July 31, 2020
Dr. Anu Bajaj, M.D.

What Are Gummy Bear Breast Implants?

Frequently I hear patients ask about “gummy bear” implants. This term creates confusion because it isn’t a medical term. Rather, it can mean different things to different people.

Today I’m going to help clear things up about the so-called gummy bear implants and discuss why it’s important to discuss your implant options with your doctor.

What Makes These Implants a Gummy Bear?

Traditionally, gummy bear implants referred to form stable (or highly cohesive) shaped silicone gel implants. Silicone gel implants have a silicone outer shell and are filled with a silicone gel inside. The gel inside the implant has changed over the years and has become more cohesive (or thicker). The cohesivity of the silicone gel inside the implant is determined by the degree of cross-linking between the molecules of the silicone gel polymer – the higher the degree of cross-linking, the more cohesive the implant. By having a more cohesive gel inside the implant, the implant can better hold its shape. But also, the more cohesive the gel, the harder the implant will feel.

The older implants with this highly cohesive gel were primarily shaped (teardrop) and textured and were referred to as being form stable. Because of the teardrop shape, some believed that the results of a breast augmentation appeared more natural. This belief has not been borne out in reality, and the teardrop shape from these early gummy bear implants has several disadvantages.

Early Gummy Bear Implants Disadvantages

The implant can move: The primary disadvantages of the teardrop shape is that the implant can move – meaning that the narrow portion which is supposed to be on the top part of the breast could be at the bottom resulting in an odd shape to the breast. Correcting the improperly positioned implant may require additional surgery. For this reason, shaped implants are always textured because the texture helps the implant stay in place – it is supposed to work like Velcro.

The implants may have health risks: Most of these gummy bear implants were textured. Textured implants have been associated with the development of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). Some of the textured implants have been taken off of the market and are no longer available because of this risk. Others do remain on the market and may be beneficial in the right patient with appropriate counseling and follow-up.

Silicone Implants Today

Since the silicone gel in today’s implants is more cohesive than what we used twenty years ago, I increasingly see physicians and patients refer to all silicone gel implants as gummy bear. But this term is inaccurate because it is not a medical term. Today, all the different breast implant manufacturers make silicone gel implants with varying degrees of gel cohesivity. A recent article in the Journal of Plastic and Reconstructive Surgery states, “Currently available silicone implants are fourth or fifth generation implants and they are all considered as cohesive implants.”

Degree of Cohesivity in Silicone Gel

However, each manufacturer of breast implants makes several implants with varying degrees of firmness or cohesivity. A more accurate way to refer to silicone implants is based on the degree of cohesivity of the silicone gel rather than using the term gummy bear. For example, the two major implant manufacturers that we use at Bajaj Plastic Surgery are Allergan and Sientra. Allergan has three types of cohesive silicone gel implants, and Sientra has two. The more cohesive of these implants from Allergan and Sientra are all considered to be form stable, meaning that the implants maintain their shape when placed in different positions.

Why Does the Cohesivity of the Silicone Gel Matter?

More cohesive implants are associated with lower rates of implant rupture. The same article in the Journal of Plastic and Reconstructive Surgery says, “The silicone filler in all modern-day implants is a firm cohesive gel; that is, it does not flow or leak when the implant ruptures.”

Implant rupture is usually related to the shear forces on the implant – the rubbing of the shell surface as it moves and deforms; therefore, the older the implant, the higher the risk of rupture. Also, if the outer shell of the implant were to rupture, the cohesive nature of the gel makes it less likely to seep into your tissues.

Another advantage of these more cohesive implants is that in thinner patients, there is less likelihood of rippling and the implant is better able to maintain its projection. One disadvantage is that the more cohesive of the different gel implants are also more expensive.

The Importance of Discussing Your Implant Choices

For these reasons, I believe that it is important that you discuss your implant choices with your plastic surgeon and understand that the term gummy bear may not be the best way in which to describe a breast implant.

At Bajaj Plastic Surgery, we believe that gummy bears are meant to be eaten and not put in your breasts. Contact us for more information about our breast implant options.