In general, gummy bear implants are great for the explanting surgeon, as the silicone is not runny. That said, MRI's are not usually able to detect leakage and have a 15% false negative rate for ruptures. And in my experience, the women with leaking implants begin to have multiple problems well before they rupture. Please see my answer to another patient who asked if silicone implants can cause autoimmune disease. I also find that women with textured implants can have increased problems over smooth implants as the texturing may enter the lymphatic system over time and cause interaction with the immune system.The answer to this is two fold. In certain patients with genetic HLA types, silicone exposure of any type leads to autoimmune disease fairly quickly. These are HLA B27 and HLA DR53 as identified in the medical peer reviewed literature. In my experience, women with these genetic types become ill very quickly after any silicone exposure, even saline implants. For a FDA research scientist's story of this illness in herself, please see The Naked Truth About Breast Implants. Treatment is explantation with total capsulectomy, silicone and chemical detoxification and immune and endocrine support.For women with leaking or ruptured silicone implants, autoimmunity can occur with time and silicone exposure due to two mechanisms. One is silicone itself, which acts as an adjuvant, and the other is via depression of T cell immunity which makes intracellular infections much more common. Intracellular mycoplasma is a known cause of autoimmune disease. Treatment would be explantation with complete capsulectomy as there is silicone in the scar tissue, silicone and chemical detoxification, immune and endocrine support and of course, treatment of the intracellular mycoplasma. These women also usually need treatment for multiple viral infections as well as yeast and in some cases mold in the biofilm.