Breast implants are medical devices that enhance the size, shape, and contour of the chest. The term “gummy bear” refers to a specific type of silicone breast implant filled with a highly cohesive silicone gel. This unique gel maintains its form and integrity even if the outer shell is compromised, offering a distinct safety profile compared to earlier generations. Individuals considering these devices must understand they are not lifetime implants and will require long-term monitoring and likely eventual replacement.
Defining the Gummy Bear Implant
The “gummy bear” nickname comes from the gel’s texture, which is similar to the chewiness of the candy, meaning the implant holds its shape without collapsing. This highly cohesive silicone gel is highly cross-linked, making the material more viscous and thicker than traditional silicone gel. This density prevents the gel from flowing freely, which is a significant advantage if the shell breaches.
This form-stable characteristic ensures the implant retains its shape. This property is especially useful in the teardrop or anatomical-shaped implants often associated with the gummy bear type. The cohesive structure minimizes the risk of the material migrating into surrounding tissue if the outer layer is damaged.
Expected Lifespan and Factors Influencing Longevity
Gummy bear implants are engineered for durability, yet they are not permanent solutions and will eventually require removal or replacement. The typical expected service life is cited as 10 to 20 years. This timeframe is influenced by mechanical wear on the device and biological changes within the patient’s body.
The primary reason for eventual replacement is the natural breakdown of the implant shell over time. Constant movement and friction within the breast pocket can physically weaken the silicone elastomer shell. Biological factors, such as major weight fluctuations, pregnancy, or the natural aging of breast tissue, also alter the stress placed on the implant.
Another common reason for revision surgery is capsular contracture, where a dense layer of scar tissue forms and tightens around the implant. This hardening can cause pain, distort the breast shape, and increase mechanical stress on the shell. Many individuals also choose replacement after a decade to address aesthetic changes resulting from natural tissue aging.
Monitoring and Detection of Silent Rupture
A unique consideration with highly cohesive silicone implants is the risk of a “silent rupture.” This occurs when the implant shell tears, but the cohesive gel remains contained within the surrounding scar tissue capsule. Since the thick gel does not leak or flow, a silent rupture often produces no noticeable symptoms and cannot be detected by the patient.
The U.S. Food and Drug Administration (FDA) recommends a specific screening protocol for all silicone implants. The first non-surgical screening is advised three to six years following the initial surgery. Subsequent routine screenings should then be performed every two to three years for the remainder of the implant’s lifespan.
Magnetic Resonance Imaging (MRI) is considered the most accurate method for detecting a silent rupture, offering detailed visualization of the implant’s integrity. A high-resolution ultrasound is often used as an effective initial screening tool due to the cost and accessibility of MRI. Imaging is the only reliable way to confirm the integrity of the shell and identify a silent rupture.
Replacement Procedures
When monitoring detects a rupture or when the patient desires aesthetic changes, a surgical procedure is necessary to manage the implant. This surgery, known as revision augmentation, involves making an incision to access the implant pocket. The surgeon carefully removes the existing implant and the surrounding fibrous capsule in a procedure called a capsulectomy.
Patients have two options: explantation (complete removal without replacement) or explantation with replacement using a new device. Replacement allows the surgeon to address changes in the breast pocket, adjust the size or shape of the new implant, or change the plane of placement. The new device is selected based on current aesthetic goals and the surgeon’s assessment of the supporting breast tissue.
The recovery process for replacement surgery is comparable to the initial augmentation procedure. This revision operation corrects long-term complications, such as capsular contracture, and restores the desired breast contour.