I am originally from Brazil, and the doctors in BR told me that they use these implants for a long time and they are very comfortable working with them, the implants also cost less there. I live in Idaho, there are not doctors in my area conducting clinical studies. Should I go ahead and travel to BR? I can stay in BR for 20 or 30 days - Any advice is truly appreciated. I would prefer to have it done here in USA (closer) but can't find a doctor.
Should I Get Cohesive Gel Implants Outside of the US?
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Caution for Surgical Safari's
I am always leary of recommending "surgical safari's." Even our FDA doesn't think there is enough evidence for this treatment to be safe, Plus, being far away from your treating surgeon and not being able to get access to care should an issue or complication arise, is not the right way to take care of your self.
I recommend a US surgeon, in your geographic area.
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"Cohesive gel" silicone breast implants are awaiting FDA approval in the U.S.
Breast implants that are formed with a more solid form of silicone, known by some as "cohesive gel" implants or the "gummy bear" implant are not yet approved for implantation in the U.S. This is because the United States Food and Drug Administration has some of the strictest standards for medical devices in the world.
I have used them during my training in Canada, and to be honest, I felt that they were not the most appropriate for the majority of women seeking breast augmentation.
Many Plastic Surgeons have used them with excellent results, but in my patients, I felt that they were a little too firm (like a stale gummy bear), and that they don't move naturally with a change in body position like the softer smooth, round gel implants that are currently available in the U.S.
The current silicone gel implants in the U.S. are also "cohesive", but contain more molecules of water and have a less viscous nature - i.e. they move more like corn syrup within their shell than a stale gummy bear.
I would caution you from getting surgery anywhere outside your normal country, unless you plan on traveling there regularly and you have health insurance coverage there. Having Plastic Surgery in a foreign country only exposes you to lack of long-term follow-up with your Surgeon, and no coverage should anything (heaven forbid!) go awry and you need additional care there.
Karen M. Horton, M.D., M.Sc., F.R.C.S.C.
Getting Breast Implants Outside the United States
The good news is that cohesive gel implants are now available in the United States and you need not go to another country to take advantage of these state of the art implants.
Going to another country for plastic surgery can be problematic and may not be worth the monetary savings. Having a local doctor you can see for follow-up visits is important to be sure you get the best results from surgery. Seeing a doctor for follow up who did not perform the surgery is a real compromise to your proper care.
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NY/NJ Area Gummy Bear Breast Implants
Travel for gummy bear implants
I would strongly recommend against traveling to Brazil for cohesive implants.
The worst breast augmentation result I have ever seen was a revision augmentation a couple of weeks ago from Brazil. Poor planning, poor execution. The standards of physician qualification and safety are just not up to par with those in America.
That said, I am not sure form stable cohesive gel implants will become popular for uncomplicated breast augmentation in the states. I have no formal experience with them but I have heard that they are unusually firm. The current cohesive gel implants available in the U.S. are soft and have been adequately studied for safety (which is why they are FDA approved).
Cohesive or "Gummy Bear" Breast Implants are not FDA Approved in the United States: Be careful with medical tourism
Cohesive gel implants or "gummy bear" breast implants are not approved in by the FDA for use in the United States. These implants have been available around the world for the last 5 years, but the trials in the US have been prolonged secondary to possible implant complications. I would caution you to travel to another country to attain these implants without any proven advantage over silicone gel implants. The advantage of these cohesive gel implants may be in the breast reconstruction population and not in the cosmetic patient. The implants are firmer and require a larger incision than normal silicone implants. I have seen implant malposition and infection, as well as rippling in the cohesive gel implants. I would wait for the FDA to pass judgement on these implants prior to agreeing to have them placed in your body or under go a silicone breast augmentation by a board certified plastic surgeon with standard implants. I would caution you to travel to another country to receive them as follow-up will be difficult and complications if they do arise will be difficult to manage affordably in the US.
Cohesive Breast implants
Thankfully, cohesive implants are available here. There are plenty of great plastic surgeons both here and in Brazil I agree with your desire to stay in the US to do your surgery. The best reults will be achieved with adequate long term follow up. It will be more convenient to see your doctor when they are local. It is also important to find the physician that you like and trust. In the best case, you can find this where you live.
Should I Get Cohesive Gel Implants Outside of the US?
Cohesive silicone gel implants (gummy bear breast implants ) are not currently approved by the FDA for use in the United States outside of experimental trials. These implants are available in many other countries, particularly South America and Europe, and are regarded by many of these surgeons as the ideal implant. In the USA there are currently several experimental trials being conducted by both Mentor and Natrelle for the use of these cohesive silicone implants in this country.
Your choices are to find a plastic surgeon who participate in cohesive silicone experimental trials or to wait for the FDA to approve the implants for general use. I would not recommend that you travel abroad for these implants because of the lack of over-sight associated with medical tourism.
Cohesive gel implants
Breast augmentation with cohesive gel implants is available in the US, and both companies (Allergan and Mentor) should be able to provide you with the names of plastic surgeons who are permitted to use them in your area. Traveling abroad for surgery may be acceptable for the surgery, but any follow up or treatment for unforeseen complications will be difficult to obtain without return trips or additional expense.
Surgery outside of the country
If you choose to have surgery outside of the US, you will have difficulty receiving adequate follow up care. You can find a surgeon in the US who is involved with the clinical trials for the cohesive gel implants and this way ensure having good followup. Although it's tempting to have surgery out of the US, I can not advise this.
Please consult with a board certified plastic surgeon in the US regarding cohesive gel implants.