While many women perceive breast augmentation as done using a breast implant, most are not aware of the diverse array that are available. Since silicone gel breast implants have been commercially available again since 2006, the two choices that women have of implant fillers is between saline and silicone. Saline is a simple filler concept and is nothing more than a ‘bag of water’ on a practical basis. Silicone is a much more complex polymer molecule that can be made in a near endless variety of physical states.
The history of silicone as a filler for breast implants was much like a thick liquid, similar to a thick syrup. (type 1 silicone) That form of the material is no longer manufactured although women still do exist with indwelling implants with this original consistency. (they are getting fewer and fewer with each passing year) The newer form of silicone is much like a gel (jello) and carries the term of a cohesive or more cohesive gel. (type 2 silicone) It is tacky and will not run or escape from the implant like a more liquid material should the surrounding shell become broken or develop a tear or hole in it. This is what is in every currently sold FDA-approved silicone breast implant.
Another more polymerized silicone gel has also been undergoing FDA-sanctioned clinical trials for the past several years. Known as a more cohesive silicone gel (type 3 silicone), it is also known as the gummy bear breast implant. It is not available for widespread commercial use and has remained restricted to those plastic surgeons who are participants in this clinical trial. Similar to the consistency of a gummy bear candy, it is more cohesive or ultracohesive and behaves more like solid than a gel. It can literally be cut like a piece of pie. While neither of the two existing U.S. breast implant manufacturers have coined the gummy bear term or use it, it has worked its way into the public’s mind and common terminology.
The perceived benefits of gummy bear breast implants to most patients is one of safety. Women fear, unjustifiably so, that a very cohesive silicone materialis more ‘safe’ because it can not escape into the body. In essence, it will not run or leak. While cohesive or type 2 gel breast implants will not do this either, it is a simple matter of perception. The other perceived benefit, although not as widespread, is that it will feel more natural or more like a real breast. What a real breast feels like can be quite variable and I doubt very highly that anyone could tell the difference in an augmented breast between a type 2 and 3 gel implant. (short of a plastic surgeon)
Despite this precise material definition of a gummy bear breast implant, it is a loosely used term. As previously stated it is not a manufacturer or FDA sanctioned name and is largely a plastic surgery marketing term. Because of this vagueness, the concept of gummy bear breast augmentation can be open to interpretation. Some plastic surgeons are using it to refer to type 2 silicone gel while others are specifically referring to type 3 silicone gel.
Dr. Barry Eppley
Indianapolis, Indiana