Breast Augmentation: Thirty Nine Years after Foam Implantation - A
Case Report
Julio Hochberg, MD, James C. Yuen, MD, Susanne Klimberg, MD, Heath Stacey, BS,
Cristiano Boneti, MD, and Harry H. Brown, MD.
The attraction of larger breasts has always seemed to be more important than the risks
associated with implantation. We would like to present a case report that may be the
longest lasting case of foam breast implantation.
A 73 year-old woman, 39 years ago, after reading a book on a novelty technique on
breast augmentation, traveled from Wyoming to Los Angeles and underwent the
procedure without inquires or explanation. She has been satisfied with two hard round
breasts. Recently, she developed abrupt significant enlargement of her left breast
without other symptoms. There was no history of trauma.
With a possible diagnosis of left breast tumor, a mammogram was requested, which
demonstrated bilateral breast implants of different size with unknown substance. No
malignancy was identified. The patient desired removal of both implants immediately.
At surgery, Franklyn Surgifoam breast implants were removed. The right implant was of
dark-yellowish color surrounded by pieces of celluloid-like ragged material, contained in
an intact thick fibrous calcified capsule. On the left, the implant was almost doubled in
size, soaked in a dark-brown liquid with similar pieces of celluloid-like wrapping and a
burst fibrous capsule. The fibrous capsule showed a foreign body reaction without
malignancy, and the cultures were negative.
The Franklyns Surgifoam implants were made of polyester foam wrapped in a
polyethylene film jacket, either with a knotted or heat-sealed closure. The outer film
membrane was supposed to prevent the ingress of tissue. The devices were made
exclusively for Dr. Robert Franklyn of L.A. from 1958-1965. During World War II, while
visiting Canada, he noted a seat cushion in a captured German aircraft made of a
unique type of a synthetic foam material, which he thought would be suitable for surgical
implantation. After the war, he developed breast implants with this material under the
name of "Surgifoam." This product was marketed before they could be tested in animals.
The main problems with the Franklyn prosthesis include degradation, resorption, and
disintegration of the foam; perforation of the bag leading to flooding and swelling of the
prosthetic compartment; and gross contamination. These adverse effects lead to
explantation and debridement.