"Gummy bear" implants vs saline? Which one is right for me and what is the life expectancy of these two and the benefits?

I am currently a 34c bra size. Had two baby's that I breast feed for about 7mnths each, 35 years old and looking at having breast implants done. Not sure what the difference would be with "Gummy bear" silicone or saline. Looking at going about 350cc to 400cc. Would one feel better then the other, I do have breast tissue, don't want to spend more and not notice a difference

Doctor Answers 11

Breast implants construction and size

Hi,

Thanks for posting your question. I am happy to try and help you. It is important to remember that a board certified plastic surgeon will be your best resource when it comes to an accurate assessment of your situation, and concerns.

Having said that, thank for your height and weight and breast size estimates, they do help. There is really no way to accurately predict what size you would like without an examination. During your examination and consultation, you should try on some sample sizes and see what you are comfortable with. Then the PS can help explain with the size and current condition of your breasts.

If you have accomplished this step, then trust your plastic surgeons advice as to what would be the best size for you. They have the experience. If you are uncomfortable, go on another consultation.

As for implant construction, please visit the link below.

Best wishes,

Dr. Michael J. Brown
Northern Virginia Plastic Surgeon

The feel may not be different, but saline can deflate!

If you have a lot of breast tissue, the feel won't be very different. But, consider the silicone implant like a run flat tire. If you ever develop a hole in the implant (through normal wear and tear) it won't deflate. It's called a silent rupture. The silicone doesn't travel. It stays contained in the capsule around the implant. With saline, it goes flat. So, if you get a flat with saline, you're lopsided until it's fixed. With silicone, you aren't rushed to fix it because you'll still look fine! Personally, I think that's worth the extra money, but it's your choice. Good luck!

Robert S. Houser, DO
Columbus Plastic Surgeon
5.0 out of 5 stars 15 reviews

Gummy bear implants vs saline.

The gummy bear implant is very cohesive to hold the shape and therefore the implant is stiffer with less "flow" within the breast.  If anatomic they are textured as well to hold the orientation in the breast. Highly cohesive or not, the gummy bear might not last any longer than a typical saline or gel implant and all implants will leak over time. We feel both classic gels and saline can feel very soft and natural, and there are qualities in each you should explore. The gummy bear is the right choice for some as well with trade-offs you should also understand so take your time. The best implant is the one right for you.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.1 out of 5 stars 40 reviews

"Gummy bear" implants vs saline?

We don't refer to breast implants as "gummy bear" anymore as all silicone implants now used in this country are cohesive, some just more than others. In my practice 95%+ of patients use silicone because they feel more natural. No implant should be considered as a lifelong device, they will all need to be replaced someday. Many patients trade their saline implants for silicone, no one ever goes the other way in my experience. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

Breast Augmentation

II appreciate your question.
Without photos, difficult to comment.
The size of implant is dictated by your chest wall measurements.
The type of implant depends on the desired look you want to achieve.
Silicone will give you a fullness at the top (upper pole fullness).
Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.
Anatomic gummy bear implants might be a good choice to give you volume.
These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.
During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.

The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

best of luck!

Dr Schwartz



Gummy Bear implants

Here is what I tell my patients : Gummie bear implants (5th generation silicone gel) look better, feel better wrinkle less and last longer and cost more than saline breast implants. Good luck. 

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 44 reviews

Gummy bear implants vs. saline

Hello!
Gummy bear is the latest generation of silicone implant, balancing the softness of gels with a solid state that leads to better duration of the implant. The older generation gels were not cohesive, crosslinked gels - they were more of a silicone oil that leaked as the implants "wore." I estimate these cohesive gel "gummy bear" implants should last at least 25 years, although there are always potential outliers. Saline implants do not feel like breast tissue and they may evaporate slowly or deflate entirely - a possibility, but most saline implants do well. Saline implants are better in fuller breasted women, not really thin women with little breast tissue.
I would recommend you see a Board Certified Plastic Surgeon to evaluate your options, see what the implants look and feel like, and get sized. You can find a surgeon on plasticsurgery.org.
Best of luck!

Michele A. Shermak, MD
Baltimore Plastic Surgeon
4.7 out of 5 stars 39 reviews

"Gummy bear" implants vs saline? Which one is right for me and what is the life expectancy of these two and the benefits?

Gummy bear cohesive silicone gel breast implants that were approved by the FDA in 2006 are chosen by over 90% of patients in my practice primarily because they feel more natural like breast tissue and do not carried the risk of deflation that saline implants carry.

In the past some patients chose saline implants because the rate of capsular contraction or hardness was 10% which was less than the rate of hardening of gel implants that were available before 2006

However the current cohesive gel implants actually have a lower rate of capsular contracture and saline implants daily  in the latest study I Mentor and therefore in my opinion the benefit of saline implants has disappeared

In addition saline implants can cause visible rippling in 10 breasted patient's.  For more information please read the flank below;

Breast Implants

Thank you for your question about breast implants. Pictures would be helpful.

Gummy Bear breast implants come in difference shapes, different base shape and different projections.

Not everyone is a good candidate for Gummy Bear breast implants. You will need an in person consultation.

To know what might be right for you, see two or more experienced, board-certified Plastic Surgeons for a complete evaluation to make sure you are a good candidate and that it is safe for you to have breast implant surgery or related procedure(s).

I hope this helps.

