Cohesive Silicone Gel Breast Implants

All About Cohesive Gel Implants

How have silicone gel breast implants changed over the years?

The first silicone gel implants (developed in the early 60’s) had a seamed rubber shell with a very thick silicone gel filler. They were anatomical in shape and very firm compared to the silicone gel breast implants on the market today.

In the 1970’s, breast implants were redesigned. The shells of these implants were much thinner, contained no seams, and the silicone gel filler was much thinner. There were problems with these implants as well. Because the shells were so much thinner, they were much more prone to rupture. In addition, the thin shells allowed silicone to seep through the shell. During one of my office visits to my plastic surgeon, Dr. Tom DeWire, I had the opportunity to hold one of these older generation silicone breast implants. I specifically remember him telling me to “be careful” with it. I can only assume that he was concerned that rough handling would result in the implant rupturing. The thin shell was very apparent as I held it in my hands, and the implant itself felt greasy and slimy, presumably from the amount of silicone bleeding through the shell.

 

Ruptured Silicone Gel Breast Implant

Custom “piggyback” Georgiade Surgitek implant (placed 1978), consisting of a smaller (100 mL) anterior contoured single-lumen silicone gel-filled implant (in a state of uncollapsed rupture) (thick arrow), shown here maintaining its original contoured shape, attached directly to a larger (185 mL) posterior single-lumen silicone gel-filled implant, shown here ruptured with the attached fragments of its shell laid out symmetrically (thin arrows).1

The 1980’s were the dawn of yet a newer generation of silicone breast implants. Manufacturers made thicker shells which rendered the implants more durable and did a much better job of controlling gel bleed through the shell.

In the 90’s, shells were again made thicker, and the silicone gel used inside the implants was even more cohesive.

Today, all silicone is cohesive, meaning that even if the shell ruptures, the silicone will not spill out. The video below shows how the newer silicone gel implants. When cut into, the gel stays in in the shell and does not spill out. This is not a gummy bear breast implant, which is even more cohesive.