Silicone breast implants by generation

First generation (1960s)
ShellThick, smooth, silicone elastomer in 2 pieces with Dacron patches posteriorly to facilitate positioning along the chest wall
FillerSilicone gel, moderate viscosity
ShapeAnatomic or “teardrop”
ComplicationsHigh capsular contracture rate (approached 100% at 10 years after implantation)
Second generation (1970s)a
ShellThinner, smooth, seamless, no Dacron patches
FillerSilicone gel, thinner and less viscous
ComplicationsRupture (nearly 60%), diffusion or “bleeding” of silicone molecules into periprosthetic space and onto breast implant capsule
Third generation (1980s)b
ShellThicker, multilayer silicone elastomer, no Dacron patches
FillerSilicone gel with larger particles, increased crosslinking, more viscous and thick
Fourth and fifth generation (1990s to present)c
Shell and fillerShell thickness and gel viscosity redesigned according to strict criteria by American Society for Testing Methodology and US Food and Drug Administration
ShapeAnatomic (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.