One of the more frequently asked Breast Augmentation questions at my Walnut Creek Plastic Surgery Office is regarding the difference between Cohesive Gel Silicone Breast Implants and Gummy-bear Silicone Breast Implants.
Gummy Bear Breast Implants
Cohesive Gel vs. Highly Cohesive Gel
All silicone gel is cohesive. It’s a property of the gel that means it likes to stick to itself. Less cohesive gel is more like a liquid; however, the more cohesive the gel, the more it behaves like a solid. All silicone breast implants currently approved in the US are filled with cohesive silicone gel. They are manufactured to remain soft, but more toward the solid end of the spectrum. Since the gel is cohesive is resists flow, or gel migration in case of a leak. When cohesive gel implants are punctured, the gel does not run out like water. When the implant is squeezed, the gel mushrooms out of the hole, and often retracts back inside the implant when the pressure is released.
Gummy bear (Gummi-bear) form-stable or highly cohesive gel breast implants are soft solids. They cannot leak, and hold their shape. The consistency is like that of a stress ball. Soft enough to squeeze, yet they go back to their original shape when the pressure is released. Since they are solid, they require a larger incision during the breast augmentation surgery. Since they are shaped, when they rotate, they can distort the shape of the breast as described below. These are not currently FDA approved, despite the fact that they are almost the same as the current cohesive gel implants, and that all the information the FDA requested was supplied several years ago.
The Differences Between Cohesive Gel & Gummy Bear Breast Implants
Both Cohesive Gel Silicone Breast Implants and Gummy-bear Silicone Breast Implants have two components:
A solid silicone shell
A soft silicone interior
So what is the difference between these two types of silicone gel breast implants?
The Outer Shell
The outer shell of both Cohesive Gel Silicone Breast Implants and Gummy-bear Silicone Breast Implants is made of a tough flexible silicone solid. The shell is made to resist damage and inhibit gel bleed. This is less of an issue with the Gummy-Bear implants, as the center, while soft, is essentially a solid and does not flow. For silicone gel implants, the greater the resistance to damage, the fewer leaks. Moreover, reducing gel bleed means the gel cannot seep between the molecules of the shell and leak out, like helium escaping a balloon, just much slower.
Since most Gummy Bear implants are shaped, most the shells of Gummy Bear Breast Implants are textured (fuzzy). This allows the breast implant’s surface to adhere to the inside of the capsule that forms around the implant, like velcro. This adherence is very important for shaped breast implants, because it reduces the risk of the implant rotating into a less flattering orientation. When a shaped implant is properly aligned, a tear drop shaped breast augmentation is the result. This will provide maximum fullness and projection at the bottom of the breast where is belongs. A shaped implant is most important in cases of breast reconstruction, but may be helpful when the volume of natural breast tissue is very small. When a shaped implant rotates, and this can occur as much as 10% of the time, the bottom rotates outward, around to the sides, giving an odd lateral fullness and reduced cleavage. Texturing and precise surgical technique are important to minimize rotational deformities.
When an implant is round, texturing is not necessary to prevent rotation. The shape of the breast is not affected by the implant’s rotation. With silicone gel filled implants, gravity tends to bring the more liquid center down, no matter how the implant’s shell may spin. Cohesive gel implants are most often round, and round implants do not usually require texturing to prevent rotational deformities.
The Soft Interior
The biggest difference between Cohesive Gel Silicone Breast Implants and Gummy-bear Silicone Breast Implants is the filling. Both types of breast implants are filled with medical grade silicone. The difference is the viscosity of the gel. Cohesive gel implants have a viscosity somewhere between liquid and solid. The silicone gel inside a Cohesive Gel Implant does not flow like water. It will not squirt, or even freely run, if the tough outer shell is punctured. The cohesive gel likes itself, and wants to remain together. It can be forced out with pressure, so it is not a solid; however, the newer cohesive gel implants are much easier to remove after a rupture than their more liquid-like predecessors.
While both resist flow, a gummy bear implant’s filling is the consistency of its namesake. It is a soft solid that has memory. It can be compressed, but will return to its original shape spontaneously. Even when cut in half, the semi-domes will maintain their shape. If compressed, they will flatten, but when the pressure is released, the semi-dome shape will return. The term for this is form-stable. The form stable breast implants’ inability to leak offers a significant advantage.
