Recently I consulted with a woman who I thought would be a suitable candidate for the cohesive (gummy bear) gel implants. She had relatively little native breast volume, non­ptotic (droopy) skin envelope, and desired a “natural” outcome, without excessive upper pole heave, i.e. push up bra appearance. We discussed surgical technique, appropriate profiles and volumes and “sized” her to simulate her outcome. After discussing the risks, benefits, alternate therapies, complications and consequences of not proceeding, she offered this parting comment, “My cosmetic surgeon says ‘gummy bear’ implants are not for cosmetic patients”.

Regrouping, without animosity to the uninformed, “armchair quarterback”, I countered:

  1. 1. Gummy bear gel implants is a term specifically invented and applied to the Allergan Style 410, cohesive gel
  2. 2. The textured surface is essential to prevent malrotation of the “tear drop” device;
  3. 3. Malrotation is unlikely, unless the space in which the implant is placed is excessively large, compared to the implant’s dimensions
  4. 4. Texturizing and the gel’s cohesivity impart a “firmer” feel to the breast
  5. 5. Like other smooth saline and gel implants, the cohesive anatomical implants also come in a variety of profiles (standard, moderate plus, high and tall), which are suitable for a range of body types
  6. 6. Long term studies demonstrate that properly placed, the cohesive gel implants stay put;
  7. 7. Inframammary fold incisions are frequently used because of the need to confirm correct placement of the implant
  8. 8. Rupture is practically nil because the gel will not travel outside of the external shell;
  9. 9. Rates of capsular contracture are the lowest of all types of implants, 2.4% for primary cases
  10. 10. The firmness of the device varies according to the manufacturer

I disagree with the “cosmetic surgeon” who relegates the gummy bear gel implants to the realm of (breast cancer) reconstruction. For many of my revisional cosmetic breast implant patients they may be part of the solution.

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