Gummy silicone vs saline implants - which are softer?

The newest generation of silicone breast implants feel very soft and natural. The highly cohesive gel within these implants also helps the implants to hold and maintain their shape. Saline implants, filled to the minimum of their fill range, can also feel soft, but have the downside of more rippling of the implant shell. For that reason, it is very common for a saline implant to be filled to the high end of its fill range which helps to round out the shell and decrease the wrinkling of the shell at least early in their life. As the saline implant gets filled to the high end of its range, it feels firmer. During your consultation with your plastic surgeon, you should examine and palpate the different types of implants available so that you can make your best decision. Best wishes.

Saline implants feel more like a thick-walled water balloon, whereas silicone (the new cohesive gel silicone ) implants feel much more like natural breast tissue.

Cohesive gel?…Form stable?...Gummy Bear?…what do these terms have in common? With the recent introduction and FDA approval of the next generation of devices, the attention of patients, physicians and the media has been focused on these terms. While these devices have certainly captured the public’s attention, an in-depth understanding continues to evade most.
Following the FDA moratorium on the use of silicone gel filled breast in 1992, “cohesive gel implants” were introduced to the market. How do these devices differ from their predecessors? The silicone gel of a cohesive gel implant is firmer (via the addition of proprietary cross-linker). The greater the cross-linking the firmer the device will feel. The result is a filling that doesn’t leak when the shell is compromised in the way that a traditional liquid does. This quality is best illustrated when cutting a device in half…it doesn’t yield a gooey mess but instead two stable halves.
Generally speaking today’s silicone implants are all “cohesive gel implants.” This broad term has been inappropriately applied to the next generation of “highly cohesive gel implants.” However, the recent media attention on “cohesive gel implants” is not warranted and is in fact misplaced.

These newest devices to reach the market are form stable implants. These higher strength silicone gel implants were approved by the FDA in March 2012. They contain a more “highly cohesive gel.” This increase confers upon these devices the ability to maintain shape irrespective of position. This quality has earned them the informal nickname of “Gummy Bear” implants. Imagine cutting into a gummy bear candy and the effect is the same.
While these implants are new, “novelty” does not necessarily equal “better.” There is a device for every patient. Form stable implants have both advantages/disadvantages. The advantages are: shape retention, no shell folding/wrinkling, no leakage, decreased capsular contracture. The disadvantages include: increased cost, limitations related to access incision, increased technical difficulty, device rotation.
In general, traditional silicone implants are preferred over saline implants by many patients and surgeons for their more natural feel. As when making decisions about any form of surgery, patients should have an in-depth consultation with their board certified plastic surgeon before selecting the type of implant to use. While form stable anatomic implants are newer, they may not be suitable for all patients.