Why do some doctors dislike gummy bear implants?

In my practice I use all kinds and brands of implants.  There is a "best" implant for each patient based on their goals and breast type.   I have found that the term "gummy bear" is being used differently in different practices.  In the truest sense, gummy bear implants are tear drop shaped implants.  The idea is that a firmer silicone is necessary to create and hold the shape of the implant.  Modern round implants are also cohesive, just less so.  Some practices are calling cohesive round implants gummy bear and I would encourage you to clarify this distinction with your consulting physicians.The advantages of gummy bear (anatomical) implants are:1) ability to control both height and width of the implant2) a softer (more natural) upper breast shape.  This could be a disadvantage for the patient who prefers a rounder result.3) lower contracture and rippling rates.4) these implants do great above the muscle if the patient is a good candidate5) theoretically less risk of silicone migration in the event of ruptureDisadvantages are:1) higher cost2) slightly longer scar (only a few mm)3) risk of deformity if improperly placed or rotated4) firmer feel (in my opinion this is very slight when covered by the breast)5) less roundness of the upper pole if the patient prefers a rounded result.I personally love these implants for the proper patient and currently use them approximately 10-15% of the time.  These have been used for over a decade outside of the U.S. with excellent results and safety.  There is definitely a learning curve and the surgery has to be very precise but I have seen results with these implants that surpass what I could do with standard round implants.  

There are certainly patients who can get a very nice result with these implants but it's important to go through the pros and cons with your plastic surgeon.  While the chance of rippling is less with these implants, it is not zero, and some surgeons are concerned about a small chance of the implants turning or shifting so that the fullness at the bottom shifts to the side.  That being said, they can create some very nice results in many patients.  Great question and good luck!

This is going to be more of a topic as time goes on and the public has used this term for a specific kind of implant, the form stable gel silicone implant.  This is different from the regular memory gel silicone implant. The form stable implant is firmer and can ripple in thin patients but any implant can ripple if there is not enough tissue to cover it.  The reason most doctors don't use them is because they are more difficult to put in and requires a fold incision which is larger and it is more expensive.  They are more firm than the other implants, memory and saline. I hope this helps.

Upsides:  fewer ripples (most beneficial in super-thin, bodybuilder types) than almost any other implantprobably a slightly lower contracture ratepossibly flatter upper pole of the breast in the upright position (helpful in short-chested women)preferentially improves lower pole breast fullness, helping women who have borderline breast sagging more than round implantsDownsides:most expensive implanttoo flat up top for women who want a round look in the upper part of the breast and/or those who are long-chestedlooks flat up top when patients lie on their backs which is not how "normal" breast tissue behavesrotation of the implant, while not likely, results in an abnormal appearance that almost always requires exchanging the gummy bear implant for a round implant (two surgeries/two pairs of implants = higher final cost)recent studies suggest textured implants such as the gummy bear implants may increase the risk of implant infection by up to 70 times over smooth implantsAs with all things medical, you should first select a surgeon who you trust.  Members of the Utah Plastic Surgery Society are Board Certified Plastic Surgeons who are required to adhere to a high level of ethical behavior.  You can search for someone in your area at their website:  (safeplasticsurgeryutah). Once you have established a trusting relationship, you can then hopefully rely on the surgeon to fully inform you on these issues and be safe in following their advice.Best of luck.

I very much prefer these implants.  Basically you only have saline and silicon implants. All of the main three manufacturers of silicon implants use a cohesive gel implant. The feel nice to the patient as well the look nice. I feel they provide a nicer look also. I would recommend nothing other than cohesive gel or a saline implant. 

These implants feel a little stiffer, and therefore some feel, less natural than standard gels. The built in shape has advantages, but also the disadvantage that if they rotate, the breasts may look different. Each has pros and cons. Choose the surgeon with whom you fell most confident. All the best. 

In my experience the major problem with textured form stable gel breast implants is that because of the texturing they are very difficult to insert.  We use a no touch technique where smooth-walled cohesive gel implants are placed through a Keller funnel so that during the course of your surgery the implant is never touched.  Our opinion is that this reduces the chance of potential chronic infection and capsular contraction.The textured implants are more difficult to place and as a result in my opinion there is more trauma to the breast tissue and pocket with their use.  The other difficulties in terms of positioning, palpability etc. are discussed in other answers.

As with all things new and different - there is a learning curve to their use.They may very well produce superior results in some people, but I generally don't recommend the "new and improved" products. Wait till they've been around in general use for at least 5 years.A lot of the improvements are offset by downsides that we don't note initially.Gel fractures and firmness are two factors being noted now. While the new products may turn out to be the best, you don't be a guinea pig for the  latest and greatest fad that fails.After all - look at the history with the polyurethane coated implants and the recalls of the French PIP implants and the problems with the soybean Trilucent prostheses.

The downside is their excessive firmness. The highly cohesive implants have pretty much all the good and none of the bad of the gummy bears.