Women considering a breast augmentation have a new responsibility. They need to take the time and learn the differences between each of the round silicone gel breast implants that are on the market in the United States. With many of the textured breast implants taken off the market worldwide, manufacturers are seeking to offer newer fills and size options to improve their options for both breast augmentation and reconstruction. The round “cohesive” gel implants that were approved by the FDA in 2006 were designed in the late 1980’s. The manufacturers have made some adjustments to their manufacturing techniques, but these implants have remained relatively unchanged for over 20 years. Each of the manufacturers, Allergan, Sientra, and Mentor, were required to go through years of comprehensive clinical trials in the United States before any of their implants were approved for sale. Allergan named these implants their “Inspira” implants. The newer implants are named for the thickness or elastomeric properties of their gel, “Soft-Touch” and “cohesive Rounds”

The Newest Generations of Highly Cohesive Gel Implants

In 2012 and 2013, all three U.S. manufacturer’s newest generation of highly cohesive gel implants were finally approved for distribution. Here is where the “cohesion confusion” comes in. Women need to have honest conversations with their doctors about all the available breast implants, not just the ones that they are comfortable using, are the lowest price to the surgeon, or may be the easiest to use. In addition, not only are there differences between the round cohesive gels between manufacturers, the gel fills come in varying elastomeric properties that behave differently in the breast. In addition to the cohesivity or thickness or flow of the gel, there are also differences in shell texture and the percentage of the gel fill. The newest implants come in several types of gels, including the “Soft-Touch” and “Cohesive Round” gels. All implants are designed to feel like a breast, yet should be stable enough to reduce the wrinkles and ripples seen with less cohesive breast implants. In the end, the feel of a breast is a combination of the implant shell thickness and the gel fill, the location of the pocket, and the breast tissue that covers the implant. The real benefits of the highly cohesive implants can be appreciated in women seeking a more proportionate shape, women with unusual problems such as constricted or tuberous type breasts, and women with asymmetry between the breasts.

So, go into your breast augmentation consultation prepared, understand your choices, and remember that there is not one best implant for every patient. Select a board certified plastic surgeon that is experienced with all the implant options available to you.

Dr. Glicksman In The Media

Dr. Glicksman is one of the founding members of the Plastic Surgery Channel and is a frequent contributor, serving on their Medical Advisory Board. Frequently asked to contribute to the health section of magazines like Allure, she also contributes educational content to many courses, textbooks, and peer-reviewed journals, including filming at WebMD studios in New York City.

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