Gummy silicone vs saline implants - which are softer?

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.

You'll likely get a different answer from each different surgeon. In my option the Motiva Ergonomix implant is the softest and most natural.

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.

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.

Dear Fabulous979442,

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

Dear Fabulous919442, thanks for sharing your concern, you can check the video below for more information. Make sure you go on consultation with a board-certified plastic surgeon. Hope this helps and best of lucks. Dr. Luis Mejia.

Hello and thank you for your question.
Yes, gummy bear implants tend to be softer and feel more natural than saline implants. The different manufacturers have a range of "Cohesivity" or gel thickness associated with their gummy bear implants. In general, the more cohesive implants feel a bit more firm, but still very natural. The other benefit of the gummy bear implants is that they tend to have less rippling than saline breast implants.

He did ultrasound testing and patient outcome surveys. You can read the article in the link below. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Hi! Thank you so much for your question! Yes, Gummy silicone implants are typically softer and feel more natural than saline implants.“Gummy” or “Gummy Bear” implants are made with a cohesive silicone gel that is designed to hold its shape while still maintaining a soft, natural feel. This closely mimics natural breast tissue. Saline implants are filled with sterile saline solution, similar to what is found in an IV, and can feel firmer or rounder. This can be more noticeable in patients with less natural breast tissue or who have thinner frames. Softness can also be influenced by Implant placement (under or over the muscle), the size and profile of the implant, and how much of your own breast tissue is present. A consultation is the best way to compare options based on your goals and anatomy. Typically, you will be able to see, feel, and compare each implant type and try the implants on, utilizing a special bra to decide on the sizing and profile you prefer as well. 3D images may be offered to show how the results may look after your procedure. Ultimately, the implant you choose is a deeply personal decision and depends on the overall look and feel you want to achieve.

Both implants are rather firm. The regular gel implants are the softest of all the implants. I am not a fan of the gummy implants because of their firmness.