Cohesive gel implants have been used in Europe since 1995. They have been available in Canada through special approval by Health and Welfare Canada since approximately November 2000. Cohesive gel implants are different than saline implants. Saline implants are filled with salt water. Cohesive gel implants are solid silicone implants. They are different than the old silicone implants which used to be filled with silicone gel. Those older silicone implants would leak silicone gel if the outer shell broke. Cohesive gel implants are significantly different. These implants are solid like a “gummy bear.†Because they are solid they can’t leak. If the outer shell is poked with a needle, broken or even cut, the implant maintains its shape because it’s solid.
Cohesive gel implants have certain advantages when compared to saline implants in some patients. In women who are extremely thin, these implants can help prevent rippling, a complication occasionally seen with saline implants. The fact that these implants come in a variety of shapes as well as sizes, allows them to change the shape of the breast in patients who need an improvement in their breast shape. Patients who need a change in their breast shape, such as tuberous breast deformity, do particularly well with these solid shaped implants . These implants come in a variety of heights, widths and projections. This can help the surgeon give a more exact result in some patients.
Another condition, which is especially helped with cohesive gel breast implants, is the “droopy†or ptotic breast. Some patients have breasts which droop either because of their natural breast shape or as a result of child bearing or breast-feeding. Cohesive gel breast implants help lift the breast because they are solid and because their rough textured surface acts like velcro in lifting up a droopy breast. This can prevent the need for a breast lift in some patients and may save them from the scars associated with a breast lift. The photos at the bottom of this web page clearly demonstrate the lift that comes from cohesive gel implants. While cohesive implants can be used behind or above the pectoralis muscle, in order to get the effect of breast lifting or reshaping with cohesive implants, the implant needs to be placed above the chest muscle and right behind the breast tissue.
Cohesive gel implants have the ability to give droopy breasts a lift as well as increase fullness and firmness.
It is important to understand that cohesive gel breast implants are not better than saline implants in all patients. For many patients, the look that they will achieve is the same with both implants. There are some disadvantages to cohesive gel implants. Because they are solid they require a larger incision on the body. They are also significantly more expensive than saline implants.
Cohesive gel implants have complications similar to saline implants and you should read the rest of the previous breast enlargement web page to learn more about implants in general and how this procedure is performed by Dr Lista at The Plastic Surgery Clinic.
There is not one implant that is better than another implant in all patients. Cohesive implants have some advantages over saline implants in some patients. In other patients, saline implants may be better or more appropriate than cohesive. It is important for your plastic surgeon to have experience with both types of implants, through various incisions, placed above the muscle in some patients and behind in others. Dr Lista has a great deal of experience using both saline and cohesive gel implants. He spends a great deal of time with his patients determining which implant, which incision and which placement will give each patient the best and most natural result.
To read about how to choose the correct implant for you click here.
Before and after photographs of Dr Lista’s actual patients who have undergone cohesive gel breast augmentation. Notice how cohesive gel implants can reshape the breast and lift a breast which droops.
Patient before surgery with markings for cohesive augmentation.
One week after cohesive gel breast augmentation. Notice the lifting effect of the breast and elevation of the nipple.