breast surgeryWomen considering a breast augmentation have a new responsibility. They need to take the time and learn the differences between the round silicone gel breast implants that are made of a cohesive gel filler, and the newest generation of highly cohesive silicone gel implants. With the availability of new implant options for both breast augmentation and reconstruction, there is guaranteed to be confusion. 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 the 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.

The Newest Generation of Highly Cohesive Gel Implants

In 2012 and 2013, all three manufacturer’s newest generation of highly cohesive gel implants were finally approved for distribution in the US. 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, or may be the easiest to use. In addition, not only are there differences between the round cohesive gels and the shaped highly cohesive gels, but each of the newer shaped implants, manufactured by Sientra, Mentor, and Allergan, all vary from each other. There are differences in shell texture, the percentage of gel fill, and the cohesivity or thickness of the silicone used to fill the implant. The newest highly cohesive gel implants are designed to feel like a breast, yet are 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. All of the new highly cohesive breast implants have textured surfaces, which again differ by manufacturer. 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.

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