All silicone gel implants are safe due the the cohesivity of the gel there is no risk of leakage and migration of gel. The shaped gel implants or "gummy bear" ones do have the risk of rotation in the pocket. However, if you are very thin, it may be worth the risk for a more natural upper pole transition. The right choice for you depends on your anatomy. Best wishes, Dr. T.
Silicone implants, some advices:
Thanks for the question. I prefer using the Cohesive Gel - Silicone Breast Implants with textured cover ("gummy bear implants") They are quite safe and aesthetically best as they give a firmer consistency, better projection and natural appearance.Kind regards,Dr. Emmanuel Mallol.-
The previous expert responders have given you a short version of the answers. Best to seek only in person discussions!
Gummy Bear Implants mean more Cohesive Gel
The so called "gummy bear" implants are a type of silicone gel implant. The silicone gel used in today's implants can range from moderately cohesive gel like that found in the round smooth Inspira implants to more highly cohesive which leads to form stability of the Natrelle 410 gel implants. There are pros and cons with each type of implant. The gummy bear implants are usually shaped. This means there is more fullness at the bottom and less on top. So those patients wanting a very full upper pole tend to choose the round moderately cohesive gel implants. However, the form stable shaped gel implants can still give you excellent upper pole fullness, but will look more natural and breast like. Additionally, the gummy bear implants have a better track record than smooth implants in the pocket above the muscle. Smooth implants have been shown to have high capsular contracture rates above the muscle, the the textured gummy bear implants have a much lower incidence of capsular contracture in the subfascial plane.
Gummy bear implants are also known as "form stable anatomic implants" and have several differences compared to smooth round implants.
1. The silicone gel is more cohesive. This means that over time (meaning years), the gel doesn't settle as much toward the bottom of the implant. This minimizes rippling and bottoming out. Patients with small breasts can be at higher risk for rippling, so this can be an advantage.
2. The surface of the implant is textured. This helps the implant "lock" in place on the chest to some degree. This can be an advantage over time since it minimizes the implants falling down and out to the sides. However, because of this it takes the implants longer to soften and settle (up to a year). For thin patients with small breasts, this can limit the look of cleavage since it can be harder to push them together in a bra.
3. They have the lowest rates of capsular contracture and rupture. For this reason, they have lower revision rates than other implants. For this reason, some people consider them to be the safest choice for silicone implants.
Of course saline eliminates the risk of silicone ever coming into contact with breast tissue, but the risk of rippling and rupture is highest with saline implants, especially for women with small breasts.
Overall, it is a personal decision, and there is no "best" or "safest" choice. I encourage you to visit with a few board certified surgeons to discuss this further. Best wishes.