Early Attempts: 19th and Early 20th Century
The earliest attempts at breast augmentation were experimental and often catastrophic. In the 1890s, surgeons attempted augmentation with paraffin wax injections — these migrated, caused chronic inflammation, formed hard granulomas (paraffinomas), and frequently required extensive surgical removal. Other materials tried in the early 20th century included ivory, glass balls, ground rubber, ox cartilage, and various synthetic sponges (polyvinyl alcohol, polyethylene). All created significant complications.
The Silicone Era Begins: 1960s
The modern era of breast augmentation began in 1961 when plastic surgeons Thomas Cronin and Frank Gerow, working with Dow Corning, developed the first silicone gel implant. The first implant surgery was performed in 1962. These first-generation implants had thick, stiff shells and firm gel; their rupture rates were high by modern standards, but they represented a transformative advance over all previous materials.
Generations of Implant Development
Subsequent decades brought iterative improvements. Second-generation implants (1970s–1980s) used thinner shells and lower-cohesivity gel for a more natural feel, but rupture rates increased. Third-generation implants (1980s) reintroduced shell improvements and barrier layers to reduce gel bleed. Fourth and fifth generation implants (1990s–present) use highly cohesive form-stable gels, multi-layer shells, and various surface technologies.
FDA Regulation and Moratorium
In 1992, the FDA placed a moratorium on silicone gel implants for cosmetic augmentation in the US (they remained available for reconstruction) pending collection of safety data. This moratorium lasted until 2006, when the FDA re-approved silicone gel implants based on data from large clinical studies demonstrating acceptable safety profiles. Saline implants remained continuously available throughout.
