Breast augmentation surgery is the number one performed plastic surgery in the world. Women outside of the United States have three primary types of breast implants to choose from: traditional silicone gel implants, saline implants, and the new cohesive gel implant.

Cohesive gel implants are relative new in the United States but they have been used elsewhere in the world for almost twenty years. Before the FDA will allow these implants to be used for unrestricted use, they must undergo a rigorous clinical trial similar to the one imposed upon silicone gel implants from 1992 to 2006. Until then, only an FDA approved surgeon may use these implants for a limited type of breast augmentation procedures.

Like the silicone gel implant, cohesive gel implants are filled with silicone gel. Only instead of using a liquid, the cohesive gel implant uses a solid mass of gel. During the production of cohesive gel, a cross linker is added to the mix. This cross linker makes the silicone gel bind together into a solid mass that has a similar consistency and feel as the popular Gummy Bear candy.

Cohesive gel implants are currently available in only one form: anatomic. This means their inherent shape is similar to an actual breast. The slope, curve, and fullness are very similar to a real breast.

When someone mentions the texture of a breast implant, they are referring to the actual surface of the implant. A smooth textured implant is exactly that: a very smooth outside surface. A textured implant uses a rough surface on the exterior of the implant. It is generally believed that textured implants result in fewer post-surgery complications, such as capsular contracture, wrinkling, and rippling.

It's important to note that cohesive gel implants maintain their shape and consistency for a long period of time. Some believe they will last a lifetime and they are impervious to the effects of aging and gravity. One must also realize that they maintain their shape regardless of the woman's posture and position; if she is lying on her side, the implants will maintain their upright shape! Is this a problem? It doesn't appear to be so, and most women like the fact that the implants maintain their form no matter what she is doing physically.

Anatomical design allows for a natural slope to the breast. This makes the breast more aesthetically appealing because it looks more like a real breast. Silicone and saline implants allow the liquid to move inside the implant. Thus, if a woman lays flat on her back, a saline or traditional silicone implant will flatten out, much like a giant M&M. Cohesive gel, on the other hand, will not flatten out; it will maintain its shape regardless.

Not all cohesive gel implants are built the same. There are currently four recognized grades of "cohesive" gel, each more firm than the previous. Only time will determine which grade of cohesive gel becomes the most popular and therefore widely used.

If you would like to learn more about cohesive gel implants, you will need to contact an FDA approved surgeon. This will not be easy to accomplish, but you can certainly find a list of approved surgeons at the FDA's website. From there, you will need to schedule a meeting with the surgeon and request inclusion into the clinical trial. There's a high probability that you will be rejected, but that doesn't mean you shouldn't try. If you are approved for the procedure, you will most likely be reimbursed for 100% of the costs incurred for the surgery. However, you will need to sign a waiver and agree to be a part of the clinical trial.

It is not the intention of this article to provide medical advice or recommendations of any sort. Only a licensed, practicing plastic surgeon should answer your plastic surgery related questions. Good luck with your research!