The regular Natrelle implants (style 10, 15, 20, 45) are round implants made by the same company (Allergan) and have the same type of moderately cohesive (non-gummy bear) silicone gel as the Natrelle Inspira Responsive implants. The only difference between these implants is the fill ratio of silicone. The regular Natrelle implants are 84% full with silicone while the Inspira implants are 95% full with silicone. The greater fill percentage of the Inspira implants creates less rippling and a more full, attractive appearance of the breast compared to the regular Natrelle implants. For this reason, most surgeons using Natrelle implants have transitioned to using Inspira responsive gel instead of the regular Natrelle implants. The Inspira Responsive implants became available in the US by FDA approval in February 2015 with a smooth shell and June 2015 with a textured shell. In September 2016, Inspira implants became available by FDA approval in a highly cohesive (gummy bear) silicone gel, which was named Inspira Cohesive. The Inspira Cohesive implant has the same gel as the Natrelle 410 anatomic (tear-drop shaped) implant. In January 2017, Inspira became available by FDA approval in a softer highly cohesive silicone gel, which was named Inspira SoftTouch. Therefore, there are now many different implant options by Natrelle, each with its own advantages for use in breast surgery to fit each patient's unique characteristics. Ziyad Hammoudeh, MD