Saline vs Silicone

This is a very common question among my patients and a topic with a lot of misinformation on the internet. Both saline and silicone implants are FDA approved for cosmetic breast augmentation in the United States. Clinical trials demonstrate similar infection, failure and re-operation rates. Neither type of implant causes breast cancer. Despite lawsuits, and internet horror stories, medical studies do not link silicone implants to autoimmune disease like lupus, scleroderma or rheumatoid arthritis. The major difference is how the implants look and feel. In general silicone is softer, lighter and will feel more "natural." Saline is firmer, rounder and gives a more augmented or fake look. These can be positives or negatives depending upon your goals. The main downside to saline is increased scalloping and rippling, meaning a higher likelihood of seeing (visibility) or feeling (palpability) the implant in thin patients. The only two things that control implant visibility and palpability are the device itself and the amount, and quality, of tissue above the implant hiding it. Therefore, the type of implant selected plays a large role in your result in terms of both look and feel. The vast majority of my patients select silicone implants. Interestingly, when we refer to saline or silicone, we are talking about the inner fill material. Both saline and silicone implants have the same silicone shell, so the body is exposed to the exact same material for the majority of woman who never experience a failure. Only if the shell was to fail would the breast pocket and capsule be exposed to the fill material. Saline is absorbed and urinated out, silicone gel remains inert, and except in extraordinary cases, stays within the breast pocket. One factor that should not be considered when choosing saline or silicone is price. A few hundred dollars is a small difference upfront, for a device you may have for decades. Additionally, both implants carry a lifetime warranty against device failure, but the silicone implant includes a 10 year warranty to help pay some of the surgery fees (up to $3500) should the device fail. To put it simply, both have a lifetime “parts” warranty and silicone includes a 10 year “labor” warranty while that “labor” portion of the warranty is an additional $200 for saline, thereby negating most of the price savings.


First, the good news is that no liquid silicone is still on the market in the U.S. So that means, currently, every FDA approved silicone implant in the US is silicone gel.
Second, the term gummy bear is not technical and has no specifications (I am an engineer so I like universal, clearly defined, industry wide specifications). Therefore, it has no useful meaning and just confuses patients. It was coined by a plastic surgeon to differentiate between older generation liquid silicone and the then new gel implants he was trialing. It now is inaccurately used by some to refer to the thickest "form stable" gel, but since that is inaccurate the confusion only deepens.
Now for the complex details: Silicone implants can have 1) Varied gel thickness or cross linking of molecules, 2) Round or Anatomic shape, 3) Smooth or textured shell and 4) Variable fill ratio.
Gel thickness
Again all silicone gel implants in the U.S. are cohesive by definition. Then there are highly cohesive (thicker gel) or ultra-highly cohesive “form stable” gel.
Cohesive Gel << Highly Cohesive Gel << Ultra Highly Cohesive Gel
Softer more natural -------------------------->Very Firm and less natural
Higher rippling potential ------------------------> Less Rippling potential
The thicker the gel, the less rippling potential, but the firmer and less natural the breast. So in the case of gel thickness, when most women don’t have to worry about rippling, more is not always better.
Implant Shape
Then there are round and anatomic shaped implants. Each patient will have their own view on these and it has a lot to do with their age range, demographics and desired result. The vast majority of augmentation patients want full round, cleavage and therefore they would be disappointed with an anatomic shape. If you desire a more discreet look they may be a consideration, but they only come in thicker gel condemning you to a firm less natural feeling breast, when a lower profile round implant can still give the natural teardrop shape, but more natural feel.
Smooth vs. Textured Shell
Textured implants were introduced in an attempt to reduce capsular contracture by "disorganizing" the scar. Studies have been mixed about whether this theory is true in patients. Now texture has more to do with trying to keep anatomic devices in the proper orientation! Imagine an upside anatomic teardrop implant. The textured shell itself is thicker and less pliable when manufactured and the devices move less so it can be less natural and firmer, many times a negative, but in the case of a lift may be beneficial. Although EXTREMELY rare it bears noting that all cases of ALCL reported have been with textured implants. So because it's, in my opinion, still just a theoretical benefit for the vast majority of primary augmentation patients, and may cause problems, I use mostly smooth unless a patient requests the textured or if I am trying to have the texture hold an implant in place on a large lift.
Fill Ratio
The Allergan Inspira line and Sientra 106 line is the same gel and shell as the Natrelle line and 105 line respectively (meaning cohesive) but is filled approximately 5-7% more giving a “fuller” look without as much volume as the next style up. It also has less rippling potential, a big positive in extremely thin patients, without as much increase in firmness as thicker gel. My thinner patients are really moving towards the Allergan Inspira and Sientra 106 implants for less rippling and more fullness than mod+, but not quite as much volume as the high profile.
Ultimately, no implant manufacturer has proven that their device looks or feels better once implanted despite all the marketing hype. Anytime there are many choices, it is because they all have positives and negatives. The implant manufacturers prey on the unknowing consumer to pick a device with flashy advertising, or the “newer is always better” marketing campaign strategy.
I make specific recommendations to each and every of the 500+ augmentation patients I see annually based on: 1) dimensional planning 2) expressed goals 3) amount and quality of tissue to hide the implant.
Only a board certified plastic surgeon specializing in augmentations (meaning they do 300+ a year) will have the expertise, knowledge and experience to understand and explain these subtle differences to you. Don’t trust your result to an office that gave you a video, booklet or patient coordinator rather than the surgeon to answer these important questions! Best of luck!

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.