Pros and Cons Of Cohesive Gel in Breast Implants


Jill Daniels, Freelance Medical Writer

Jill Daniels is a freelance health writer based in New York City. She spent several years writing for WebMD, including their Weight Loss Clinic and Fertility Center programs. Jill has also written/reported for publications including InStyle, People and Women's Own. She received a degree in journalism for Northwestern University's Medill School of Journalism.

November 19 2007

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A new – and seemingly improved – type of breast implants called cohesive gel implants have been piquing people's curiosity lately. These implants are dense enough to hold their shape if they are cut or punctured, and are said to feel and look more like real breasts than the saline and silicone implants currently used in breast augmentation. Are you curious to know what the new implants are all about? Here are answers to several common questions about cohesive gel implants.

What are cohesive gel breast implants?
Cohesive gel breast implants are a new kind of implant that is currently being tested in clinical trials in the United States. They are made of a thick silicone gel that is more like a solid than a liquid. The dense consistency of the gel allows the breast implants to maintain their shape inside the body and create a more natural-looking appearance.

What makes cohesive gel implants different from silicone gel implants?
Unfortunately, sometimes "regular" silicone gel implants are referred to as cohesive gel implants because all gel is cohesive to some degree. True cohesive gel implants, however, are highly cohesive and made of a silicone gel that is firmer than the material used in implants currently available in the United States.

Are cohesive gel implants and "gummy bear" implants the same thing?
Not all cohesive gel implants are alike. The most cohesive breast implants are referred to as "gummy bear" implants because their thicker silicone gel consistency is much like that of the popular gummy bear candy.

Are cohesive gel implants more resilient than other types of implants?
The gel in cohesive gel breast implants is more solid than the material used in other implants and may be less likely to break or leak into the body. No long-term studies, however, have shown that cohesive gel implants are any more durable than other types of implants. Most breast implants, regardless of what substance they are made, are fairly sturdy when they are new. However, after the implants have been in a body for many years, even the strongest breast implants may weaken.

Will the shape of cohesive gel implants be different from saline or silicone implants?
Saline and standard silicone gel implants have a more liquid consistency, which makes them more likely to sag or change shape due to gravity. Cohesive gel implants, on the other hand, have a definite shape which they retain better because of the firmer gel they contain.

How will cohesive gel implants look and feel?
Once inserted, cohesive gel breast implants should maintain their upright position and look more like natural breasts. The implants are also less likely to ripple or fold than liquid-filled implants, and unlike liquid-filled implants that can be overfilled and feel hard to the touch, cohesive gel implants should feel soft and more natural. Of course, the feel of the enhanced breast will ultimately depend on how large the implant is and how much breast tissue there is relative to the implant size.

Because the cohesive gel implants will not change shape as readily as their liquid cousins, working with your doctor to choose the right size and shape for your body is very important.

How are the implants inserted?
Unfortunately, the fairly solid form of cohesive gel implants means they can't be squeezed through tiny incisions. The incisions do have to be larger, and the most common place they are made is in the folds under the breasts. While insertion from the areola area or the armpit region is possible, it's considered more difficult.

Will cohesive gel implants leak?
Although no studies have proven it, this type of breast implant may be less likely to leak than other implants because the shell is very resilient to folds, where most ruptures are believed to take place. It is also believed that the gel consistency will prevent or slow oozing even if a tear in the shell occurs, but this has not yet been confirmed.

Who can receive cohesive gel implants?
Although they have been used for over a decade in Europe and for several years in Canada, cohesive gel implants are still in clinical trials in the United States. If you are interested in participating in a trial, you must meet certain physical and health criteria, and you must be willing to participate in follow-up examinations. For more information, ask your doctor about cohesive gel implants.