{"id":626436,"date":"2017-08-04T11:00:29","date_gmt":"2017-08-04T11:00:29","guid":{"rendered":"https:\/\/hauteliving.com\/hautebeauty\/?p=626436"},"modified":"2019-07-17T15:09:20","modified_gmt":"2019-07-17T19:09:20","slug":"dr-leonard-hochstein-traces-the-evolution-and-safety-of-breast-implants","status":"publish","type":"post","link":"https:\/\/hauteliving.com\/hautebeauty\/626436\/dr-leonard-hochstein-traces-the-evolution-and-safety-of-breast-implants\/","title":{"rendered":"Dr. Leonard Hochstein Traces the Evolution and Safety of Breast Implants"},"content":{"rendered":"

\"shutterstock_687044542\"<\/p>\n

Breast augmentation has become increasingly more popular and with the growing popularity many misconceptions have arisen.\u00a0I would like to clear some of those.<\/p>\n

The first option for women wishing to have larger breasts was to have silicone gel injected directly into the breast.\u00a0The results were predictably poor as hardening and scar tissue was the likely result.\u00a0In 1962, a pair of Houston plastic surgeons introduced the first silicone breast implant.\u00a0It consisted of an outer silicone shell filled with a thickened silicone gel.\u00a0 Although this was a tremendous upgrade from direct injections, the procedure had its own complications.\u00a0Most of the complaints stemmed from the implants\u2019 firmness.<\/p>\n

In response to these complaints the second-generation implant was introduced in the late 1970s.\u00a0These implants had a thinner shell and less cohesive(more liquid) silicone.\u00a0Although they solved the problem of firmness they created a leaking issue.\u00a0At the 10-year mark a high enough percentage of these implants were leaking or completely ruptured that a recommendation came out to have them routinely replaced at that interval (10 years).<\/p>\n

It was during this time that allegations emerged linking silicone breast implants to autoimmune diseases, which spawned multiple lawsuits against the manufacturers.\u00a0In the late 1980s in response to these issues the third-generation implant was introduced.\u00a0These had a slightly thicker shell and a more cohesive silicone fill.\u00a0Although these implants solved the high rupture rate problems, the controversy of the implant-induced illness fed by the hunger of plaintiffs\u2019 attorneys pushed the FDA into taking silicone-filled breast implants off the market in 1991, in spite of no data to support such a link.<\/p>\n

The only option became saline breast implants, which, of course, still used a silicone shell.\u00a0In 2006, after reviewing the international research, the FDA deemed that there was no link between silicone breast implants and disease and allowed silicone breast implants to be used once again.<\/p>\n

Since that time the implants have undergone tremendous improvement.\u00a0The current models used are highly cross linked with a thicker shell but are softer with fewer rippling\/feel issues.\u00a0I call these the fourth generation implants and I believe they are the best implants I have ever used.\u00a0 If you cut these implants in half they will maintain their shape, have no bleed, but are remarkably soft with minimal rippling.\u00a0These new generation implants have such a low leak rate that the manufacturers offer a lifetime warranty for leaks.\u00a0If one should develop not only do they replace the implants for free but they also pay for the replacement surgery.<\/p>\n

Capsular contraction is the greatest risk associated with breast implants.\u00a0This is a cosmetic issue where the body reacts to the implant distorting it and making it feel firm.\u00a0This is not a rejection and typically happens on only one side.\u00a0Although treatable, it requires an additional operation in which the implant is wrapped by a biologic scaffold (typically human or pig skin) to prevent a recurrence.\u00a0In these situations the manufacturer typically offers the implant for free but the skin itself is not cheap.<\/p>\n

Unquestionably this is the highest non-elective reason for reoperation in my practice but, to put things in perspective, in my career I have had to deal with under 200 such contractions in my patients out of 24,000 implant surgeries.<\/p>\n

There are other inherent surgical risks such as infections or hematomas (bleeding) but in a clean operation like this these risks are very low. I have only experienced two significant infections and fewer than 10 hematomas in my practice. The other common reasons for reoperation are to change the size of the implant or malpositional issues in which the implants sit in a non-symmetric position.<\/p>\n

Lately, there has been a great deal of press about a link to cancer. Lat me clearly state that women with breast implants do not have any increased risk of developing breast cancer, making breast cancer treatment more difficult or receiving later diagnosis. Textured breast implants do, however, have a link to a rare blood cancer called anapestic large cell lymphoma (ALCL).\u00a0There has not been a single confirmed case of this with a smooth surface implant, which is what is predominantly used today.\u00a0I, personally, have not used a textured implant in over 10 years.\u00a0My reasons were primarily for how they look and feel \u2013 certainly another good reason to avoid them.<\/p>\n

I would like to end this by readdressing the nonexistent link to illness as that is the topic that seems to garner the greatest emotional response.\u00a0There are women who believe that their breast implants have made them sick.\u00a0The fact is that autoimmune diseases occur, however the incidence is no greater in women with silicone breast implants than it is with women who have never had breast implants.\u00a0There are also anecdotal stories of women whose symptoms ceased after the implants were removed.\u00a0In these situations I believe this is a somatoform illness and unquestionably the removal of the implants would be warranted.<\/p>\n

\"Dr.Dr. Leonard Hochstein heads a Miami-based\u00a0surgical center dedicated to the safe and comprehensive care of his plastic surgery patients. He has performed over 23,000 breast procedures in his career.<\/em><\/p>\n

View Dr. Leonard Hochstein's Haute Beauty profile and contact information here.\u00a0<\/a><\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Breast augmentation has become increasingly more popular and with the growing popularity many misconceptions have arisen.\u00a0I would like to clear some of those. 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