Fifth-generation highly cohesive silicone breast implants (both round and shaped) are available in the U.S. by three manufacturers: Mentor (MemoryShape), Allergan (Natrelle 410) and Sientra (Silimed). In the United States, 90% of all breast reconstruction with implants involves these so-called "gummy bear" breast implants, which offer several advantages over breast implants filled with saline or earlier-generation silicone gel:
- They are said to be form stable: they retain their shape as you move, stand up and lie down, and better retain their shape over time.
- Silicone from a ruptured gummy bear breast implant is less likely to leak into the breast or beyond: it holds together in a single mass, like Jello or gummy bear candy when it is squished together or even cut in half.
- Because highly cohesive gel doesn't shift as other implant fillers do, wrinkles and ripples (more of a problem with saline implants), and folds that often cause implant leaks are less likely. This not only improves appearance, but limits friction and tension that may weaken the outer shell; cohesive silicone gel breast implants are expected to last longer than earlier models.
- Shaped implants (also called "anatomic" or "teardrop") mimic the shape of natural breasts with gradually-sloped tops and full bottoms, rather than the “half-grapefruit” appearance that often results from round implants.
- The outside shells of all shaped breast implants are textured to help hold the implant in place so that it doesn't rotate or tip in the pocket.
- Although long-term data is not yet available, gummy bear breast implants are believed to reduce the rate of capsular contracture (the most common problem and source of reoperation with other breast implants).
Gummy bear breast implants may be an improvement over older models, yet despite a high rate of patient satisfaction and reported lower problem rate, they are still subject to problems that are inherent to all implants:
- They are more expensive than saline or previous silicone versions.
- Like other types of breast implants, gummy bears are not lifetime devices and need to be replaced sooner or later.
- Compared to saline and non-cohesive gel implants, a larger incision is required.
- The risk of rupture, although reduced with highly cohesive silicone gel implants, is not eliminated. The FDA recommends MRI screenings beginning three years after the implant is placed and every two years after that to detect “silent” rupture.
- Infection may occur anytime after placement.
- Many women report that highly cohesive silicone gel implants feel firmer and less natural than earlier silicone implants.
- Women who prefer more projection or fullness at the top of their reconstructed breasts may better served with round implants.
- Long-term study data (10 years or more) is not yet available.
Gummies may not be right for all women, but they do add another choice to the menu of breast reconstruction options.