Silicone breast implants by generation
| First generation (1960s) | |
| Shell | Thick, smooth, silicone elastomer in 2 pieces with Dacron patches posteriorly to facilitate positioning along the chest wall |
| Filler | Silicone gel, moderate viscosity |
| Shape | Anatomic or “teardrop” |
| Complications | High capsular contracture rate (approached 100% at 10 years after implantation) |
| Second generation (1970s)a | |
| Shell | Thinner, smooth, seamless, no Dacron patches |
| Filler | Silicone gel, thinner and less viscous |
| Shape | Round |
| Complications | Rupture (nearly 60%), diffusion or “bleeding” of silicone molecules into periprosthetic space and onto breast implant capsule |
| Third generation (1980s)b | |
| Shell | Thicker, multilayer silicone elastomer, no Dacron patches |
| Filler | Silicone gel with larger particles, increased crosslinking, more viscous and thick |
| Fourth and fifth generation (1990s to present)c | |
| Shell and filler | Shell thickness and gel viscosity redesigned according to strict criteria by American Society for Testing Methodology and US Food and Drug Administration |
| Shape | Anatomic (teardrop) |
↵a During this period subpectoral implant placement gained popularity, decreasing capsular contracture rates.
↵b Restricted from US market temporarily in 1992; textured surfaces were introduced during this period in an effort to decrease capsular contracture.
↵c Greater quality control during manufacturing; wider variety of implant shapes and surface texturing available.