The FDA has recently approved the use of a “gummy bear” breast implant by the new breast implant manufacturer Sientra. Many people consider this implant to be the ultimate device for breast augmentation in San Diego and in Southern California. There is no question that this will enhance the options that women have when choosing to undergo a breast enhancement surgery. However, there are limitations with his implant that must be understood prior to choosing the best breast implant.
A “gummy bear” type breast implant is shaped like a teardrop and has a textured surface. This means that the upper portion of the implant is relatively flat and the lower segment fuller much like the shape of a normal breast when upright, however, this will not change when the patient is laying down. Normally, gravity will direct most of the breasts weight to the lower aspect on the chest giving it this “natural” shape. However, this means that they implant has a specific orientation of top, bottom, front and back. If this implant shifts its position is possible that patient will end up with a fullness in an unwanted area or vice versa. This means that there is more of a challenge in the surgical insertion of this implant as there are very specific requirements. Also, when a woman lays on her back, her breast will take a more flattened position. This allows gravity to distribute the breast tissue evenly across the chest. An anatomic/tear-drop “gummy bear” implant does not change its shape with gravity. And thus, when a woman lies down with these implants will maintain an anatomic appearance, unlike the natural tendency of a breast.
Purported Advantages over current silicone gel implants:
- Improved breast shape
- Decreased capsular contracture rate
- Decrease risk of implant rupture
- Decreased risk of rippling of the breast
- Increased cost
- Feel – they are firmer than memory gel implants.
- Longer scar
- Possibility of rotation – The implants are “anatomic” or “tear-drop” shaped and there is a possibility that the implant could rotate early in the healing process leading to an unusual shape [though a textured surface can help prevent this]
- Difficulty with secondary surgeries such as removal and replacement of implants due to the textured surface of the implant causing in-growth of tissue onto the implant capsule
A standard round breast implant will follow along with the natural breast when gravity is factored in. There is a tendency for the cohesive silicone gel to settle at the lower end of the breast when the patient is upright. This allows for an effective teardrop shape of the breast despite the round design. In addition, what a patient lies down the implant will lay in a flattened out position, much like a regular breast. Finally, since standard implants are round there is no top bottom front or back to these implants. This allows a considerable degree of flexibility with round implants. This implant can move freely within the breast pocket, much like a natural breast, without any of the restrictions related to its anatomic counterpart.
I currently feel that round implants are superior to the new “gummy bear” devices despite the fact that they have been on the market for the past five years. Just because something is new does not mean it is better.
Despite all of this, there are circumstances where the gummy bear implant will prove to be useful for women and breast augmentation. This will be most notably in women who have had previous problems related to breast augmentation. Patients suffering from capsular contracture may find that these implants resists this better. Also, patients who suffer from visible rippling of the implants may see improvement as these implants do not have this tendency related to the cohesive nature of the implants. Also, women who undergo breast reconstruction surgery will likely see improved overall outcomes from these implants.
In conclusion these implants do add additional choices to the marketplace for women considering breast augmentation. That being said, it may not be the best choice for every patient but something you should discuss with your surgeon. It is of utmost importance to choose a board-certified plastic surgeon when scheduling your consultation. This will allow you will be able to determine which implant is best for you and your specific circumstances so that you have the highest chance for success with your breast augmentation.
Board Certified Plastic surgeon