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In 2019, there were 280,692 breast augmentation procedures performed in the USA, demonstrating an decrease of 14.9% since 2018. These statistics are part of a survey commissioned by the ASAPS. (the American Society for Aesthetic Plastic Surgery) and show breast augmentation as the most popular surgical procedure in the USA. At the moment, similar accurate statistics are not available for the UK, but estimated figures from the major cosmetic surgery providers indicate that cosmetic surgery on breasts is the most popular aesthetic procedure in this country.
The first breast implants of the kind that are used today underwent medical trials during the 1960’s, but before that, breast augmentation had dubious origins. We know that Japanese prostitutes sometimes had their breasts injected with substances such as paraffin, and non-medical grade silicone to enlarge them as they believed that American servicemen favoured women with larger breasts!
Twenty years later, the first breast implants were developed by two plastic surgeons from Texas: Frank Gerow and Thomas Cronin. These were filled with silicone and signalled the beginning of the breast implant revolution which continues today. Saline (a salt water solution) filled implants were introduced in 1965 and in 1974 further developments led to the production of inflatable implants.
In the early 1990s, breast implants became the subject of heated controversy as reports of women claiming their silicone implants had seriously damaged their health became widely publicised in the media. In 1991, U.S. implant manufacturer Dow Corning lost a multi-million dollar lawsuit based on claims that its silicone implants were the cause of a plaintiff's autoimmune disease: i.e. the woman claimed that her silicone implants had caused her body’s natural antibodies to be damaged, making her much more susceptible to infections and disease. Shortly afterwards, in January 1992, the U.S. Food and Drug Administration (F.D.A.) issued an outright ban on the use of silicone-gel filled implants for cosmetic augmentation. However, some people claimed that the F.D.A.'s actions were not based on any scientific proof that silicone is harmful but, rather, on political and social pressure. (This ban was subsequently lifted in 2006.)
No such ban exists or has ever existed in the UK and silicone implants can be used here without restrictions.
In June 1999 scientists from the Institute of Medicine (I.O.M.) in the U.S. released a very detailed report on breast implants. After the earlier controversies and legal action relating to the use of silicone implants, much scientific research had been undertaken to establish whether there really is a link between silicone and damage to the immune system or cancer. The report concluded that there is no solid scientific evidence of a connection between breast implants and any disease. Similar findings were published by health agencies in the United Kingdom and Europe.
Simultaneously, doctors were trying to discover a substance which might be a substitute for silicone in breast operations. For a while, an implant- filler made from the oil of the soya bean seemed promising, but in June 2000, questions of the long-term safety and effectiveness of this product led to its use being discontinued in the UK.
A handful of doctors from various areas of medicine are currently promoting breast enlargement by fat injection as a safe and effective alternative to implants. However this method may produce only temporary results due to the injected fat being absorbed into the body. An even more serious complication of such a procedure is fat calcification which is caused when the fat which has been absorbed into the body forms little lumps in the breast. These lumps can then show up on a mammogram (breast x-ray) and may cause some women and doctors to be alarmed at the possible existence of “tumours” in the breast. These lumps are not cancerous, of course, but are the lumps of fat which were earlier injected as implants.
The use of sustained mechanical force to promote tissue growth in the breasts, and hence cause the breasts to enlarge, has recently been touted as a new method to achieve a modest improvement in breast size. This involves a large bra-like device which is fitted with a motor and worn by the patient for a minimum of ten weeks for ten hours a day (usually at night). The principle of the procedure is that the breasts are gently stretched by the motor in the bra which causes them to expand during the night. This device is marketed under the name of “Brava”. While some doctors have reported promising results with this technique, others claim widespread failure to achieve satisfactory results. Consequently, patients have often been disappointed with this treatment.
Even allowing for the controversy surrounding breast implants, surveys have shown that the overwhelming majority of women who undergo breast augmentation say they would make the same decision again and that they are pleased with the improvement in their appearance as a result of breast enhancement.
If you are considering breast implants, the following information will give you a basic understanding of the procedure. It can't answer all your questions, since a lot depends on the individual patient and the surgeon. Please ask a surgeon about anything you don't understand.

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