Silicone gel implants for breast enlargement

Since 2006, silicone breast implants have been FDA-approved for use in the United States, after being removed from the breast implant market in the early 1990s. In previous posts, I have discussed the pros and cons of silicone vs. saline breast implants in my northern Virginia cosmetic breast implant surgery practice.
Now there is a “new kid on the block”—the gummy bear implant. Actually, the implant hasn’t been approved in the US just yet for use in breast enlargements but has been used by European plastic surgeons for augmentation of the breast for a few years.

Types of silicone breast implants

There are historically three types of silicone breast implants:

Classic silicone gel breast implants

These implants are the type that was used up to a few years ago. The outer silicone shell of the implant was either smooth or textured. The inner silicone filling was a gel the consistency of honey. Once a breast implant was ruptured, the gel leaked out of the body, first into the scar tissue surrounding an implant and then into cells, after which it was transferred around the local tissues.
A leaky silicone implant has to be removed, and the surgery is messy.  As part of the research done over the decade when silicone implants were not available in the US due to health fears from the silicone, new types of implants were developed. By the way, no health risks have ever been shown to be associated with silicone breast implants for cosmetic breast enlargement.

Cohesive silicone gel breast implants

These silicone implants have been in use for a number of years and are approved by the FDA for breast enlargement in the US. The US manufactures Allergan and Mentor chemically altered the silicone gel to make it more “cohesive” or frim. When these implants are cut, there is no longer an oozing of silicone gel; rather, the gel holds itself together as if it were made of firm gelatin. Cohesive implants come in a number of different “profiles,” or shapes, based on the diameter and height of implant that that is suited for each cosmetic patient. Other than that, the implant is really the same as any other silicone implant, though it may be a little firmer than a liquid gel implant.

The cohesive silicone gel breast implant used by Dr. Tavallali does not drip silicone

silicone gel implants

Gummy bear silicone gel  breast implants

  • A gummy bear breast implant is only the latest type of cohesive gel breast implant. The gel has been made even firmer so that the breast implant actually retains its “shape of a breast” or its “contoured” look outside the body when sitting on a table.
  • The outside of gummy bear implants are also textured so as to decrease the risk of capsular contracture in cosmetic breast surgery.
  • These implants are firmer, so breast incisions have to be larger than for a cohesive gel implant, which can still be squished around into a small cut.
  • Another disadvantage is that since the implant is narrower at the top and wider at the bottom, like a pear, it can actually flip and cause an upside-down breast that then requires another surgery.
Gummy bear implants are now available in the US.

Gummy bear silicone implants are firmer

gummy_bear_implantThe engineers and designers of breast implants seem stuck on a few concepts regarding breast implants that have never been shown to be of any value to cosmetic surgery patients. They just keep hitting their heads on them again and again. The gummy bear implant has a textured surface to supposedly decrease the rate of capsular contracture scar tissue forming around the implant. Though this may work for implants placed over the chest muscles, the rate of capsular contracture for textured implants has not been shown to be lower when implants are placed under the muscle. A contoured shape in implants is another design that has been shown time and again to be more trouble than it’s worth. In a classic study done a decade ago, a plastic surgeon showed that all implants, contoured or not, are “anatomic” in their shape when inside a body. After all, we are all subject to gravitational effects, and all implants end up looking like pears inside the body. The gummy bear offers no advantage on that point.

Gummy Bear vs. cohesive silicone gel breast implants in my view is no contest. Gummy bears are just too hard.

With the larger scar, firmer (gummy-bear-hard) feel, risk for implant flipping and the obvious higher cost, I’ll keep my gummy bears limited to what I can buy in the grocery store.

Morad Tavallali, M.D., FACS

Cosmetic Plastic Surgeon