Does highly cohesive implants look fake?

Hello, thank you for your question. Highly cohesive implants have nothing to do with how "fake they look" highly cohesive is a description of the silicone molecules inside the implant. The type of profile you use determines the look you desire. So highly cohesive moderate profile vs high profile can give you two different looks. I would suggest bringing in wish photos of women with a similar physique as you.

In and of itself, highly cohesive implants don't necessarily look fake. When combined with increase shell fill (like Natrelle Inspira implants), a higher implant profile, a larger implant volume, and a thinner soft tissue envelope, the result will likely look unnatural. It's not a simple formula and unfortunately only the surgeon can help guide you.

Dear amj1104,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Hi, thank you for sharing your question. The cohesivity of the gel does not impact the projection. It describes the cross linking between the silicone.

What makes implants look fake is going too large for your frame and tissue and/or placing the implants just behind the breasts in women with little breast tissue. The cohesiveness is related to how soft the implants will feel.

All the silicone implants are cohesive now and Sientra are the best (data supports that). The alternative, saline implants, will look and feel much faker. Ultimately, it is the surgeon and the size chosen that will determine how you look. Make sure you pick a surgeon that consistently gets natural results and has a lot of experience.

No they do not need to look "fake". There are different degrees of cohesive gels so some are softer than others. I recommend you discuss this further with a Board Certified Plastic Surgeon so you are at peace going into the surgery.

I’ve found that there is not so much of a difference in the look of the cohesive gel as much of the feel. The thicker the implant, the firmer they generally are and feel.
There are multiple shaped silicone implants. If you desire upper pole fullness without too much fake look, consider a Moderate plus X silicone implant (made by Mentor).
Best wishes.
Dr. T

The best way to determine if they look "fake" to you would be to look at the postoperative photos from the plastic surgeon that you are seeing. They should be able to provide you with information such as the cohesivity level of implants of various patients.

Hi and welcome to our forum!
Cohesive gel breast implants are more viscous than silicone gels, tending to maintain their shape. In addition, the cohesion may slow migration of silicone if there is implant rupture and will have less tendency for unnatural rippling. The implants will not look "fake", with a natural softness superior to saline implants.
Implant profile will determine projection. High profile implants may look somewhat "unnatural", especially in smaller framed individuals.
Best wishes...