Cohesive Breast Implants

Why Are Cohesive Gel Implants Anatomically Shaped?

A breast projects more at the bottom than at the top. Therefore, it makes sense for an implant to be shaped that way. And the thinner an implant is at the top, the more gradually and naturally it will feather into the upper chest, making itself less conspicuous. Without a cohesive, form stable filler, there is little point in making shape into an implant, as the implant will ultimately lose the shape. But with a form stable filler, the shape will be maintained.

Is this the ideal breast implant?

There is no perfect implant, but this one is a big step in that direction, with preliminary results better than any other implant data we have seen. They offer an improved option for patients desiring either reconstructive or cosmetic surgery.

Why is the implant being studied?

Cohesive gel implants have been used clinically in Europe and Brazil for over 10 years and have become the most popular implant internationally due to excellent results; however, new devices must undergo well planned FDA clinical trials prior to approval in the US, and the cohesive gel implants are currently under FDA clinical trials in the US.

If I am part of the study is the surgical procedure free?

No. All fees (surgeon, hospital, anesthesia and implant) still apply in the clinical trial. The benefit to the patient is access to a new technology otherwise not available in the US. Patients on the clinical trial must be willing to return annually for a follow-up visit in order to generate long term data for the study.

Are There Round Cohesive Gel Implants?

Form stable round cohesive gel implants are available in Europe, but not in the United States. There is actually very little use for them. If you look at an implant lying on its side on a table, it looks much like an M&M. But when it is held upright, the upper pole gradually collapses. It is that upper collapse that allows those implants to look natural (though it is doing so at the risk of folds on the implant shell.) A true cohesive round does not do that. By maintaining that M&M shape when vertical, it creates a dome-like, relatively top-protruding shape.

However, degree of cohesion is not a black and white issue; there is an endless continuum in cohesive gel from very liquidy to very solid.

Do Cohesive Gel Implants Come With A Smooth And A Textured Surface?

All anatomic (a.k.a. teardrop) shaped implants are textured, as the texturing increases friction and helps keep them from rotating. Since a teardrop implant is different at the bottom than the top, it is important that it maintains its position.

What Happens If A Cohesive Gel Implant Ruptures?

We do not really know, because there is so little experience with this. In thousands of cases in Sweden over the part 10 years there has been only one reported implant rupture. If it did happen, however, one would imagine that the gel, being relatively stiff and solid, would not migrate in any significant amount. Since it has the consistency of a gummy bear, the gel would presumably stay in place.

In a recently published article in Plastic and Reconstructive Surgery the rupture rate was 6-8% for the standard silicone gel implants vs. 0.3- 0.7% for the Inamed 410 ( form stable implant) over similar time periods, which suggests a longer shell longevity in the form stable devices.

How Would You Know If A Cohesive Gel Implant Has Leaked?

Given the gummy bear nature of the filler of these implants, it is likely that it would be difficult to tell if they ruptured. Perhaps it might be detected by mammogram or MRI. When any implant is placed in the body, the body forms a capsule around the implant. If a cohesive implant were to leak, it would probably just stay within the capsule. The capsule might thicken, and a patient may notice a difference in the feel of the breast. But it is also possible that there might be no change at all. The important point, however, is that silicone gel has not been linked with any health problem, so even if there were a shell disruption, it should not prove to be of any medical problem.

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