Gummy Bear Breast Implants vs Saline or Silicone?

What are gummy bear breast implants? Are they better than silicone breast implants or saline implants?

Doctor Answers 32

Gummy Bear Breast Implants as Compared to Silicone Gel or Saline Breast Implants

The answer to this question has
changed over the last couple of years especially as breast implant technology
has changed recently.

Let’s start by defining each
implant.

    1. Saline breast implants are a
silicone shell that is filled with saline at the time of surgery so they can be
placed through very small incisions.  However, they are prone to leaking the saline and as a result you can
end up with a flat breast that requires implant placement.  These implants are also prone to a wavy look
also known as ripples.

   2. Silicone gel filled implants are 4th
generation implants that are a shell that is prefilled with a silicone
gel.  This gel is moderately cohesive or
like a really thick glue or like a soft jelly.  They require a little bigger incision, and have some ripple
problems.

   3. The gummy bear implants are the
newest implant available.  They are the
so called 5th generation implants and are called highly cohesive
implants because when you cut them they maintain their shape just like a gummy
bear candy.  They also have a shell that
is usually textured to reduce scarring or capsule contracture around your
implant.  This is a problem that can
cause hardening of your implants and is the number one long term problem with
breast implants.

There are almost as many opinions as
to which is the best implant but recent articles in the plastic surgery
literature suggest that the Sientra gummy bear implants have the lowest rupture
rate, and the toughest shell.  They also
have the very best warrantee.

The women I have spoken with, who
have had both saline and silicone, all of them swear that the silicone feels much
better.  I can tell you that the gummy
bear implants look and feel much better as well.

I hope that helps.

Beat regards.


Kirkland Plastic Surgeon
4.9 out of 5 stars 58 reviews

"Gummy bear" vs "regular" silicone gel vs saline

There is no "best" breast implant.  However, there are clear advantages and disadvantages to each.  Let's start with silicone gel vs. saline.

Advantages of silicone gel

  1. More natural feel than saline
  2. Reduced rippling relative to saline
  3. Longer implant lifespan (on average)

Advantages of saline

  1. Smaller incision (3 cm vs about 5 cm)
  2. Smaller cost ($5450 total vs $6750 total with silicone gel)
  3. Smaller risk of capsular contracture (excessive firmness of the implants due to scar tissue)
  4. No concern regarding safety of deflated implants (vs. postoperative MRI surveillance recommended by FDA for silicone gel)

Silicone gel is the more natural feeling, less ripply implant.  But you can't argue with the cost or safety of saline.

Now let's look at "gummy bear" vs "regular" silicone gel.  The difference is simply the level of cohesion of the implants.  Regular silicone gel implants are cohesive (meaning that the silicone gel molecules stick together, unlike the molecules of salt water).  Gummy bear implants are highly cohesive (meaning that the silicone gel molecules stick together even more than in regular silicone gel).

Advantages of "regular" silicone gel

  1. Potentially smaller incision than "gummy bear" implants.

  2. Lower cost than "gummy bear" implants.

Advantages of "gummy bear" silicone gel

  1. Reduced rippling relative to regular silicone gel.  This makes very little difference in a primary (first-time) augmentation but is quite useful for secondary (redo) augmentations if the breast tissues are stretched out and thin.
  2. Reduced spread of silicone gel if the implant ruptures.  We have an ongoing "experiment" in which I took an Exacto knife to a gummy bear and a regular silicone gel implant about three years ago.  The regular silicone gel implant has spilled silicone up to an inch away.  The gummy bear silicone has barely moved.

Just remember that you can get a good or bad result with any type of implant.  Choose your surgeon first, and then the two of you can work together to choose the best implant for your anatomy and desires.

Ronald Friedman, MD
Plano Plastic Surgeon
4.9 out of 5 stars 38 reviews

Silicone, Saline & Gummy Bear Implants - The Differences

The type of breast implant used is one of the most important decisions facing patients undergoing breast augmentation surgery. Recently, cohesive gel implants have been introduced as an alternative to silicone and saline implants. These implants which are also known as gummy bear implants have a higher density silicone gel with a greater number of cross links. The implants are shaped and texturized to maintain their position.

These implants have several advantages and are especially helpful in women with small breasts. Under these circumstances they are less likely to have ripples or develop capsular contractures. They are associated with a natural shape and high patient satisfaction rates. When these implants rupture, the silicone doesn’t migrate into the surrounding tissue because of the gels thickness.

Although gummy bear implants have several advantages they also have disadvantages, these include firmness and the maintenance of the same shape regardless of the patient’s positioning. In addition, these implants can rotate which causes malposition of the implant and distortion of the breast.

It’s important to realize that each patient has specific anatomic findings and unique aesthetic goals that effect the choice of implant. For this reason it’s important to discuss this decision with a  board-certified plastic surgeon. 

