Cohesive Breast Implants

What are Cohesive Gel Breast Implants?

The standard implant in the United States has been saline filled, ever since the FDA moratorium on silicone gel filled breast implants in 1992. The type of implants that were available before the ban are available today as part of an "adjunct study," which is open to patients with congenital deformities or having a revision for particular reasons.

What distinguishes cohesive implants is that the silicone gel is firmer, essentially a soft solid. If a cohesive implant is cut in half, there is no gross movement of gel, and the implant maintains its shape.

The way these are made is that the company uses more "crosslinker" in the making of the implant. The ingredients are the same, but with more crosslinker added, it makes the gel firmer. The term "cohesive" has been bastardized in recent years. Cohesive breast implants implies form stability, or form retention. That means that in any position, the implant maintains its shape. That is an important distinction, because it means that the shell should not fold, and that it will maintain a particular shape.

Unfortunately, given the recent media attention to cohesive implants, many are using the term to describe "regular" silicone gel implants. Technically, they are correct; all silicone gel is cohesive to some degree. But the term cohesive has always meant form stability, and when patients ask for cohesive gel, it is because they are looking for an implant with those particular characteristics of durability and shape retention. Hopefully, the terminology will be clarified in the coming years.

Which Surgeons Can Use Cohesive Gel Implants In The United States?

Each of the three studies has a group of only several dozen surgeons that are allowed to order the implants and implant them. Surgical expertise and a commitment to careful patient follow-up were the criteria the manufacturers used to select the surgeons that they would have implant their implants.

Which Patients Can Receive Cohesive Gel Implants In The United States?

The trials are open to patients seeking a first time augmentation, a revision of a breast augmentation, or breast reconstruction following mastectomy. Patients with certain medical problems cannot participate. In addition to the objective medical issues, patients must be committed and willing to participate for a full ten years of follow-up to be considered for the study. Patients must be in the geographic vicinity of the implanting surgeon in order to facilitate this follow-up.

What Are The Main Advantages Of Cohesive Gel Implants?

The main advantages of cohesive gel implants are longevity and shape. Longevity, because they do not develop folds, and it is along folds that implants ultimately fail. And if, somehow, the shell does fail, since the gel is so thick, it hopefully will not migrate anywhere in any significant quantity.

This unique filler produces superior breast shaping compared to other existing saline and silicone gel implants. Shape is enhanced because, from the point of view of a surgeon, there is only control of breast shape if there is control of distribution of fill in an augmentation. If the fill cannot be controlled, then the shape cannot be controlled. And to control distribution of fill in the breast, fill distribution must be controlled in the breast implant. All fillers other than cohesive silicone gel - saline or regular silicone gel -can migrate around within the shell of an implant, which means that there is not control over breast shape. Looking at results from breast augmentation objectively, these implants appear to have the most aesthetically natural and beautiful results.

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