What’s the Gummy Bear Implant All About?

Untitled7According to the latest statistics on plastic surgery, over 300,000 women got breast implants last year. There are several options for breast implants for women, which was not the case just a few short years ago.

Silicone filled gel implants that became available for primary breast augmentation in 2006, after approximately 17 (or so) years of study. These are wonderfully updated versions of the original silicone breast implants. They have been studied more than almost any other medical device and have been found to not cause any disease or issues in women. Within the realm of silicone implants, you’ll hear words or phrases such as “memory gel,” “gummy bear,” or “cohesive gel” used to describe each individual company’s implants. Basically, each company uses a different process to get their silicone to a certain thickness. Some implants use a thicker gel than the others, and if you had all of the implants side by side, it would be hard to discern between the three unless you had handled them a lot! They did a “blind” test at one of our national meetings, and it was pretty close. You’ll also hear “textured” and “smooth,” as well as “anatomic” and “profile” – high, moderate and moderate classic. As a patient, I think it would be incredibly hard to pick an implant!

How do you choose which one to get?

As far as silicone versus saline, for me it’s a no brainer. I choose silicone every time. For my patients, however, it is a decision they come to after a lot of education (as well as hours on the internet and talking to their girlfriends, I’m sure). I spend most of our consult discussing the pros and cons of each choice.

Now, to the minutia of all that other stuff – I generally like the Mentor MemoryGel® implants for several reasons. Primarily, it’s the consistent behavior of the implant. It’s been on the market for longer than I have been in practice and it’s always the same. I love the warranty for my patients – a warranty that drove the industry to meet it because it’s that good. The company is good – all the way to the corporate level. Additionally, this company makes its implants in the United States; we have been to the plant in Texas! As for the feel of these implants, they are the “memory gel” ones, meaning if you cut them in half and squeeze really hard, the gel will come out, but then as soon as you release it, the gel goes right back into the shell. I like that they are soft but strong, rarely ripple, and are reasonably priced. Other companies have similar products that are wonderful too; this is just the one I prefer.

I generally prefer smooth round vs. textured anatomic implants. I went through the first texturing craze in the 90’s when we all thought they were the next great thing… I didn’t like them then, and I am not running to try them again. The studies that show less incidences of capsular contracture with textured implants are generally conducted over a time period of less than three years; I am waiting to see what the results from 10-year studies will look like. Texturing (supposedly) keeps the anatomic implants in proper anatomic (or tear drop) position. With no way to attach the implants in that position, even with texturing, I have seen significant malposition of anatomic implants, leading to the need for surgical repair. Smooth round implants are always in anatomic position. If you hold one up, you’ll see that all the gel gravitates toward the bottom of the implant, making it tear-dropped anyway.

As for profiles – my choice on that is based on my patients’ anatomy (meaning the width of their chest) and what look they are going for. Patients who want a more adventurous look may get a high profile implant. Conversely, someone who just wanted a little more volume most likely wouldn’t get a high profile. But I generally decide this in the operating room, with sizers in the patient. It’s too difficult to guess in the office about exactly what profile or which item number will work best. I feel it’s prudent to use the intra-operative sizer to help make that decision. 99.9% of the time, if the patient is clear about what she wants, we nail the size right away. I couldn’t sleep at night just taking one pair of implants to the OR and saying, “Okay, this one is a 350cc.” (Although it would make my job much easier.)

I read on the chat rooms, especially on RealSelf.com patients posting questions about “my measurements are this, should I get this or this implant?” and it makes me cringe… this question is for the surgeon. I would never tell my mechanic what kind of part to get for my engine, I pay them to do a good job and my car works very well.

Invest your time and research into a plastic surgeon you are comfortable with; one that hears your concerns and is willing to care for you in a safe environment. A surgeon that is willing to explain to you the differences between all the options in breast implants and helps you pick the type and size that is best for you. Choose a surgeon you know you can call and trust that will take care of you just in case something goes wrong… and then let them do their job… make them work for your hard-earned breast implant fund!

Live well.

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