The term “gummy bear breast augmentation” refers to a procedure utilizing a specific type of silicone breast implant known for its highly cohesive, form-stable gel. This nickname comes from the implant’s consistency, which is firm enough to retain its shape even if the outer shell is compromised, much like a gummy candy. These implants represent a newer generation of silicone devices, quickly gaining popularity among patients and surgeons for their aesthetic feel and perceived safety advantages over earlier models. They are widely adopted for both cosmetic enlargement and reconstructive surgery due to their predictable shape.
Defining the “Gummy Bear” Cohesiveness
The unique characteristic of the “gummy bear” implant lies in its material composition: a highly cross-linked silicone gel. The term “cohesive” describes the strength of the chemical bonds holding the molecules together. A higher degree of cross-linking makes the silicone thicker, giving it a consistency closer to a soft solid than a liquid.
This consistency allows the implant to be considered “form-stable,” meaning the gel will not flow or run if the implant shell is cut open. Older generations of silicone implants contained a more liquid gel that could spread into the surrounding tissue upon rupture. The highly cohesive gel minimizes the risk of silicone migration, which is a significant safety benefit.
When this type of implant ruptures, the gel tends to remain contained within the scar tissue capsule, an event known as an intracapsular rupture. The firm, non-liquid nature of the gel means the implant maintains its overall shape even after a break. This lack of obvious change can lead to the designation of a “silent rupture.”
Anatomical Shape and Form Stability
Gummy bear implants are designed to be “form-stable,” holding a specific, pre-determined shape regardless of the patient’s position or gravity. They are commonly manufactured in an anatomical, or teardrop, shape, tapered at the top and fuller at the bottom. This contour mimics the natural slope of the breast, offering a result that appears less augmented and more natural than a fully round implant.
The cohesive gel makes the anatomical shape possible, as a less cohesive gel would settle to the bottom of the shell. This stability also helps reduce the risk of visible rippling or folding of the implant shell, which is common in traditional, softer silicone implants. Because the shape is fixed, proper orientation during surgical placement is necessary.
Manufacturers often use a textured outer shell on these anatomical implants to help the surrounding breast tissue adhere to the surface. This adherence prevents the implant from rotating within the surgical pocket. If a teardrop-shaped implant were to rotate, the breast would take on an unnatural appearance, requiring a follow-up procedure to correct.
The Surgical Procedure and Placement
The physical properties of the highly cohesive gel necessitate adjustments to the standard surgical technique. Due to the implant’s firmer consistency and inability to compress easily, the required surgical incision must be slightly longer. The incision size must be adequate to allow for the careful insertion of the firm, pre-shaped implant without damaging the shell.
Surgeons create a specialized pocket to accommodate the implant, often opting for placement either behind the breast tissue (subglandular) or beneath the chest muscle (submuscular or dual plane). Precise pocket creation is important because the surgeon must ensure the implant is locked into its correct vertical orientation. Any rotation compromises the aesthetic outcome, requiring meticulous planning before surgery.
The surgeon must carefully select the implant dimensions, considering the patient’s existing breast width, height, and projection needs. The fixed, anatomical shape requires a greater degree of precision in preoperative planning compared to round implants. A surgeon with specific experience in form-stable devices is generally preferred due to the increased technical demand.
Safety Profile and Longevity
Gummy bear implants have a safety profile comparable to other silicone devices, with advantages related to the cohesive gel. A significant benefit is the reduced risk of silicone gel migration into the body, as the thick gel tends to stay encapsulated even if the outer shell tears.
No breast implant is considered a lifetime device, and they will likely require future revision surgery. The expected lifespan of any silicone implant is generally 10 to 20 years before they may need to be exchanged or removed. The likelihood of rupture or complication increases by about one percent per year the implants are in place.
The Food and Drug Administration (FDA) mandates a screening schedule for all silicone implants to detect silent rupture, which occurs without obvious symptoms. The current recommendation involves an MRI screening three years after the initial surgery, followed by a repeat screening every two years thereafter. Some highly cohesive implants have also been associated with a lower incidence of capsular contracture, a complication where the scar tissue around the implant tightens and hardens.