Gummy-Bear Breast Implant Availability in the US
For San Francisco Bay Area Breast Implant patients the wait for FDA approval of the gummy-bear breast implants continues. Each March, there are rumors of impending approval, and in 2012, the rumors are again stirring. There has been a long delay between fact finding and decision making, but eventually the US should follow the lead of the rest of the world.
As much as I would like the FDA to make its decision, I am thankful for our FDA. It protected American women, and American Plastic Surgeons, from the recent European and South American problems with low quality Poly Implant Prothèses (PIP) breast implants. The PIP implants were made with non-medical grade silicone, and have failure rates of 10% at one year. This does not compare well with the US manufacturers’ breast implant failure rates of less than 1% at 3 years. Faulty PIP implants were used in about 300,000 women in 65 countries, and the recommendation is that they should all be removed or replaced. If you had breast augmentation surgery abroad, it is in your best interest to find out if your breast implants were manufactured by PIP. If so, find a Board Certified Plastic Surgeon near you for breast implant removal or replacement.
PIP saline filled breast implants were briefly available in the US. Since I have only used FDA approved breast implants, I never performed breast augmentation using PIP saline implants. I have had to replace them though, as they too leaked more frequently. Gummy-Bear highly cohesive silicone breast implants seem less controversial. They have the obvious benefit of not leaking, and much more specific scientific information is available about their safety. So FDA, if you’re reading this, how about a decision this March?
Seven million minimally invasive wrinkle reduction procedures were performed in 2011. Neuromodulators like BOTOX Cosmetic, Dysport and Xeomin enjoyed a 5% increase in number of treatments compared to the 2010 statistics, while dermal fillers like Restylane, Juvederm, Perlane and Radiesse experienced a 10% increase from a year ago.
Facial Wrinkle Reduction
Prevention is the best medicine, so sun protection and moisturizers are always recommended, but once the damage is done, how can it be corrected? Facial wrinkle reduction can be actively corrected with cosmetic plastic surgery like:
As a Board Certified Plastic Surgeon, I offer the full spectrum of facial wrinkle correction. From surgical procedures that offer more effective and longer lasting results, to injectables that offer fast results and minimal downtime. The video below focusses on minimally invasive correction, but information on the cosmetic plastic surgery procedures is available on my main web site by clicking on the links above.
Facial Wrinkle Correction Video
Today’s video is the final segment about how to use minimally invasive procedures to achieve maximum results. It is part 4 of a recent television appearance on San Francisco’s KRON‘s Body Beautiful. The (415) number in this video was for viewers to call during the live broadcast only; however, if you have questions about dermal fillers, botox or other cosmetic plastic surgery procedures, please a call us at (925) 943-6353.
The offers in this video expired in 2011; however, special discounts are available from time to time. Be certain to call the office to find out what offers are available now.
Facial Wrinkle Correction Video Contents
This Facial Wrinkle Correction Video includes:
Liquid Facelifts and Facial Wrinkle Reduction
What are the risks associated with non-surgical wrinkle treatments?
How often do bruises occur after non-surgical wrinkle treatments?
How long do bruises last after non-surgical wrinkle treatments?
What are stretch marks?
Are there reliable treatments for stretch marks?
Who Am I?
I am a Board Certified Plastic Surgeon in private practice in the San Francisco Bay Area city of Walnut Creek, California, for 15 years. My practice includes a wide range of plastic surgery, with specialization in cosmetic plastic surgery. To learn more about my practice visit the Meet Dr. Mele page.
Why see a Plastic Surgeon for Non-Surgical Wrinkle Correction?
While I specialize in Cosmetic Plastic Surgery, the development of injectable therapies has revolutionized the way I approach facial rejuvenation. Dermal Fillers and Wrinkle Relaxers are no substitute for real plastic surgery; however, they do allow for real improvement in the appearance of facial lines and wrinkles, in ways that were just not possible before. The advantage of seeing a Board Certified Plastic Surgeon for your non-surgical wrinkle correction is two-fold. You get the immediate advantage of a trained plastic surgeon’s advanced knowledge of facial anatomy, and the future advantage having a trusted relationship with that plastic surgeon should longer lasting, surgical correction be desired.
