I found a surgeon whose work I really like, but I know he does not do gummy bear implants yet, should I wait until he starts using the cohesive (gel) implants? I also want a few consultations before I decide on a surgeon. Since there are not that many surgeons using cohesive gel implants yet, how long will this be until they start?
How Do I Find Surgeon Using Cohesive Gel (Gummy Bear) Implants? Since Allergen's Approval, when Will All Surgeons Use It?
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Finding Plastic Surgeon for "Gummy Bear" Implants
The Allergan 410 highly cohesive silicone gel implants were only released by the FDA two weeks ago. In order to use them Allergan requires surgeons to view a 90 minute didactic webinar. I have been waiting for these implants for years. So I became certified yesterday. But others may not have such an interest in these implants and therefore it could take a while for everyone to get certified.
I think they are the best solution for implant breast reconstruction following mastectomy. I really don't see a need for them in primary augmentation as the cohesive gel implants currently in use are a superior device.
Are Gummy Bear implants the best?
While they have a cute name, these highly cohesive implants are not the most commonly used nor are they necessarily the best for each situation. The latest is not always the greatest...
Gummy Bear Implants
Your question is not clear. You could be referring to cohesive form stable shaped breast implants, which are just now coming on the market or the round silicone gel breast implants that are very common and will probably remain the implant of choice. Both have cohesive (gummy bear) gel.
The newer ones are shaped and feel firmer and require a larger incision. They seem to be best suited to breast reconstruction after cancer surgery. Their application to cosmetic breast enhancement remains unclear at this time.
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It's probably going to be about 4-6 months before significant numbers of surgeons complete the training process. And maybe some surgeons will decide that it's not worth the bother of a more complex sizing system and more complicated surgery.
After all, right now it's not totally obvious that these new implants are going to be better for the average American cosmetic patient- due to a larger incision, increased firmness of the implant, lack of superior pole fullness, size limitations, etc. - even though they will be good for reconstructive patients. It does look like there's less of a capsule rate and less issues with implant leakage. So there are pros and cons. When I trained, textured teardrop saline implants were the popular thing. Now you hardly see them....
410 gel implants
Surgeons useing allergan implants can use the 410 implants after taking the online review. Placing these implants are similar to using the other implants with slight variation in technique.
Cohesive gel implants
Although a significant amount of press is out there surrounding these implants, the ones that the majority of surgeons use now, and not dramatically different in terms of safety, appearance, and longevity. They feel slightly firmer that the implants that are out now.
The implants of the late 70's and early 80's had much thinner walls and the silicone was much thinner. The safety and tract records of implants now are much much improved.
I do not believe all surgeons will use the gummy bear, due to firmness, costs etc. It will have a place on the market, but not take it over.
In all new technology that comes out in plastic surgery and other fields, there are pros and cons. The textured shaped anatomic implants were supposed to take over the market back a number of years. It never happened due to some of the disadvantages of the implants.
I believe that the most important factors for a good long lasting result in the majority of patients are correct evaluation of the patient regarding size of implant chosen, the need for an uplift, good technical surgery, and patients following the postoperative care regimen of the surgeon.
Web reference: http://www.drrickrosen.com/breast-augmentation-connecticut/
How Do I Find Surgeon Using Cohesive Gel (Gummy Bear) Implants?
Any surgeon who uses Allergan implants can use these model 410 implants after taking a two hour on-line study course. The insertion technique is different than for the other style gel implants, but only slightly so. Surgeons can use these whenever they choose to.
Like all implants, these will have advantages and disadvantages over the alternatives, and it is not likely that these will soon become the implant of choice for all patients.
RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified, but also is a member in good standing of the major plastic surgery organization in the U. S. Contacting the surgeons by phone or email will let you decide which surgeons are using the implants you prefer. Thank you for your question, best wishes.
Gummy Bear breast implants
Allergan has released the new 410 anatomic shaped highly cohesive gel implant just a few weeks ago. Physicians need to be certified (an FDA requirement for putting them on the market) to obtain and use them. Not all surgeons are interested in becoming qualified to use them. They are really for specific situations and I will not plan on using them on all my patients. There are plusses and minuses which a qualified surgeon can explain to you. They will cost aproximately $1000 more than "standard" cohesive gel silicone implants and about $2000 more than saline implants and this is just the cost for the physician to buy the implants. Even though many docs are not yet (or never will be) qualified to put them in, most board certified surgoeons know the advantages or disadvantages. I would suggest you go back to the surgeon you are comfortable with and have a discussion with him about these implants. If he decides they are right for you it may push him to do the short qualifying course in order to be able to use them for you.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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