Do gummy bear implants droop too low when settled in? Also, how bad is scarring from incision?

Question

Do gummy bear implants droop/hang too low once settled in? My friend got hers only a year ago,400cc's, and she feels like they look a little old lady-ish already! But then I read about tons of people that love them. I'm starting to get nervous, surgery is soon. I've had round saline implants for the last decade, but really desire a more natural look....Also, curious about people's experiences with scarring since the incision has to be quite large...

Shlomo Widder, MD · Answer

Dear Nikki,
   Front and side view pictures of your chest would have been very helpful, to figure out what is wrong with your saline implants. Corrective surgery in the right expert surgeon's hands can create a very attractive and natural looking breasts.
   I have been in practice for over 29 years and performed thousands of breasts augmentation surgery with, almost exclusively,  smooth, round, moderate profile saline implants made by Mentor. Many of my patients who had breasts augmentation surgery were mothers and daughters and it would be inconceiveable  that a mother would have referred her daughter to me if she was unhappy with her breasts augmentation with saline implants...
   I do not  recommend 'gummy bear' implants for the following reasons:
  1. Cost much more than saline implants.
  2.  Long entry incision is needed in the submammary fold , which is scar unfriendly, while saline implants require short entery incision in the sub areola line which is very scar friendly.
  3. The sub areola incision , allows for the creation of consistently nice cleavage , while the sub mammary incision is too far for easy and safe dissection and if you will check the before and after pictures of that technique, you will see frequently wide cleavage !
   4. The 'gummy bear' implants require tight pocket, in order to prevent them from flipping, which gives an unnatural feel for the breasts.
   Always, consult with experienced board certified plastic surgeons who perform surgery in accredited surgery center for your safety. Most importantly , check the before and after pictures in the photo gallery of redo breasts augmentation , to make sure that they are numerous, consistent and attractive with nice cleavage, perky, symmetrical and natural looking.
                          Best of luck,
                                             Dr Widder

Ram Kalus, MD, FACS · Answer

"Gummy bear implants" are textured, and therefore will not move once placed. They tend to get fixated in position, and therefore their original placement and positioning is critical. That being said, a "natural" appearance is absolutely not dependent on the use of a "gummy bear" or "form stable" or "anatomic" or "shaped" implant compared to the round implant. The "natural" appearance relates specifically to the size and projection of the selected implant, and this is entirely dependent on proper planning by your plastic surgeon. They do, however require a longer incision, and they uniquely have a risk of rotation, which does not exist with round implants. To share with you a recent presentation by a plastic surgeon to a conference hall full of plastic surgeons, (I among them) at one of our international meetings, images were presented of women following breast augmentation and the audience (all plastic surgeons) were asked to vote if they felt the patient in the photo had "gummy bear" or traditional "round" implants. The voting results were essentially 50% correct, meaning, no better than a coin toss, meaning that one cannot tell the difference. The bottom line is that your plastic surgeon needs to be experienced and knowledgable in properly evaluating his or her patients and making good decisions regarding implant selection based on patient preference and physical examination. The type of implant selected is far less important than the dimensions (width, projection, and volume) and the surgical technique employed, including the placement of the implant and its position in relation to your breast.  If in doubt, discuss your concerns with your plastic surgeon. If you remain insecure about your decision, I recommend a second, or even third opinion before proceeding with scheduling your surgery. Best of luck to you.

Randy Proffitt, MD · Answer

There is a lot of use of the term "gummy bear" implant and people sometimes misuse it.  If your are talking about a shaped implant, then all of them will not move much once implanted.  If you have a significant amount of breast tissue beforehand you may not be a good candidate for a shaped implant. A shaped implant may require a slightly longer incision to insert than a round implant and certainly a saline implant. The type of implant however has nothing to do with how the scar will heal and look.   All the shaped implants are 5th generation silicone which is the more cohesive silicone gel, that is what gummy bear refers to.  There are also round smooth and textured implants which are 5th generation silicone gel implants.  They can move a little more in the pocket, especially smooth walled. A lot of the shape of your breast has to do with your anatomy also, and not the implant itself.  Find a board certified plastic surgeon to discuss all of this with you and what your options are.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.  In my experience gummy bear implants do not drop anymore and saline implants or smooth round cohesive silicone gel breast implants.  The most important factors contributing to implant dropping R the surgical technique,, the size of implant–very large implants drop more, and the quality of your skin and tendency for your skin to drop.  Of course discuss your concerns with your plastic surgeon.

Do gummy bear implants droop too low when settled in? Also, how bad is scarring from incision?

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