Gummy bear implants are the newest generation of silicone breast implants used for breast augmentation. They are otherwise known as form stable cohesive gel implants and are used for breast enhancement frequently in Europe and South America. They were invented in the early 1990's. They are not yet FDA approved for use in the United States aside from clinical studies. These implants were developed with two goals in mind: 1) decrease the gel bleed and associated problems in breast augmentaton from more liquid silicone implants and 2) control the shape of the breast in breast augmentation.
Silicone can be cross-linked to alter its form from a thin liquid to a firm, solid, stable mass. The cohesive gel implants have been developed with a greater degree of cross-linking than previous implants. Memory gel implants fall somewhere in between older generation silicone and form stable cohesive silicone gel implants. These are the silicone implants that we currently use for breast augmentation in my practice and I and have been quite happy with the shape, feel and low complication rate.
The purported advantages of form stable implants over current silicone gel implants include: (it is important to note that these are largely theoretical as there is no long term data as the implants are relatively new)
1) Improved breast shape - the breast implant can hold its shape and effect the overlying tissue
2) Less capsular contracture - capsular contracture is in part due to silicone "bleed" from the breast implant. There is theoretically less "bleed" in a cohesive gel implant.
3) Decrease risk of implant rupture - Breast implant rupture is often caused by a "fold flaw" in the implant. This is an area of repeated folding on the breast implant that eventually causes it to wear out. The gummy bear implants may have decreased folding due to their form stable nature.
4) Decreased risk of rippling of the breast
Form stable cohesive gel implants have their disadvantages as well:
1) Increased cost
2) Feel - they are firmer than memory gel implants.
3) Longer scar - the implants are not able to be squeezed through the same size of incision as other silicone implants
4) Possibility of rotation. The implants are "anatomic" or "tear-drop" shaped and there is a possibility that the implant could rotate early in the healing process leading to an unusual shape.
5) Difficulty with secondary surgeries such as removal and replacement of implants due to the textured surface of the implant causing ingrowth of tissue onto the implant capsule
My best guess is that when these implants hit the market in the United States, they will make a big splash. There will likely be a 2-3 year period of time where a patient will feel that they are compromising on the results if they do not use the new implants. We as plastic surgeons will gain experience with these implants and we will figure out who would benefit most from these implants which will likely be a small percentage of the population. When this will occur, is still unknown but it looks like a couple of years still.
