What are “GUMMY BEAR” Implants?

One of the most common questions that breast augmentation patients ask me is whether they can have “gummy bear” implants. Usually, they are not really sure what that term really refers to, so I thought I would address that question here. First off, the term “gummy bear” only refers to silicone implants. Saline implants are just filled with saline (salt water) from an IV bag. Silicone implants are filled with silicone gel, and it’s that gel filler material that can have different consistencies. Sometimes it is softer and almost liquid, and other times it is firmer and stiffer (almost like a gummy bear).

Originally in the 1970s, silicone implants were filled with a very thin gel. In fact, it was so thin (and the shells were so thin) that the gel would “bleed” right through the walls. I remember putting these implants on a piece of paper, and then after a while I could pick it up and the paper would have a “wet” spot from the oil! This silicone gel “bleed” and weakness that predisposed the implants to rupture caused a few problems. First, they almost all ended up with rock-hard capsules (scar tissue) around them and unnatural look. Also, the pretty much all ruptured. Finally, when they did rupture, the goo could seep far away from the implant and end up in awful places like around the nerves and blood vessels in the armpit.

Since then, implants have gone through a few generations of advances. The shells got stronger and the filler gel got less gooey. Whereas the early implant gel felt and flowed like honey, now you can literally cut an implant in half and nothing runs out. Once shaped silicone implants were developed, firmer gels were needed so the shaped implant would maintain the right shape. Even though we don’t currently use those silicone shaped implants much due to problems with their textured surfaces, the firmer gel has remained as the popular fill material. Therefore, you could argue that all implants now are “gummy”.

Now, there are different levels of “gumminess”. That’s because the level of “cohesivity” (firmness or how tightly the molecules of the gel are linked together) can vary between different implant styles and manufacturers.  Although there are subtle contrasts, let’s just say that each company now offers ”gummy”, “gummier”, and “gummiest”.  Since the “gummiest” or highly-cohesive round silicone gel implants stay the roundest and ripple the least when you stand up, they are good choices for patients who want a push-up bra look even without a bra or those who are very thin and worried about seeing rippling at the top of their breasts in their bikinis.  On the other hand, the softer implants tend to form a more natural teardrop shape when you stand, and some people prefer that more conservative look.

In conclusion, my answer is basically “yes” when someone asks if their silicone implants will be gummy.  But how gummy?  That’s what consults are for…