What is the difference between cohesive implants and highly cohesive implants : texture, solidity ?

Thank you for your question! Allergan Natrelle implants have 3 options for silicone gel each of them ranging in level of cohesivity. These gels are known as: Responsive (least firm), Soft Touch (middle), and Cohesive (most firm). The type of gel that you select is dependent on budget as well as desired outcomes. The cohesive gel will maintain its shape the most against gravity and is ideal for someone who does not have much breast tissue. In my practice, Soft Touch implants are the most popular because they have a natural feel and look and still maintain shape. I would make sure you discuss all options with a Board Certified Plastic Surgeon and make sure it is one that specializes in breast procedures. Best of luck to you!

Very important questions. The cohesivity describes the amount of crosslinking of the silicone in the implants. The more cohesive the implant, the firmer and also the less it will change with gravity. Essentially what this means is that it will have greater upper breast roundness. This ultimately makes it look a bit more towards the artificial side. Cohesive implants can also be helpful in women with thin breast tissue because there is a lower risk of wrinkling at the edges of the implants. I hope this helps your decision.

Best wishes,

Dr. Jan

Gummy Bears are highly cohesive or form stable and typically require a deeper incision. The silicone in Gummy Bear implants have a much high cohesiveness than cohesive gel implants meaning they have a lower likelihood of toxicity. Some say the feel of the Gummy Bear is like jello; other silicone implants, like honey. You can feel them in your PS's office and determine which is best for you.

Hi there, thank you for your question. The gel structure of them are different basically. Cohesive is more soft while high cohesive has more durable form.

The higher the cohesiveness of the implant means the implant will be a bit firmer (though still soft). The higher cohesive implants tend to maintain their shape a bit better than the lower cohesive options. At consultation, your surgeon should be able to provide you with examples of each to feel for yourself. Often, the high cohesive implants are a bit more expensive. The shells (or outside coating) of the implants are the same so they provide the same strength. As always, be sure to research your surgeon before going under the knife.

All silicone implants marketed in the USA today are more cohesive then they were 30 years ago. The shells are thicker as well.The highly cohesive implants may give more projection then the softer less cohesive implants. The less cohesive feel more natural to me...

Hardness of the implant may be desirable feature in some occasions and for some patients. Highly cohesive implants (harder) are used in our practice very rarely and mostly for reconstructive purpose since they seem to retain shape under tight skin envelope better. They are also textured, in order to maintain their position, a feature that is less popular these days when we are seeing increase in ALCL, a potentially malignant breast disease related almost exclusively to textured implants.
It is very hard to feel the difference between highly cohesive and cohesive implant based on touch and examination in most patients a year or longer after surgery. Hope this may help.

I appreciate your confusion, and you are not alone!
The cohesive nature of silicone implants became a talking point when the original “Gummy Bear“ anatomical implants first came out years ago. These implants had greater cohesiveness but were significantly firmer than the regular silicone implants of that generation. At the time it became a popular choice because of rave reviews from Europe were they had been used for years prior and an excellent marketing campaign by the manufacturer.
In reality these implants were way too firm for many individuals and did not feel natural. The newer generation silicone implants have different degrees of cohesiveness, and generally speaking, I recommend Choosing an implant with moderate cohesiveness to maintain a natural and soft appearance. However this is an individual choice, because some patients prefer larger firm breasts. Consult with a board-certified plastic surgeon in our area to explore the best options for you. Good luck!

Thank you for your questions. Implant choices today are more than ever before and it can indeed be very confusing. A breast implant is made up of a shell made of silicone (a plastic rubber type envelope) and that shell or envelope can be either smooth (like a beach ball) or textured (like Velcro). The inside contents of a breast implant may be most commonly silicone gel, or saline (salt water). The silicone gel filled implants are pre-filled and sealed from the factory, and the saline implants arrive sterile yet empty and are filled to the proper volume during the time of surgery by your plastic surgeon.

Cohesivity refers to the firmness or softness of the gel within a breast implant. The higher the cohesivity ('highly cohesive"), the firmer. Some women (and/or their partners) prefer one versus the other and that is a personal choice. The "anatomic" or "gummy bear" or "shaped" or "form stable" implants are all terms for highly cohesive implants, all of which will be with textured surfaces, since they need to be oriented one correct way because of their shape. A round implant is always round and therefore cannot have an incorrect orientation, yet the degrees of cohesivity (firm versus soft) can also occur in round implants, which can be either textured or smooth.

While all of this can be very confusing, it is important that you consult with a board certified plastic surgeon who can review all of your options with you, and explain in more detail the reasons why any one implant may be best for you. Best of luck to you.

The highly cohesive implants are firmer feeling and not my preference for breast augmentations. The strength of the implant is related to the bag, which is the same between the two types of implants. I only use the smooth round implants which have fewer long term problems of rotation issues and late seromas if the textured bag is pulled away from your tissue.