Gummy bear breast implants

Gummy bear breast implants are filled with silicone that is more cohesive than the currently FDA approved silicone breast implants. Silicone can be any consistency from similar to water to a solid. The consistency is varied by changing how many cross-links are between the silicone molecules. The gummy bear implants have 3% more cross-linking. The FDA approved silicone gel implants have a silicone consistency similiar to honey, it also very tacky like taffy. This type of silicone flows in the implant; that is, if the implant is placed in a different position, the silicone will flow to the most dependent area of the implant, pulled by gravity. The top of the implant will lose volume and "collapse"; there is rippling.

The gummy bear silicone implants are called "form stable" because the silicone does not flow, the shape of the implant remains the same despite changing its position; gravity has no effect on the silicone. Because of this, the top of the implant does not "collapse" and there is very little, if any, rippling. It also has much lower leak rates compared to silicone gel implants according to the data accumulated so far.

There are other differences -- the gels are round, the gummy bear is anatomic shape, etc. The implants are available through plastic surgeons that are participating in the FDA approved study. If you have additional questions about this type of implant, please feel free to call my office. You can find other plastic surgeons who are participating in the study by contacting Allergan. Mentor also has a form stable silicone implant. Hope this helps.

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
4.8 out of 5 stars 27 reviews

Gummy bear implants?

Your question is not easy to answer without an examination or photographs. There is certainly not once size or type of implant fits all. Some women are more appropriate candidates for smooth walled implant while other are better candidates for textured shaped anatomic implants. It you have sufficient soft tissue to cover the implant and you have a normal distance from the inframammary crease to the nipple then a smooth walled gel implant will be fine. But if you have a short distance from the nipple to the crease, in the 3 to 5 cm range and the only shape of the breast is the implant then a round implant will look round and not as natural as an anatomic implant. In some individuals I believe that the shaped textured implants will prevent complications such as a double bubble or bottoming out and malposition because the texturing helps the implant stay where you want it. The dissection for a shaped device is much more meticulous than with a round device since a shaped implant must fit in like a hand going in a glove. I use both smooth and textured implants. The procedure must be individualized and your plastic surgeon should have experience using both types so that you can get the optimal result. I find one of the biggest differences between a smooth implant and a shaped implant is that with a shaped implant the implant shapes the breast and not the other way around. Educate yourself about both types and make the best decision with the help of your plastic surgeon.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 16 reviews

Gummy bear implants

Gummy bear implants are the latest generation of cohesive gel implants. These implants have a higher gel density making them more firm than the standard silicone implants. The gel inside both types of silicone implants is thick and cannot leak into the body, however gummy bear implants are thicker than standard silicone implants.

Although there is a possible safety advantage, this can also be a disadvantage to patients because the breasts tend to look and feel less natural due to the implants holding their shape better. The implant will fall less naturally in the pocket of the breast, similar to issues found with tear drop implants. These implants are still unavailable for widespread use and are still under strict testing guidelines, but are expected to become more prominent in the market after receiving FDA approval.

Gummy Bear implants

"Gummy Bear" implants are silicone implants that have two particular features:

1) They are firmer and retain their form more so than the normal cohesive gel implants

2) They can be manufactured in a shaped form so that the implant itself has a more full lower pole, and a tapered upper portion, much like the natural breast.

These implants have their proponents, and currently are only available from physicians who participate in studies to examine their use. I personally do not use these implants, because I don't like having a shaped implant behind the breast tissue. These implants look LESS natural when patients are not in an upright position, because they don't move and flow with the normal breast tissue naturally.

Additionally, if the implant shifts, the shape of the implant may not be correctly positioned, and the most protruding part of the implant may end up in an area of the breast that should not have significant protrusion. I have personally seen this problem with shaped implants more than once when I have been asked to revise previous breast augmentations in patients who have received shaped implants, and so i do not recommend them.

Current "cohesive gel" implants are softer and more natural feeling, and particularly when they are smooth walled (as are the ones I use), they can naturally move around much like normal breast tissue would. MRI examinations of current round breast implants have shown that they achieve a teardrop shape once placed in the breast and in the upright position, but return to a round shape in the reclining position--this is just what should happen!

It is more likely that these "gummy bear" implants will have more use in breast reconstruction, where the goals of the operation, as well as the method of the operation, are significantly different than in breast augmentation.

The term "gummy bear" implant can refer to one of two...

The term "gummy bear" implant can refer to one of two types of implants, depending on who you're talking to.

The new generation cohesive silicone gel implants, which are very commonly used now in the US, are sometimes referred to as the "gummy bear" implant because the new cohesive gel is different than the old silicone gel implants -- as the name implies, it is a more cohesive substance, and therefore is less likely to leak if the implant shell fails.

The "gummy bear implant" is also used to describe a "highly cohesive gel implant", which can be used primarily for breast reconstruction, as these patients have no remaining breast tissue to camouflage the implant.

In general, I prefer the standard cohesive gel silicone implants for most breast augmentations as I think they give a very natural look and feel, in particular if the patient is very thin or if we choose to place the implant above the muscle (these decisions vary based on the individual patient).

Patients can also obtain very nice results with saline implants as well, but it really comes down to sitting down with your doc and having a nice discussion about the advantages and disadvantages of each option.

