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Board Certified Plastic Surgeon | Plano, TX

Posted April 19, 2019 in Gummy Bear Implants

Okay, you’ve heard about the new gummy bear implants, and they sound really cool.  But what the heck is a gummy bear implant,  and what’s so good about it?
Saline implants are filled with salt water.  Since they’re liquid, they are about as far from “gummy” as you can get.  Silicone gel implants, on the other hand, are filled with a gel (or jelly).  The thicker the gel, the more viscous or “gummy” the implant.  
Dr. Friedman generally uses breast implants manufactured by Allergan, the maker of Botox and Juvederm.  Unlike Mentor and Sientra gel implants, Allergan silicone gel implants are available in three levels of viscosity:
                       Responsive                Smooth Touch                Cohesive
Firmness         Softer                             Moderate                        Firmer
Rippling          Greater                           Moderate                        Lesser
Incision           Shorter                           Moderate                        Longer
Price                Lower                             Moderate                        Higher
Dr. Friedman uses Responsive (the least gummy) implants in the vast majority of women.  Why?  
1. They are the softest and the most natural feeling implants.
2. They require a little smaller incision than more viscous implants.
3. They are the least expensive silicone gel implants.
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So what is the advantage of the gummier, Smooth Touch and Cohesive, implants?  Very simply, they ripple less.  All silicone gel implants ripple to some degree; they are viscous liquid, not solid.  The more viscous the implant, the less rippling occurs.  This is a non-issue in most breast augmentation patients who are undergoing placement beneath the pectoralis major muscle.  However, in a small subset of women, the Smooth Touch and Cohesive implants may prove a better choice than the Responsive.  These are women in whom rippling may be visible because they have minimal breast tissue and subcutaneous fat (i.e. not much camouflage).  This most commonly occurs in women who have had previous breast augmentation with implants above the muscle or who have undergone significant muscle release with submuscular placement.  In these women, the tradeoffs of increased implant firmness (perhaps unnaturally firm in the case of Cohesive implants), incision length, and price may be worthwhile in an attempt to minimize visible implant rippling.
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Any other advantages to gummier implants?  Maybe.  
  1. They demonstrate greater fullness of the upper breasts since they hold their shape better than Responsive implants. (More viscous implants are more “form stable.”)  This can be good or bad depending upon the amount of upper breast fullness that is desired.
  1. In the case of an implant rupture, the gel is less likely to spread away from the implant.  Although this is definitely a good thing, it does not mean that Cohesive implants will last forever.  All implants will eventually rupture.
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“Gummy bear” implants are an excellent option to minimize implant rippling in women with minimal breast tissue, particularly those who have undergone previous breast augmentation.  For women with adequate soft tissue coverage, Responsive implants remain a softer, more cost-effective alternative.