Saline and silicone gel breast implants have been around since the mid 1960s. When concerns were raised about the safety of the silicone gel implant, there were not enough incidents to force government action. However, when the boom hit in the late 1980s and early 1990s, the number of surgeries multiplied dramatically. Suddenly the news media reported incidence after incidence regarding silicone gel rupture stories. The FDA finally had no choice but to act: they banned the silicone gel implant from further use. Their reasoning was that clinical studies needed to be conducted to correct the safety issue.
The FDA finally approved the silicone gel implant for unrestricted use in 2006, after fourteen years of intense clinical research. They did not approve the cohesive gel implant, often called the Gummy Bear implant, and probably will not do so for years.
To understand the difference between the three implants, picture three filled water balloons. The first has a saline solution inside of it. If it springs a leak, the salt water will not hurt the body. When bumped, the water sloshes around. When squeezed, it feels like a sack with water in it. When set down, gravity pulls the saline flat.
The second balloon is filled with liquid silicone gel. If it springs a leak, the silicone gel is toxic to the body. When bumped, the silicone jiggles. When squeezed, it feels more like breast tissue. When set down, gravity pulls at the silicone gel but it doesn't flatten out as much as the saline does.
The third balloon is filled with cohesive gel. If it springs a leak, there is no liquid to release. In fact, you can cut it in half and you will then have two solid masses. When bumped, it keeps it original shape. When squeezed, it will indent like Gummy Bear candy but return to its original shape when released. No matter what position you put it in - horizontal or vertical - it keeps its original shape. Cohesive gel implants only come in one shape: anatomical.
The saline implant is empty and filled with saline solution during surgery. This means it requires the smallest incision (resulting in the smallest scar). It can also be overfilled to match the patient's desired size and reduce the risk of rippling or wrinkling. The silicone gel implant is filled with the liquid gel prior to surgery. The Gummy Bear implant is already filled when the surgeon gets it. That means they are a larger size going into the breast, so they require a larger incision and result in a larger scar.
If you believe you would like to use the Gummy Bear implant for your breast augmentation, find an expert who can educate you on the most accurate information and the latest technological advances. That would be a board-certified plastic surgeon specializing in breast augmentation, and who is participating in the FDA clinical trial. Search for "cohesive gel implant" on the internet and you will find a list of websites advertising surgeons who are participants.
This article is not intended to provide medical advice. You should only heed medical advice or guidance from a practiced, licensed physician.
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