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
4.9 out of 5 stars 144 reviews

Goldilocks and the Gummy Bears

Both saline and silicone implants have advantages and disadvantages. When you consider breast enlargement, the best way to decide whether to have saline or silicone gel implants is to learn more about the different types of breast implants and talk about your ideal outcome from this procedure with your board certified plastic surgeon.

"Gummy Bear Implant" is a fun marketing term, but it can be misleading as it used to describe various silicone implants brands and types. I think it also tends to mislead patients into thinking other "non gummy bear implants" are inferior. All silicone breast implants in the US market today are cohesive gel. This means the silicone is thick gel and not runny like syrup. The only difference is the fill (how much silicone gel is in the implant shell, how "full" it is) and how thick that silicone gel is. The actual term usually meant by saying "Gummy Bear" is a "Form Stable" Implant. This simply means the silicone gel is the most cohesive available and usually at a very high fill amount inside the implant shell. (Think gummy bear in shrink wrap versus jello in a ziplock bag!) Form stable silicone implants used to only come in a textured shaped implant, but as of this last month are now available in a smooth round implant as well. 

 A saline breast implant is a shell made of silicone filled with salt water. The implant is inserted empty then filled with sterile saline through a tube during surgery. Saline implants were first introduced in 1965. Over the years there have been many improvements in the shell integrity to decrease the chances of deflation, and in the valve to prevent leaks. Some advantages to saline implants can be a smaller incision, and therefore you have a smaller scar, they cost less than silicone and there is greater variability in size, because the fill level is adjustable. Something that is a positive to some patients, but a negative to others is that if you have a deflation with saline, it’s obvious. The harmless saline solution leaks away and your breast will be visibly smaller by the loss of volume. Another possibly disadvantage with saline implants are the feel that some patients say can be less natural than silicone and likelihood to show a rippling appearance, especially in thinner patients.

The slicone gel-filled breast implant is pre-filled with silicone gel. Silicone implants pre-date saline by a few years. When it comes to silicone implants, safety is everyone’s concern. We are now on 5th Generation silicone implants in America and MUCH has improved since their introduction many years ago. The FDA ban on silicone implants was lifted in 2006, because as most plastic surgeons already knew, there was no conclusive evidence of them causing any health problems. That being said, this ban and re-evaluation caused breast implants to become one of the most well researched and tested medical products on the market. If nothing else, we now have a product that is better than ever! Silicone implants have a slightly lower rupture rate and some patients say they are softer and have a more natural feel. One of the possibly disadvantages of silicone implants is that it is harder to detect when they rupture. We say this is a possible disadvantage because patients happily live unknowingly with ruptured silicone implants with no adverse affects for years. The silicone does not leak so there is no volume loss so they are not affected aesthetically. The only other disadvantages would be their higher costs from saline and they may require a longer incision, and therefore scar. Also, due to FDA regulations, only patients over age 22 can receive silicone implants.

For full disclosure you need to read the implant manufacturer’s brochure and the FDA patient information on breast implant safety. I make my best recommendation during a patient's consultation, but the final choice is always up to my patient.

One think I encourage you to do is to see multiple board certified plastic surgeons who can set realistic expectations based on the goal you want to achieve, not the product you may think that you want. We see many patients that make requests, but they don't exactly know what they're saying. For example, "I want High Profile Silicone implants." This patient could just want to look a certain way and thinks this implant is what will give her that outcome. An experienced surgeon will let you know when what you're asking for is not going to give you the outcome you requested and help educate you. A lesser surgeon will just say "Okay!" and move forward, leaving you responsible when you're unhappy with the outcome. Choose wisely!

William Aiello, MD
Orange County Plastic Surgeon
4.9 out of 5 stars 35 reviews

Gummy Bear Breast Implants vs. Saline vs. Silicone?

The current trend in breast augmentation is for a more natural result.  There are several new additions to the breast implant family that makes it much easier for your plastic surgeon to help you achieve a natural full appearance from your breast augmentation. One, the use of silicone implants has made a dramatic change in terms of the natural feel and shape women have after their breast augmentation. There are the traditional silicone implants and now the “gummy bear” silicone implants.  The gummy bear implants are a more cohesive silicone gel. This means that the gel stays together an is not a liquid as previous generations of silicone breast implants.  The benefit of a “gummy bear” implant is that the gel stays together if the implant has a leak.  Also the gummy bear implant can reduce the risk of rippling from your breast implant.  The silicone implants in general are much softer in look and feel than the saline implants which leads to a more natural appearance. This is because the saline implants are very firm and thus create a round unnatural shape. The other benefit of silicone implants over saline is the decrease appearance of rippling from your implants. Patients that are very thin are at risk for rippling, the use of silicone implants can help decrease this visible rippling as the new silicone implants have a cohesive gel that is much less likely to ripple.  The majority of my patients use silicone gel breast implants, as they tend to be softer, more natural and less likely to have visible rippling.  Please discuss your breast augmentation surgery with your board certified plastic surgeon and let them help guide you during the process.  He or she will be able to show you the range of silicone and gummy bear breast implants during your consultation.  

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.