Silicone Implants: It’s What’s Inside That Counts? Or Is It?

I often get asked the question about the consistency of the silicone inside implants. Consumer marketing verbiage such as “gummy bear” can be descriptive, yet confusing and not very specific to those patients who are seeking the best choice.
In general, all FDA approved silicone implants are cohesive made from silicone gel. Silicone is polymer that has a wide range of uses in personal care products and surgical implants. It is found ubiquitously in liquid, gel or rubber-like solid forms. Silicone is made of silicon, oxygen and other elements, usually carbon and hydrogen. It has many advantages, including: stable at high temperature, resistant aging, sunlight, moisture and extreme temperatures.
In our daily lives, we have consistent exposure to silicone, which we absorb through our skin, either through make up, kitchen utensils or children’s toys. It has never been implicated in any type of breast cancer, autoimmune disease or reproductive impairment. We probably absorb more silicone through our skin from using these daily products, then we would from a ruptured silicone implant.
Both saline and silicone implants have a silicone outer shell. They are approved for breast augmentation in women, age 22 and older, and for breast reconstruction in women of any age. They can also be used for revision surgeries, which can correct the result of a previous procedure.
Per below, there are 5 different types of silicone implants that are FDA approved:

  • Mentor MemoryGel (approved in 2006)

  • Mentor MemoryShape (approved in 2013)

  • Sientra silicone gel breast implant, approved 2012)

  • Allergan Natrelle (approved in 2006).

  • Allergan Natrelle 410 Highly Cohesive Anatomically Shaped Implant (approved in 2013).

The term, “highly cohesive” or “gummy bear” refers to a denser, semi-solid silicone gel, which is firmer and a more form stable type of implant. It is still prone to the same leaking and capsular contracture rates as other silicone implants. They are significantly more expensive, slightly firmer and can be felt more easily. This may not be the best option for patients seeking breast augmentation because they produce more projection along the upper portion of the breast, which doesn’t look as natural.
Most breast implants used for breast augmentation are round implants, however, a surgeon may suggest the use of anatomic or shaped implants. In multiple studies, there is little difference between the appearances of well-done breast augmentation using round, or shaped implants. Shaped implants are prone to rotation and have textured surfaces. With the current data on ALCL and textured implants, and the lack of significant aesthetic advantage, I truly don’t see a significant reason to use a shaped, textured implant at this time.
Breast implants are not made to last forever. The longer a woman has her implants, the more likely she will need to have them revised.
The most frequent complications include capsular contracture, re-operation and implant removal, with or without replacement. Other complications include implant rupture, asymmetry, wrinkling, scarring, pain and infection.
Despite all the recent media attention regarding ALCL and textured implants, breast implants continue to be safe. Please visit my previous blog post regarding current data on breast implant associated ALCL, as well I encourage you to visit our San Francisco office to learn about which breast implant options best suit your needs.