There have been two new silicone gel implants approved by the FDA since March of 2012. Each is a type of implant that is commonly called a “gummy bear” implant, because the consistency of the new generation of silicone gel resembles that of the popular candy.

Up until these implants were approved, the most commonly used implants in aesthetic surgery were round. They contained cohesive silicone gel. The newer gummy bear implants contain highly cohesive gel which allows them to be form stable, or to maintain their shape at all times.

There has been a lot of chatter about these implants in blogs and discussion forums because each of the implants—the Natrelle 410 from Allergan and the Silimed line from Sientra—have been available outside of the United States for a number of years. Breast augmentation patients were clamoring for the products because they felt they offered more choice and a superior result. But were they right?

They do offer the consumer more choice. The Natrelle 410 is an anatomically shaped implant, while the Silimed line is available in both a shaped and a traditional round shape. Each is available in a number of sizes and profiles.

But are they better? During the trial period, I was one of the post-operative investigators who examined patients with gummy bear implants. After viewing the results of many augmentations with these implants, I identified the following issues that don’t match well with my ideal aesthetic result: natural in feel and appearance.

  • They are much firmer than smooth-walled cohesive gel implants
  • The textured or rough outer shell is thicker and easier to feel
  • They are less mobile than a natural breast
  • They require a larger incision

I have been using the smooth cohesive silicone gel implants with great success since 2006 and do not plan to switch. Because I had first-hand experience with the shaped gummy bear implants during the clinical trials, I was able to make direct comparisons between the results created with smooth cohesive gel implants and those provided by the newly approved textured highly cohesive gel implants. As a result, I realized that I am happier with the results I have seen in my patients than with those obtained from the gummy bear implants. I do think that textured, anatomically shaped highly cohesive gel implants may offer an advantage in reconstructive breast surgery as they recreate the shape of the breast that is lost after cancer surgery.

There are many innovations in my field that have proven to have great value for both patients and plastic surgeons. For example, my patients are very enthusiastic about using 3D imaging to simulate breast augmentation results, and I feel this is a valuable tool in planning aesthetic breast surgery. While I don’t plan to switch to gummy bear implants in my practice, I am happy to say that cohesive gel implants are here to stay and are allowing me to create wonderfully natural results.

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