Although the practice was decried by most physicians, some surgeons pioneered breast reconstruction and augmentation by injecting paraffin, implanting skin and fat grafts, and using subcutaneous glass-ball prostheses between 1895 and 1945. New plastics developed during World War II revolutionized breast implant technology. Along with shaped plastic sponges, silicone—a synthetic polymer known for its flexibility and chemical stability—seemed to offer an ideal material. Liquid silicone was originally an engine lubricant, but by 1946 Japanese doctors were injecting it into women's breasts to increase their size. Reports of complications from silicone injections prompted the Food and Drug Administration (FDA) to regulate liquid silicone in 1965, and in 1971 physicians began abandoning silicone injections. In 1963, however, Texas plastic surgeons Thomas Cronin and Frank Gerow, working with Dow Corning, unveiled a "natural feel" implant, a silicone rubber capsule filled with silicone gel they named Silastic. An estimated 2 million American women had received silicone implants by the late 1980s.

Silastic also presented complications, however. A tissue capsule tended to surround the implant, sometimes causing hardening. Some women developed inflammation; others exhibited symptoms that mimicked rheumatoid arthritis and immune system disorders. The discovery that Silastic implants often leaked precipitated a crisis. Between 1990 and 1992, Congress and the FDA held hearings on the safety of silicone implants. Implant advocates blamed complications on poor surgical technique, not silicone. Satisfied recipients argued that women, as part of their ability to control their own bodies, had a right to choose implants. Opponents argued that women had been misled, exposed to unnecessary health risks, and sacrificed for corporate profits. The FDA began regulating silicone implants in 1992. Thousands of lawsuits against implant manufacturers ended in multi-billion-dollar settlements between 1995 and 1998. Controversy continued because numerous scientific studies after 1995 disputed the links between silicone implants and disease. Silicone gel implants remained restricted, however, and most women preferred implants filled with saline. While breast augmentations dropped dramatically to 30,000 per year in 1992, by 1997 they had rebounded to more than 120,000, with many women using illegally obtained silicone gel implants.

Bibliography

Coco, Linda. "Silicone Breast Implants in America: A Choice of the 'Official Breast.'" In Essays on Controlling Processes. Edited by Laura Nader. Berkeley, Calif.: Kroeber Anthropological Society, 1994.

Jacobson, Nora. Cleavage: Technology, Controversy, and the Ironies of the Man-Made Breast. New Brunswick, N.J.: Rutgers University Press, 2000. Comprehensive, fascinating, and brilliant.

Parker, Lisa S. "Social Justice, Federal Paternalism, and Feminism: Breast Implants in the Cultural Context of Female Beauty." Kennedy Institute of Ethics Journal 3 (1993): 57–76.

—Gregory Michael Dorr

Encyclopedia of American History Copyright © 2006 by The Gale Group, Inc. All rights reserved.