Soft touch vs cohesive - Any difference in the way they look in the long term?

Great question!  The cohesive gel will feel more firm than the soft touch which is more firm than the responsive line.  The more firm you go, the less chances of rippling, however the breast do feel more firm.  I don't think there is really a big difference between these long term.  I use the responsive line which is the softest since my patient population tend to want the soft and squishy breast and haven't had any patient issues, so these firmer gels you like should not cause any long term issue as far as looks are concerned.Best of luck and hope this information helps!
- Dr. Roger Tsai  @DrRogerTsai
Board Certified Plastic Surgeon

The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Dear TAGEBO,Thank you for your question. In my practice implant choice is really dependent on the patient. I find that younger patients tend to want firmer, cohesive implants while older patients with fattier breasts tend to prefer softer implants. The advantage of cohesive gel implants is if they rupture, the silicone tends to stay with the implant rather than move around the breast pocket.Best regards,Nirmal R. Nathan, M.D.Certified, American Board of Plastic SurgeryMember, American Society of Plastic Surgeons

Both these implants are cohesive gels! However, different manufacturers will have their own terms and marketing concepts.Ultimately it is down to choice and patient preference, and 'feel' often guides decisions which is fine! Go with your gut feeling. The choice of size is more critical and the education process pre-operativelyGood luck!

TAGEBO Excellent question. There is now a myriad of choices with regard to style, shape and type of breast implants available. Each have pros and cons and it is important to understand those prior to selection of your implant. For example, the higher cohesive silicone implants can be firmer and less natural feeling in some cases. Discuss these differences with your board-certified plastic surgeon and be prepared with questions about each type of implant, the pros and cons, and which should be the best option for you. Good luck.

The choice of implant style is really a  decision related to how you want to look post operatively.  Some women want a very "natural" look, while others want to look like they had an augmentation.  The highly cohesive implants were developed to maintain the upper pole fullness and create a long term, round shape.  However, patients liked the shape, but not the firm feel.  The soft touch was brought out to achieve a softer feel and a higher, more round shape.  This tends to be a more youthful look, as opposed to the slope shape of the responsive traditional implant.  In general, most patients prefer the soft touch over the firm highly cohesive.  There is no long term difference between those two implants.  Good luck with your decision.

Both are excellent options.  The Cohesive has a little thicker gel and ripples less.  Under the muscle it probably doesn't make a big difference. If you have an element of  skin laxity I favor the Cohesive. On top of the muscle Cohesive may be a better option.  Really it boils down to patient preference.

Thank you for the good question.  
All of the FDA approved breast implant manufacturers provide good products. Each of the manufacturers will use different terminology when it comes to describing their breast implants (and each will claim that they have the "newest" and "best" breast implants).  
Personally, I think that careful selection of plastic surgeon and careful communication goals are  the two most important "factors" when it comes to achieving the desired outcome with breast augmentation surgery.  The specific breast implant manufacturer and even type of breast implant are far less important factors, in my opinion.
 Much of the final look and feel achieved after breast augmentation surgery depends on several factors:
1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the preoperative breast appearance the more likely the breast augmentation “look” will be optimal.   The more soft tissue a patient has present, the less important the type of breast implant is.
2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing long-term well-placed breast implants. Careful measurements (dimensional planning) and careful selection of breast implant size/profile are part of the surgeon's  responsibilities.   Similar to point #1,  the more precise the breast implant pocket dissection, the less important the specific type of breast implant becomes.
Again, I personally think that these 2 factors are more important than any others, including type (saline or silicone) or model (low/moderate/high profile) of implant.
3. The type of implant used may determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. In other words, if a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.   For patients with an extreme paucity of soft tissue coverage, the specific type of implant (for example, more gel fill per shell) may be more important when it comes to aesthetic concerns such as breast implant rippling/palpability.
4. The size and model of breast implant used may make a significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C or D cup” etc. may mean different things to different people
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
To summarize, my best advice: select your plastic surgeon very carefully. Make sure that he/she has significant experience achieving the types of outcomes you will be pleased with. Then, communicate your goals carefully, as  well.   I find that the use of goal photographs and computer imaging are very helpful during this communication phase. Working together you will come up with a good plan to achieve your goals. 
 Best wishes.