In our Caribbean plastic surgery practice at Trinidad Institute of Plastic Surgery we are able to offer a wide variety of the latest breast implant choices such as gummy bear, teardrop or furry Brazilian breast implants for breast augmentation and breast enhancement.
The variety of breast implant options is overall beneficial with respect to optimizing results in breast augmentation, but also introduces additional variables into the decision making process as opposed to a “one type fits all” approach, as it is prevalent in environments with limited availability of breast implant types for breast augmentation (e. g. women considering a breast augmentation in the US are limited to saline filled implants and a narrow variety of silicone implants). And, naturally, with the number of options the number of urban legends and misconceptions increases.
The foremost fact about breast implants is that there is no “best breast implant” for breast augmentation and breast enhancement. If that were the case, all the others would not be around. There are just improved choices in the context of what the desired function of the implant is in the context of the surgery required for its insertion (position of incision, plane of the pocket for the breast implant above or below chest wall muscle, shape and tissue distribution in the non augmented breast amongst others).
“Gummy bear” breast implants got their nickname from the perceived feel of the implant resulting from being filled with so called cohesive silicone gel. The cohesiveness results from various degrees of cross linking (polymerization) of the silicone molecules. Cross linking eventually produces a jello like substance, which does not run out and keeps its overall shape even if the “shell” (the container enclosing the gel) is removed. This characteristic allows the creation of “form stable” breast implants for breast augmentation having say the shape of a teardrop, which – being an anatomic implant – resembles a breast with a gentle upper take-off from the chest wall and a full lower aspect, or a more conical shape of a very projecting breast with a sharper take off from the upper chest wall resembling more the appearance of the famous rescue swimmers.
So form stable implants make it possible to distribute the overall volume of the silicone gel in the shell differentially having more in the lower pole as in anatomic implants or more centrally, depending on what the breast implant is intended to accomplish. The shape is stable no matter which way the breast implant is turned and thus is stable in its form no matter whether the patient stands up or lies down or assumes any position in between. Due to the cohesiveness of there are no ripples, folds or similar visible on the breast implant and this characteristic is maintained once the gummy bear, tear drop or furry Brazilian breast implant is inserted during breast augmentation. Together with the natural feel of the breasts after augmentation the latter is of great advantage when the breast implant is placed directly above and not under the chest wall muscle.
Now “gummy bear” implants which have an asymmetrical shape like a “teardrop” implant have to stay in the correct position after breast augmentation. By changing the surface of the shell from smooth to “textured” by creating a large number of small pits during the manufacturing process the interface between the surface of the implant and the soft tissue of the pocket – the so called capsule – becomes like a velcro strap holding the breast implant in position. Capsules do form around all breast implant types used in breast augmentation, but exhibit subtle differences depending on the implant type. It was assumed that “texturization” of the shell would result in a softer capsule, but the scientific data to support this belief are inconclusive.
The exception is the “furry Brazilian” implant, which is coated in polyurethane microfoam to provide surface texturization resulting in a feel similar to suede. The available scientific data (e. g. Vázquez G, Pellón A. Polyurethane-coated silicone gel breast implants used for 18 years. Aesthetic Plast Surg. 2007, Jul-Aug;31(4):330-6; Handel N, Cordray T, Gutierrez J, Jensen JA. A long-term study of outcomes, complications, and patient satisfaction with breast implants. Plast Reconstr Surg. 2006 Mar;117(3):757-67, …) shows the lowest rate of problems with the capsule in the long run while achieving outstanding aesthetic results.
The latter two considerations – avoidance of long termbreast implant related problems and excellent aesthetic results – are my two overriding concerns. So if there is something like a surgeon’s pick of breast implants for breast augmentation and enhancement- the “furry Brazilian” is definitely on top of my list.