Everybody knows that silicone implants are great. They were reintroduced to the American market in 2006 and have been very popular. So why change things? The gel filler used in silicone implants allowed for round implants and let them deform with gravity to a soft somewhat breastlike shape. The slightly stiffer gummy bear implants allow the shape of the implants to hold a teardrop (or anatomical) shape.
Many of my patients still like the round smooth implants because the restore the upper fullness (think cleavage) and roundness that mature breast tend have lost with age or pregnancies. But for someone who wants a stealth augmentation, with less evidence of this unnatural (but often desired) behavior the round smooth implants leave something to be desired. Enter the “Gummy bear”; with its stiffer composition it could provide maximum fullness at the bottom of the breast with little or no evidence of its presence at the top of the breast slope. In 2012 the first shaped silicone implants cleared FDA approval and there are now three manufacturers (Allergan, Mentor, and Sientra) who provide these newer shapes. Sientra implants are the most like the round gel with the most upper fullness of the shaped devices. The Mentor memory gel implants are intermediate in the upper fullness, and the Allergan Style 410 is the flattest at its upper edge. All the manufacturers have a range of styles (and of course, sizes) within each type of implant.
Most of the gummy bear implants I put in are for reconstruction patients, where it is more common to want less exaggeration of the upper pole to minimize the “coconut” appearance of the reconstructed breast. And the added stiffness is relative. These are NOT hard immobile rocks in your breast; for people who desire a more natural augmentation, the shaped silicone implant can be wonderful.