Failure properties of leaf valve inflatable saline breast implants

In 1963, Cronin and Gerow (1) introduced the Silastic (silicone gel, Dow Corning, Tennessee) breast implant, opening the new era of breast augmentation surgery. This original ‘Cronin’ implant was made of a thick gel contained in a thick, rigid, elastomeric envelope, which had a Dacron (Dupont, Delaware) backing on the posterior surface to anchor the implant to the chest wall to attempt to reduce ptosis. It was available in only a limited number of sizes. Many women who received these implants developed early and severe capsular contracture (1,2). Inflatable saline breast implants were introduced in 1965 by Dr Arion (the Simaplast implant [Toulons, France]) (3). The elastomeric envelopes were filled with a hypertonic solution (6% dextran) or saline. Clinically, these implants were softer than the Cronin implant and were soon declared the first implant to produce a ‘bouncy breast’ (3). These implants could be inserted through a smaller incision than the gel implant and could be inflated to varying sizes, allowing a wider range of final breast sizes. Many manufacturers developed and marketed their own particular brand of inflatable implants (eg, Roger Klein Association [New York], Heyer-