Breast Implant Generations
Implant Filler
Modifications in the characteristics of the implant filler
have also occurred. The most obvious being the change to
saline-filled devices during the "implant crisis"; however,
significant modifications have occurred in the silicone gel
characteristics. The modifications in silicone gel technology
are significant enough that many consider the modern
era gels a fourth implant generation. Since 1992, due to
increase demands to improve manufacturing processes,
current silicone gel implants are improved devices with
slightly thicker shells and more cohesive gel filler than
third-generation devices.
Because breast implants are filled with medical-grade
silicone, changes in silicone gel chemistry have centered on
the cohesive quality of the gel. All silicone gels are cohesive
but the degree of cohesiveness has clinical importance. The
degree of cohesiveness is a reflection of the elastic memory
or shape retention of the gel. Cohesiveness is produced by
the chemical cross-linking of the silicone gel molecules. The
degree of cohesiveness imparts important characteristics to
the structure and feel of the implant. Second-generation
implants produced before 1985 contained minimally
cohesive gels. Third- and fourth-generation devices evolved
to contain increasingly cohesive gels after 1985, and in
1993, form-stable cohesive gel implants were
introduced.
The fifth-generation implants are form-stable cohesive
gel implants (e.g., Inamed 410 and Mentor CPG). These are
shaped silicone gel devices with enhanced cohesion that
offer improved breast shaping and results. These implants
are currently undergoing clinical trials in the United States.
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