Gummy Bear Breast Implants vs Saline or Silicone?

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. 

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.  

Gummy Bear breast implants are a 5th generation highly-cohesive silicone gel implant.  What this means is that the silicone in the implants are no longer liquid, but a highly cross linked silicone which is like a gel.  Therefore, when one of these implants are cut in half, they do not leak and they maintain their form and shape.  If a rupture occurs, the silicone does not leak into the surrounding tissues or migrate to lymph nodes like older implants. Also, there is less chance of rippling with these types of implants because they keep their shape better.  They are a little more firm and that can be a drawback for some and an advantage for others.  There are round and shaped anatomic (tear drop shaped) gummy bear implants.  Saline implants do not look or feel as natural as silicone implants in the majority of cases. Seek a consultation with a board-certified plastic surgeon, by the American Board of Plastic Surgery, in order to discuss which implant is best for you. 

"Gummy Bear" breast implants are silicone gel implants.  The silicone gel in the "gummy bear" implants is more cohesive than traditional silicone gel implants, meaning there are a greater number of cross-linkages among the silicone molecules.  The greater cohesiveness of the "gummy bear" or cohesive implants allows them to maintain their shape better, thus giving breast implant manufacturers the option of more aggressively shaping the implants, so that, for instance, the lower pole of the implant can have more projection than the upper pole, thus avoiding the appearance of a "shelf" that can sometimes be seen in patients who have undergone breast augmentation.  The increased cohesiveness also means that silicone gel is less likely to leak from the breast implant should a tear occur in the shell surrounding the gel inside the implant.  However, because these "anatomic" breast implants are shaped and not round, they must be placed precisely in a tight breast pocket that prevents them from rotating off the midline, as this may make the breast look cockeyed or misshapen.  It is for this reason that most of the anatomic cohesive gel breast implants that we place in our patients have a textured shell that attaches to the scar tissue, or capsule, that forms around the breast implant, thus fixing the implant in place, and preventing its rotation

At this point in time, I use smooth, round silicone implants in the submuscular position in all cosmetic breast patients. I feel that this scenario is safest for patients, and offers the best cosmetic outcome, in my experience.

For all intended purposes, there are two types of implants:  Silicone and Saline.  These two categories can be divided up further.Saline:  these implants are made of a silicone shell but the fill is physiologic salt water.  There are two types of saline implant currently available: Traditional vs Ideal Implant.  The Ideal implant is a saline implant like the traditional saline implants but has multiple lumens and baffles to help slow down the movement of the saline fluid that is inside the shell.  This helps improve the feel and rippling that is inherent with saline implants.Silicone:  there are now several different cohesiveness levels of silicone.  All silicone can be considered "gummy bear" as the silicone gel sticks together and are bonded strongly incase there is a shell break, the gel will remove as one.  However, with the newer cohesive gels, the bonding has been increased there for making the gel implants more firm to help decrease the rippling even further as well has maintain the "upper pole" of the breast.  Currently there are 3 levels of silicone gel cohesive implants:  Responsive, Soft Touch, Cohesive.Hope that helps.

Gummy bear breast implants refers to implants that are shaped and contain highly cohesive silicone gel. "Highly cohesive" means that the inner silicone is actually a solid, and is no longer a silicone liquid. There are now highly cohesive round silicone gel implants also. These implants maintain fullness in the upper pole of the breast. Choosing breast implants can be confusing and sometimes you may feel like you need to do all of the research to choose the perfect implant for you. I would focus your research on finding a safe and caring board-certified plastic surgeon. A good surgeon will spend a lot of time with you during the consultation. They should explain the surgery, the differences between the different types of implants, how to select the implant size and help you plan for the recovery. They should be telling you all of the information that you need to know to proceed with confidence. Good luck with the process!

The term "gummy bear" implant is widely used but poorly understood.  Initially, this term was coined to describe form stable or anatomic type implants which held a tear drop shape.  However, in the last several years, this term is being applied to cohesive silicone implants which are round and not form stable.  These implants contain a cohesive silicone which resists extravasation outside the implant capsule.  Allergan, Mentor, and Sientra make both form stable and cohesive implants which fall under the general description of a "gummy bear" implant.

Silicone implants that are a little firmer in consistency are called gummy bear, but really the terms have become interchangeable.

Cohesive gel?…Form stable?...Gummy Bear?…what do these terms have in common? With
the recent introduction and FDA approval of the next generation of devices, the
attention of patients, physicians and the media has been focused on these
terms. While these devices have certainly captured the public’s attention, an
in-depth understanding continues to evade most.



Following the
FDA moratorium on the use of silicone gel filled breast in 1992, “cohesive gel implants” were introduced
to the market. How do these devices differ form their predecessors? The
silicone gel of a cohesive gel implant is firmer (via the addition of
proprietary cross-linker). The greater the cross-linking the firmer the device
will feel. The result is a filling that doesn’t leak when the shell is
compromised in the way that a traditional liquid does. This quality is best
illustrated when cutting a device in half…doesn’t yield a gooey mess but
instead two stable halves.



Generally
speaking today’s silicone implants are all “cohesive
gel implants.” This broad term has been inappropriately applied to the next
generation of “highly cohesive gel
implants.” However, the recent media attention on “cohesive gel implants” is not warranted and is in fact misplaced.



These newest
devices to reach the market are form
stable implants. These higher
strength silicone gel implants were approved by the FDA in March 2012. They
contain a more “highly cohesive gel.”
This increase confers upon these devices the ability to maintain shape
irrespective of position. This quality has earned them the informal nickname of
“Gummy Bear” implants. Imagine
cutting into a gummy bear candy and the effect is the same.



While these
implants are new, “novelty” does not necessarily equal “better.” There is a
device for every patient. Form stable implants have both
advantages/disadvantages. The advantages are: shape retention, no shell
folding/wrinkling, no leakage, decreased capsular contracture. The
disadvantages include: increased cost, limitations related to access incision, increased
technical difficulty, device rotation.



There are
currently 3 devices with FDA approval available to the public at large. They
are the Allergan/Inamed 410, Mentor Memory Shape, Sientra. Each represents a
different point along the cohesive gel spectrum, the former being the firmest
and the latter the softest.



In general, traditional silicone implants are preferred over
saline implants by many patients and surgeons for their more natural feel. As
when making decisions about any form of surgery, patients should have an
in-depth consultation with their board certified plastic surgeon before
selecting the type of implant to use. While form stable anatomic implants are
newer, they may not be suitable for all patients.