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Question of the week: what are cohesive gel or form stable breast implants?

I want silicone implants for my augmentation, but I’m confused about the difference between gummy bear, cohesive gel and form stable implants.

How do I choose the safest?

- patient

Dr David Sharp Specialist Plastic Surgeon

Dr Sharp:

It’s good to hear you are thinking about these factors and how they may impact your breast augmentation surgery, as they are important pre operative considerations!

Essentially all of the implants you mention come from the same ‘family’ of silicone implants. Implant manufacturers use words such as cohesive gel, form stable silicone and gummy bear implants to describe variants of the same thing; breast implants that contain a silicone that maintains its shape and consistency inside the body – and has a solid (rather than liquid or runny) consistency.

What are Cohesive Gel Implants?

Cohesive gel is formed by increasing the number of cross-links between gel molecules, which results in an implant that has better retention of shape and is less likely to fold or collapse, especially in the upper pole.

This kind of silicone has been successfully used for many years – and in millions of patients. Most specialist plastic surgeons in Australia use modern implants that contain this gel.

Unlike the older implants from the 1980s and early 1990s, which contained a gel of syrup-like consistency, today’s implants resemble a firm gel. When you cut into the outer shell of a contemporary implant, the gel inside doesn’t leak due to this extensive cross-linking. 

What Happens if a Form Stable or Cohesive Gel Implant Ruptures?

Breast implants are very strong and ruptures aren’t common, but even when cohesive gel implants do rupture, the gel stays inside the implant – hence the term ‘form stable’.

Silicone implants have dramatically changed over the past 40 years; the original silicone gel that was used as early as the 1970s, consisted of a liquid gel. If the outer layer of the implant ruptured, the liquid would leak into the body. The big difference between a liquid gel and cohesive gel is that the cohesive gel stays in one solid form if cut or ruptured.

The cross linking of the silicone in these implants can vary, creating different levels of cohesiveness and firmness. Your surgeon will discuss the appropriate implant for you. New generation implants are able to balance the benefits of form stable silicone with the goal of creating a softer feel.

The implant brands I use do this particularly well, while maintaining an excellent safety record and lower complication rate than other, cheaper, implants – so doing your research and asking your surgeon which brand she or he uses is also important. Experienced surgeons will be attracted to certain implants or deterred from using others, so ask your surgeon how they decided upon their preferred implant type.

Read more here about the warranties involved with the two types of implant brands Dr Sharp uses. 

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