Breasts
Tuesday, October 22, 2013 | 0 comments
History
It was in 1962 that Timmie Jean Lindsey was offered a solution to a non-existent problem. A factory worker from Texas, she had married at 15, had six children, divorced in her mid-20s, and taken up with a man who encouraged her to have a vine tattooed on her cleavage. Roses tumbled across her breasts. When the relationship faltered, Lindsey decided she wanted the tattoos removed. "I was ashamed," she says, "and I needed them taken off." Her low-paid work made her eligible for treatment at a charity hospital, where she was told the tattoo could be removed through dermabrasion. And the doctors had another proposal. Had she ever thought about breast implants?
Lindsey had not. She'd never felt self-conscious about her breasts – and even if she had, the options at that time were primitive and problematic, involving substances injected directly into women's chests, or implants made of sponge. "The only person I'd ever talked to about breast implants was my cousin," says Lindsey, "who had had some kind of surgery. She said: 'Sometimes I wake up and my breast has moved to another part of my body,' and I thought: 'My God. I never want that.' It wasn't long after she and I talked that I came into contact with these doctors."
The team was led by Dr Thomas Cronin, who had been developing the world's first silicone breast implants. Thomas Biggs, then 29, and a surgical resident under Cronin, says the idea came about when one of his colleagues, Frank Gerow, went to the blood bank. "They'd stopped putting liquids in glass bottles, and begun putting them into plastic bags," says Biggs, "and he was walking in the hall with this bag of blood, and felt that it had the softness of a breast." Around the same time, Cronin travelled "to New Orleans to a plastic surgery meeting and encountered a former resident of his. This fellow told him there was a company who had a new product which was interesting because it had very little body reaction, and could be made into a variety of thicknesses, a variety of viscosities, all the way from liquid to solid. If you can make a solid, you can make a bag – and if you can make a liquid, you can make something that goes in it."
Cronin had the idea for a breast implant. A prototype was created, and implanted into a dog called Esmeralda. "That worked OK," says Biggs, "and so then they got to Timmie Lindsey." After spending some time with the doctors, she says, "they asked me if I wanted implants, and I said: 'Well, I don't really know.' The only thing I'd ever thought about changing was my ears. I told them I'd rather have my ears fixed than to have new breasts, and they said, well, they'd fix that too. So I said, OK. When they put the implants in they said: 'Do you want to see them?' and I said: 'No, I don't want to look at it. You put it in me, and it'll be out of sight, out of mind. My theory was that if you think you've got something foreign inside you you're just going to worry about it." She's 80 today, still living in Texas, working night shifts in a care home, and those first, experimental globes remain in her chest.
What are breast implants
Breast Implant Basics
Breast implants are small, medical-grade sacs comprised of an elastomer shell with a self-sealing filling valve located on either the front or back. Breast implants are filled with silicone gel or a sterile saline solution (salt water).
Some implants are pre-filled, but most are filled after surgery. It's this filling that blows the implant up like a water balloon to increase breast size. Saline implants are the most common type of implant used today due to the FDA's ban on the use of silicone breast implants in the United States in 1992 (although silicone implants are still available in certain circumstances)
Procedure
Depending on the patient and the desired outcome, breast augmentation surgery can be a very simple or very complex procedure.
After pre-operative preparation, the surgery starts by cutting one incision into the patient for each implant. The incisions are small and placed so that the scarring is minimal and hard to see. Once the incision is created, the surgeon must cut a path through the tissue to the final destination of the implant. Once that path has been created, the tissue and/or muscle (depending on placement) must be separated to create a pocket for the implant. This is where the surgeon's skill really comes into play: When deciding where to cut the pocket in the breast, the surgeon must predict what the breasts will look like once the implants are filled. In more extreme augmentation surgeries, this involves repositioning the nipple, adjusting for cleavage and creating a new crease under the breast.
In some cases, augmentation surgery is accompanied by mastopexy (breast lift) surgery so that everything ends up in the right place. To aid in positioning, the surgeon may decide to use a sizer or disposable implant. Sizers are temporary implants attached to a tube that the surgeon can work inside the pocket and fill up to test placement, implant size and fill levels. Once this has been tested, the sizer is removed and replaced with the permanent implant.
When inflatable implants are used, they are rolled up like a cigar and pushed into the incision, through the channel and into place. This is true no matter which type of incision is used (we'll talk about incisions in the following sections). Once the implant is positioned, the incision is closed. In the last step, the surgeon uses a syringe to fill the implant with saline through the valve, filling it to the predetermined size.
If the patient has opted to use pre-filled implants, the incision will be larger. Inserting textured, pre-filled implants requires the longest incision, providing more room for inserting an implant with a rough shell and for manipulating the less-pliable implant once it's in place.
Plastic surgeons can use one of four different types of incisions to insert the implant into the breast: peri-areolar, inframammary fold, transaxillary, and TUBA. In the next sections, we will learn the difference between these types of incision.
Costs
$3816 (US), ￦9,400,000 (KR)
