Gummy bear implants are the newest generation of silicone breast implants used for breast augmentation. They are otherwise known as form stable cohesive gel implants and have been used for breast enhancement for years in Europe and South America, before recently receiving FDA approval in the U.S. These implants were developed with two goals in mind: 1) decrease the gel bleed and associated problems in breast augmentaton from more liquid silicone implants and 2) control the shape of the breast in breast augmentation. As of the time of this edit, May 2013, there are two implant manufacturers with FDA approval for their gummy bear implants in the U.S., Sientra and Allergan. Mentor gummy bear implants are expected to receive FDA approval very soon. In Utah, gummy bear implants are growing in popularity at an astounding rate.
The terminology can be confusing. Gummy bear implants are a term used to describe a form stable silicone implant. These are also referred to as tear drop, anatomical, or cohesive breast implants. Silicone can be cross-linked to alter its form from a thin liquid to a firm, solid, stable mass. The cohesive gel implants have been developed with a greater degree of cross-linking than previous implants. The current round silicone implants fall somewhere in between older generation silicone and form stable cohesive silicone gel implants as far as cross-linking is concerned.
- Mentor – Contour Profile Gel (CPG) implant
- Allergan – The style 410 was the original cohesive implant. These are sized based on volume, height, and projection with 12 possible shape choices for each size.
- Sientra – Cohesive gel implants.
The advantages of form stable cohesive “gummy bear” implants over current silicone gel implants include:
- Improved breast shape – the breast implant can hold its shape and effect the overlying tissue
- Less capsular contracture – capsular contracture is in part due to silicone “bleed” from the breast implant. There is theoretically less “bleed” in a cohesive gel implant.
- Decrease risk of implant rupture – Breast implant rupture is often caused by a “fold flaw” in the implant. This is an area of repeated folding on the breast implant that eventually causes it to wear out. The gummy bear implants may have decreased folding due to their form stable nature.
- Decreased risk of rippling of the breast
Form stable cohesive gel “gummy bear” implants have their disadvantages as well:
- Increased cost
- Feel – they are slightly firmer than standard silicone gel implants.
- Longer scar – the implants are not able to be squeezed through the same size of incision as other silicone implants
- Possibility of rotation. The implants are “anatomic” or “tear-drop” shaped and there is a possibility that the implant could rotate early in the healing process leading to an unusual shape. This was quite common with anatomical shaped saline implants but is not as common with gummy bear implants due to improved weight balancing.
- Difficulty with secondary surgeries such as removal and replacement of implants due to the textured surface of the implant causing ingrowth of tissue onto the implant capsule
- Less upper pole roundness. Lets face it, not all women like the natural breast look and want maximal roundness of the upper breast.
Choosing between the expanding options for implants for each patient is a difficult process and one that takes careful communication between the patient and their plastic surgeon. In my Utah breast augmentation practice the key components to this process are.
1) Getting on the same page with a patient regarding their desired breast shape. Natural, slightly augmented, very round…
2) Determining the size of implant a patient desires. Based on goals, body type, and trying on implants
3) Imaging available implant options with Vectra 3D imaging to show the patient possible outcomes with different implants
I have been using gummy bear implants in Utah for several months now and have been thrilled with the outcomes. There are just some additional factors that can be controlled that cannot be adressed with traditional round implants in some patients. Careful selection and planning of tear drop implants is a must.