More Wrinkle Correction Information
Information on facial wrinkle reduction is available in English and Español. Please follow the links below:
In the not so distant past, wrinkles were treated with creams or plastic surgery. Now, all that has changed. The new millennium has brought a wide range of treatments that fit nicely between creams and plastic surgery. They offer better, stronger, faster correction than creams, with quicker recovery and lower cost than the gold standard — plastic surgery.
Wrinkle Fillers
Products like Restylane, Juvederm, Perlane and Radiesse allow for quick correction of moderate wrinkles with minimal downtime. They are all dermal fillers, and as the name implies, they are used to fill in unwanted wrinkles and folds. The correction can be increased with increased volume, and the downtime is about 24 hours of mild redness and sometimes longer for resolution of the occasional bruise. The improvement is immediate, and continues to improve for the first month. They can be used anywhere on the face. Since fillers do not inhibit muscle motion, they excel in the correction of lines around the mouth and in the lower face.
Neuromodulators
Products like BOTOX Cosmetic, Dysport and Xeomin are neuromodulators. They relax the muscles that cause wrinkles, like the frown lines found between the eyebrows. These take a few days to relax the muscle, and gradual improvement is seen as the skin is no longer folding from the muscle motion. Since neuromodulators reduce, or even stop, muscle motion, they are used mostly in the upper face. Use around the mouth needs to minimal and requires advanced techniques and good judgement.
Facial Wrinkle Correction Video
Today’s video is about how to use minimally invasive procedures to achieve maximum results. It is from a recent appearance on KRON‘s Body Beautiful. The (415) number in this video was for viewers to call during the live broadcast. If you have questions about dermal fillers or botox, please a call us at (925) 943-6353.
Facial Wrinkle Correction Video Contents
This Facial Wrinkle Correction Video includes:
Liquid Facelifts and Facial Wrinkle Reduction
Why have a Plastic Surgeon do your non-surgical wrinkle treatments?
Is Wrinkle Reduction Art or Science?
What happened to Collagen?
What are the problems with dermal fillers?
What is Hyaluronic Acid?
How does Hyaluronic Acid improve wrinkles?
Can you get Botulism from Botox?
Viewer Question – How can a scar beneath the eye be improved?
What can be done at home to improve scars?
Does massage or using topical silicone improve scars?
Who Am I?
I am a Board Certified Plastic Surgeon in private practice in the San Francisco Bay Area city of Walnut Creek, California, for 15 years. My practice includes a wide range of plastic surgery, with specialization in cosmetic plastic surgery. To learn more about my practice visit the Meet Dr. Mele page.
Why see a Plastic Surgeon for Non-Surgical Wrinkle Correction?
While I specialize in Cosmetic Plastic Surgery, the development of injectable therapies has revolutionized the way I approach facial rejuvenation. Dermal Fillers and Wrinkle Relaxers are no substitute for real plastic surgery; however, they do allow for real improvement in the appearance of facial lines and wrinkles, in ways that were just not possible before. The advantage of seeing a Board Certified Plastic Surgeon for your non-surgical wrinkle correction is two-fold. You get the immediate advantage of a trained plastic surgeon’s advanced knowledge of facial anatomy, and the future advantage having a trusted relationship with that plastic surgeon should longer lasting, surgical correction be desired.
More Wrinkle Correction Information
Information on facial wrinkle reduction is available in English and Español. Please follow the links below:
Like most Plastic Surgeons, I like to operate. Plastic Surgery is a versatile tool. It can restore function after injury or disease, and it can improve form for even the normal body. But just because I have a hammer, I don’t think the whole world is a nail.
Plastic surgery is extremely personal, and I depend on you to help me know what the best course of treatment will be. Sometimes plastic surgery is the best answer, and sometimes less is more appropriate.
