It's written by my friend and mentor, Dr. Pat Maxwell, who knows as much on this subject as anyone on the planet. I think it's worth paying particular attention to his description of "biodimensional" principles, a now wide taught concept he pioneered. Another interesting thing Dr. Maxwell outlines is to look back at the sequential stages in implant development to see what went wrong (thin shell/thin gel designs in the 1970's) all the way to the sophisticated manufacturing of current and future devices. The engineering and computer modeling of implant designs is indeed impressive.
First Generation (1962-1970)
Thick, two-piece shell
Smooth surface with Dacron fixation patches
Anatomically shaped(teardrop)
Viscous silicone gel
Second Generation (1970-1982)
Thin, slightly permeable shell
Smooth surface (no Dacron patches)
Less viscous silicone gel
Third Generation (1982-1992)
Thick, strong, low-bleed shell
Smooth surface
Round shape
More viscous silicone gel
Fourth Generation (1993-present)
Thick, strong, low-bleed shell
Smooth and textured surfaces
Round and anatomically shaped
More viscous (cohesive) silicone gel
Fifth Generation (1993-present)
Thick, strong, low-bleed shell
Smooth and textured surfaces
Round and diverse anatomical shapes
Enhanced cohesive and form-stable silicone gel
* In accordance with technical parameters established by the ASTM.
Fifth generation devices will hopefully be available late this year or early 2008. While not useful in all scenarios, they offer significant advantages in breast reconstruction and in primary (initial) breast augmentation procedures.
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