Augmentation Mammoplasty: Reactions Induced by Silicone Implants

Abstract

The history of augmentation mammoplasty is eventful, and the earliest description of surgery on the breasts is from the 1890s. Back then the modern materials we nowadays utilize were not familiar to surgeons. In the 1930s, for example, glass balls and polyvinyl alcohol sponges were used as breast implants. It was later thought out that the sponges could be covered, and that is how silicone implants were discovered. From the 1960s onward, the popularity of silicone breast implants grew significantly. However, in the 1990s their safety was questioned. Breast implants were pulled off the market in the United States by FDA until sufficient research had been done on the safety of silicone breast implants. In 2006, the implants were returned to the market restrictively. Safety concerns arose from links between silicone implants and autoimmune diseases and cancer. This thesis presents the reactions that occur in breast tissues during and after breast augmentation mammoplasty. The purpose is to carefully familiarize the reader to the stages of breast augmentation and the materials used in it. In addition, the aim is to distinguish normal tissue reactions from possible complications. This is achieved by spreading awareness on how silicone behaves as a material in the augmentation mammoplasty, especially in a soft tissue environment. The implantation causes multistage immune-provoking reactions in tissues with depending on the type of implant. Therefore, it is important to know how silicone implants could be manufactured so that they are protected from the evolved immune responses. During the thesis, it is noted that there are multiple methods to control these reactions with expertise on foreign body reaction and silicone. At the same time, we learn how a prolonged foreign object reaction affects the durability of the implant, the immune system and the range of symptoms of the patient. This thesis is ultimately a literature review, which concludes that research on breast augmentation is still needed on a multidisciplinary basis, and that there is a particular need for expertise in tissue technology for breast augmentation surgery research.