Many plastic surgeons use Botox and Restylane in their practices. While non-surgical, these products are complementary to what we Plastic Surgeons do. For example:
Forehead Wrinkles and Frown Lines
Relaxing the frown lines and forehead wrinkles has always been a part of the Brow Lift procedure. If you have droopy eyebrows that are pushing skin onto your upper eyelids, deep wrinkles running across your forehead, or vertical lines between the eyebrows that make you look angry (frown lines), a brown lift might be for you. On the other hand, if you have the frown lines the forehead wrinkles, but the eyebrows and eyelids are fine, Botox, Dysport and Xeomin, may provide you with an equally attractive result.
Lower Face Wrinkles
Lower facial wrinkles include the Naso-Labial Folds (NLF’s), Marionette Lines (ML’s), lip lines and other wrinkles found on the lower face. These areas can be treated with a Facelift, when coexisting with lower facial skin laxity, but when found in isolation, a face lift is more than what is needed. Dermal fillers like Restylane, Juvederm, Perlane and Radiesse can pinpoint the treatment to exactly where it is needed, without the downtime associated with surgery.
Naso-Labial Folds (NLF’s)
The Naso-Labial Folds are the lines that extend from the sides of the nose down to the lips. They are the result of muscle attachments to the skin, and are deepened when we smile. The more firmly the muscle is attached, the deeper the resulting fold. Filling the NLF’s with Restylane, Juvederm, Perlane or Radiesse can reduce the appearance of folds without affecting the ability to smile. Unlike botox, dermal fillers do not inhibit motion.
Marionette Lines (ML’s)
The Marionette Lines are a continuation of the NLF’s, extending from the corners of the mouth down to the jaw line. These too are reinforced when we talk and smile broadly. Like the Naso-Labial Folds, the Marionette Lines respond well to fillers. The ML’s often require more volume than the NLF’s for what would seem to be wrinkles of similar depth.
Lip Lines
Lip lines are the fine lines that radiate out from the lips. Often referred to as Smoker’s Lines, the lines are formed when we pucker our lips. Lip lines allow lipstick to bleed, and can make maintaining a clean line at the edge of the lip difficult. By carefully filling in the edge of the lip, a smoothed contour can be formed, and less lipstick bleed occurs. This can be done with or without Lip Augmentation, or purposefully adding volume to the lips.
Facial Wrinkle Correction Before and After Photos
This segment focusses on dermal fillers, and shows numerous before and after pictures illustrating the areas more commonly treated with fillers like Restylane, Juvederm, Perlane and Radiesse. Wrinkle relaxers, like Botox, Dysport and Xeomin can complement results in facial wrinkle reduction, but were not used for the areas shown in these before and after pictures.
Facial Wrinkle Correction Video
Today’s video is from a recent appearance on KRON‘s Body Beautiful during which I discuss how to use minimally invasive procedures to achieve maximum results. The (415) number in this video was for viewers to call during the live broadcast. If you have questions about dermal fillers or botox, give us a call at (925) 943-6353.
Facial Wrinkle Correction Video Contents
This Facial Wrinkle Correction Video includes:
Liquid Facelifts or Facial Wrinkle Reduction
The effects of gravity and aging on the face.
Who is a good candidate for wrinkle reduction treatments?
Before and After Pictures of Dermal filler treatments
Before and After Pictures of Howdy Doody Line treatment
Before and After Pictures of Naso-Labial Fold treatment
Before and After Pictures of Facial Wrinkle treatment
Before and After Pictures of Acne Scar treatment
Before and After Pictures of Lip Augmentation
Before and After Pictures of Non-Surgical Rhinoplasty
Dermal fillers used include
Restylane
Juvederm
Perlane
Radiesse
Neuromodulators can also enhance the results of fillers. For example:
BOTOX Cosmetic
Dyport
Xeomin
The best areas to treat with fillers
Temporary vs. “Permanent” Correction
Who Am I?
I am a Board Certified Plastic Surgeon in private practice in the San Francisco Bay Area city of Walnut Creek, California, for 15 years. The development of injectable therapies has revolutionized the way facial rejuvenation is approached. While no substitute for real plastic surgery, they do allow for real improvement in appearance of facial lines and wrinkles, in ways that were just not possible before.
More Wrinkle Correction Information
Information on facial wrinkle reduction is available in English and Español. Please follow the links below:
