Form stable, cohesive gel implants provide a more natural contour.
To date, saline and silicone implants have essentially been round. Even though we can get good results with round implants, a natural-looking breast tends to have a more “teardrop” profile. Some efforts have been made through the years to create implants that have a natural shape, using a cohesive gel, meaning a gel that could hold a different shape. The shortcoming of these implants was that they weren’t cohesive enough, and over time we found that they would lose their special shape and gradually become spherical.
The new generation of form stable, shaped gel implants puts this issue to rest. They are made of a truly cohesive gel that comes in a variety of sizes and contours. Sometimes referred to as “Gummy Bear Implants”, they hold their basic shape even when upright in the palm of your hand. These implants look more natural, feel more natural, impart upper and lower fullness using less material and the complication rates are even lower. That is a lot of good news. It’s certainly the biggest breast implant innovation in a long time. As physicians, we are cautious in embracing new products that don’t have an established, positive track record in the field, and shaped gel implants are no exception. Fortunately, the data is there. These implants have only recently been approved by the FDA for use in the United States market, but they have been used extensively in Europe for many years. The indicators are good: 69% lower capsular contracture rate (hardening of tissues around the implant), 96.5% satisfaction rate in patients who have had the implants for seven years, and they are considered to look and feel “most natural” among available implant options.
This type of implant is not for everybody. Only about half of our patients may qualify as good candidates for this type of implant. If there is a lot of extra skin around the breast or the nipples are positioned too low, it’s not going to be a good choice. If the candidate desires exaggerated upper breast fullness or wants to be very large breasted, a round implant is a better option. Good candidates have tighter skin envelopes, well-proportioned if small breasts, no major asymmetries between right and left breast and desire a more natural level of upper breast fullness. By law, candidates must be over 22 years of age for all gel implants, 18 for saline implants.
It is more technical and more expensive. Placing a round object inside the body is often more forgiving than placing a shape that has specific alignment requirements. Teardrop profiles need to fit the body with a more exacting and technical procedure. The incision for inserting these implants is slightly larger, the time we spend in the operating room is longer and the implants themselves are more expensive than other options. A shaped gel implant procedure will typically cost $600 more than round implants.
Saline implants may feel slightly less soft than natural tissue. Silicone implants are sometimes considered to feel softer than saline implants and natural tissue. Shaped gel implants are considered to feel the “most natural” of these three options.
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