Lipoma transfer
Czerny tried to enlarge a breast by implanting a lumbar lipoma. Paraffin injections and polyvinyl alcohol sponge implants followed, with poor results.[1]
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History
From the first silicone implant in 1962 to the 2021 boxed warning: the steps that changed the operation and its rules.
Timeline
Czerny tried to enlarge a breast by implanting a lumbar lipoma. Paraffin injections and polyvinyl alcohol sponge implants followed, with poor results.[1]
Wise published a method for planning the mammaplasty, used to make reduction outcomes safer and more predictable.[1][2]
The first silicone breast implant was placed in 1962. First-generation implants had a thick shell, thick gel and Dacron patches, with high capsular contracture rates.[1][2][3]
Inflatable saline implants came into use in 1965.[1]
The FDA moratorium on silicone gel implants began in April 1992. During it, saline implants were used almost exclusively in North America, while silicone stayed in use in the rest of the world.[1][2]
Lejour reported 100 patients, 192 breasts, with vertical scar reduction and lift, using liposuction in the fattier breasts.[1][2]
Keech and Creech reported anaplastic T-cell lymphoma next to a saline-filled breast implant, the first reported case.[1][2]
Tebbetts published dual plane augmentation in 468 patients. Cohesive gel implants entered US use the same year under an investigational study.[1][2]
In November 2006 the FDA approved the Allergan Natrelle and Mentor MemoryGel silicone implants and required each maker to follow patients for 10 years in post-approval studies.[1][2]
The FDA identified a possible association between breast implants and anaplastic large cell lymphoma.[1]
The WHO designated breast implant-associated anaplastic large cell lymphoma as a T-cell lymphoma that can develop after breast implants.[1]
On 24 July 2019, at FDA request, Allergan recalled its BIOCELL textured implants and tissue expanders worldwide. The FDA counted 573 BIA-ALCL cases and 33 deaths, 481 cases with Allergan implants.[1]
On 27 October 2021 the FDA restricted sale of breast implants to providers who give patients the risk information, and required a boxed warning, a patient decision checklist signed by the implanting physician, updated rupture screening recommendations and a patient device card.[1]
Pioneers
Their papers set the methods in use today.
Published the planning pattern used for anchor-scar reductions and lifts.[1][2]
Developed vertical mammaplasty and reported 710 patients over 30 years.[1][2]
Modified the vertical scar reduction and added liposuction of the breast.[1][2]
Simplified vertical reduction with a medial pedicle in 400 reductions.[1]
Described the periareolar round block lift, with the scar only around the areola.[1]
Described dual plane augmentation and a 24-hour return to normal activities after augmentation.[1][2]
Introduced the subfascial implant pocket.[1]
Reported structural fat grafting to the breast.[1]
Reported the first case of lymphoma next to a breast implant.[1][2]
Analyzed 173 cases of BIA-ALCL; every patient with a known implant history had at least one textured implant.[1]
Showed that complete surgical excision gives the best outcomes in BIA-ALCL.[1]