What are cohesive gel implants?

Cohesive gel implants have been designed to more closely mirror the natural look and appearance of the breasts. They are ideal for providing a breast augmentation to increase cleavage and breast size without producing an undesirable and unnatural upper breast fullness.

Cohesive silicone gel breast implants have been available in Canada since approximately November 2000.

All silicone gel filled breast implants are cohesive but today’s gel filled devices are filled with a thicker material than older style gel-filled implants. If you cut into an older style gel implant, the liquid silicone gel escapes from the implant shell. In contrast, when you cut into a cohesive gel implant, the implant itself maintains its shape and integrity. This is not dissimilar to what you see when you cut into a "gummy bear".

Because breast augmentation with cohesive gel implants is designed to focus more on proportion and dimension rather than volume, gel implants are particularly indicated for women who are looking for a natural-shaped and proportionate-sized breast augmentation.    

Cohesive gel implants can be round or teardrop shaped and may have a smooth or textured surface. They will also vary in the degree of cohesiveness of the gel. Dr Brown will review with you the specific issues that are important in selecting the right implant to meet your personal goals and objectives.

What are the advantages and disadvantages of cohesive gel implants?

The advantages of highly cohesive gel implants are primarily that they provide a proportionate-sized breast augmentation with a soft and natural-feeling breast implant. The implant maintains its shape in an upright position (has a "memory") which decreases the incidence of folding of the implant shell and the development of rippling. As well, there are twelve models of anatomic cohesive gel implants which vary with respect to height, projection and base width. Each model comes in a variety of sizes, providing flexibility for the patient and surgeon in determining the appropriate implant to balance body proportions and breast aesthetics.

Cohesive gel implants require a slightly larger incision for insertion compared to saline implants. Because of this, insertion is usually performed through an incision in the fold under the breast or occasionally through an incision around the areola. Cohesive gel implants are very difficult to insert through an incision in the armpit. Although surgical costs are usually similar, the cohesive gel implants themselves are more expensive than standard saline breast implants.

What are the complications associated with cohesive gel implants?

Complications with cohesive gel implants are similar to those in any breast augmentation. The largest published study looking at complication rates with cohesive gel implants showed an overall capsular contracture rate of <5%. The majority of these contractures were minor in nature with only 4/600 patients having a severe (Baker IV) contracture. Infections occurred in 2/800 patients and improper implant position was noted in 1.1% of patients. Of note, half of these were in secondary breast augmentations. (Breast augmentation with anatomical cohesive gel implants, Per Heden, MD, PhD, et al, Clinics in Plastic Surgery, Vol. 28 No. 3, July 2001, pg 531-552).

Following the silicone implant controversy of the early 1990s, many academic centres have performed large scale research studies looking at the safety of silicone breast implants. These studies have failed to demonstrate an increased risk of any disease process in women undergoing silicone breast augmentation, as compared to women in the general population. Dr. Brown will review and discuss with you the risks and complications associated with cohesive gel breast augmentation at the time of your initial consultation.

How should I proceed if I am interested in finding out more about cohesive gel implants?

The most appropriate first step would be to arrange for a consultation at which time Dr. Brown will discuss with you the various options of breast implants currently available. Based upon your personal goals and expectations, desired breast size and shape, Dr. Brown can help you to select the implant or implants that may best allow you to achieve your desired look.

To book an appointment, click here.

To view before and after photographs of cohesive gel implants, click here.