implant placement techniques such as Inframammary. Periareolar. Transaxillary. Transumbilical. Transabdominoplasty. Breast Implant pocket placement: The placement of implants is described in relation to the pectoralis major muscle. Subglandular Subfascial Subpectoral Submuscular Complications: There are always negative points whenever you get a surgery done. Some of the risks of breast implant surgery are: Post-operative bleeding Fluid collections Surgical site infection Breast pain Alterations in nipple sensation Interference with breast feeding Visible wrinkling Asymmetric appearance Wound dehiscence Thinning of the breast tissue Synmastia There are also some very common reasons which ask for a re-operation after the breast implantation is done 1. rupture saline implant rupture silicone implant rupture capsular contracture systematic reviews on claims of systemic illness platinum
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