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The Gummy Bear breast implant captures a lot of patient and press attention and may represent a valuable role in the future of breast augmentation. While under clinical trial investigations for years by the two U.S. breast implant manufacturers, it is rumored that they are the verge of being approved by the FDA for widespread clinical use sometime in 2011. Given their potential availability, I thought it a good time to discuss the facts from the myths about these type of breast implants.

The name, gummy bear, is very appropriate based on how the implant material looks. Rather than being like a thick Karo syrup or more congealed like a pudding, it is more form stable. It is closer to refrigerated Jell-O in appearance and form. If you cut these breast implants in half with a knife, the two pieces would just stay intact. Like gummy bear candy, the implant will stay solid although it does not feel as hard as the actual candy.

The gummy bear implant is not a name ascribed to it by any of the manufacturers or the FDA. It is really an urban term coined by a plastic surgeon. It has different names by various nmanufacturers such as the Mentor CPG and the Allergan 410. It is really a fifth generation silicone implant, generically known as a form-stable cohesive gel implant. These implants were invented over 15 years ago and have a theoretical basis of being a longer-lasting breast implant that keeps its shape. The gel is more cohesive and firm. The gummy bear implants that will be initially available will have a teardrop and not a round shape. The implant’s teardrop shape anatomically matches that of a natural breast which projects more at the bottom than at the top. As the implant is thinner at the top, it will more naturally blend into the upper chest without an upper bulge which creates a round-looking breast.

Plastic surgery investigators of these implants state that they have a lower capsular contracture (hardening) risk, fewer problems with implant wrinkling and folding and an improved appearance of the breasts. They also offer the psychological benefit that should the implant fail (shell disruption), the implant material would remain intact and not migrate from the original breast pocket.

One of the criticisms of a more form-stable implant is that they can not be put in through very small incisions. They don’t deform as easily as the less stable forms of silicone gels. Some investigators have stated that it is not a problem, going even through a periareolar or nipple incision. Others, however, felt that it is easier to go through a lower breast fold incision. The shaped implant also can suffer from turning or rotating of the implant causing a distortion in the shape of the breast.

The gummy bear implant may be most ideal for the primary breast augmentation woman. This is because its teardrop form is most likely to remain positionally stable with a fresh pocket. In those patients who has indwelling implants, who are unhappy with certain aspects of their implants or want to change the size of their implants, a teardrop-shaped implant is less ideal. This is because existing breast pockets are much more likely to allow the implant to shift around its smooth interior pocket lining. This concern will eventually be obviated when form-stable silicone gel breast implants which are round are introduced.

Dr. Barry Eppley

Indianapolis, Indiana

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