The Surgeon Minute

New Implants Restore Volume in All the Right Places

New Implants Restore Volume in All the Right Places

For the past decade, surgeons have achieved great results with third and fourth generation silicone breast implants. Unfortunately, these implants tend to lose their shape once they are inside the breast. While the implants are staying physically intact – thanks to thicker shells than previous generations – patients are finding themselves with very little fullness in the upper portion of the breast as the implant volume settles into the lower half.

“Many of our patients have come to us wanting more of that superior pole fullness, that pop that they had before they lost weight, before they lost volume after breast feeding and the like,” shares Dr. Kevin Smith of Charlotte Plastic Surgery. “Though we were able to achieve that for a while, by doing lifting, by tightening up the skin of the breast with mastopexy surgery, over time, the implant would have a tendency to puddle, or collapse in that superior pole.”

To combat this, researchers and manufacturers have worked to create new implants with gel qualities aimed at solving these issues.

Engineering a Better Implant

Implant manufacturers have listened to these concerns and have recently delivered a fifth generation of silicone gel breast implant technology. These new implants are specifically designed to treat superior pole volume loss. Women who are happy with their breast size but would like a little bit more “up top” now have options.

Allergan’s Natrelle Inspira line of breast implants offer surgeons a range of implants, each implant type offering a different degree of shape retention. “The new family of breast implants allows us to put in an implant that maintains superior pole volume,” says Smith. “There are different levels of cohesivity.”

Modern implants and cohesivity.


What is Cohesivity?

Historically, older implants were filled with a silicone gel that was the consistency of honey. This runny gel did not hold shape well at all. When scientists bonded the molecules of silicone together in a tighter fashion, the silicone gel became less runny and more firm. This produced silicone gel the consistency of jello, instead of honey.

The first cohesive silicone gel implants available on the market became known as gummy bear implants. These new implants felt somewhat firm to the touch when compared to traditional silicone gel. Today, plastic surgeons can choose from a range of gummy consistencies. With new implants ranging from soft to slightly firm to more firm, the different levels of cohesivity provide surgeons with the ability to shape to the breast.

Older implants with their honey consistency silicone took on the shape of the natural breast. If a breast was flat on top and full on the bottom, the implant would also settle to the bottom of the breast. New cohesive gel implants maintain their shape inside the breast. They also have the added advantage of wrinkling and rippling less. If a cohesive gel implant is punctured or the shell is ruptured, the gel inside maintains its shape and does not leak.

Benefits of Gummy Bear Implants

  • Maintain shape
  • Less rippling or folding
  • No Leakage

Level 1: Responsive Gel®

Natrelle’s Inspira Responsive Gel is the least gummy of Allergan’s cohesive gel implant series. At just over 80% shape retention, these implants offer better shape retention than traditional silicone gel implant. Responsive Gel implants are also the softest of the cohesive silicone gummy implants, offering a very natural look and feel.

Level 2: SoftTouch®

The SoftTouch implant is slightly firmer than the Responsive Gel implant. This implant provides even more shape control while still allowing natural movement and feel of the breast. With approximately 90% shape retention, the SoftTouch gives surgeons a new option to provide more upper pole fullness without compromising softness of the breast.

Level 3: Highly Cohesive®

The firmest level of cohesivity is the Highly Cohesive silicone gel. With approximately 97% upper pole volume retention, this implant is a great option for the woman who does not want to change her breast size drastically, but does want to boost the volume in the upper portion of the breast.  “Also,” shares Dr. Smith, “in those patients who want a rounder breast, or especially in those patients who want a breast lift, this has become a perfect implant for that patient with more superior pole fullness.”

Before and after - cohesivity in modern implants.

Superior Pole Volume Retention Levels

  1. 84% Retention: Responsive Gel
  2. 91% Retention: SoftTouch
  3. 97% Retention: Highly Cohesive

The cohesive range of new implants from Allergan allows surgeons to choose an implant that will help to shape the breast in the long term, restoring volume where many women have lost volume.  “With different levels of cohesivity,” concludes Dr. Smith, “We can choose an implant to give somebody a look that they are really trying to achieve with more reliability.”

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