Breast augmentation surgeries are the most performed plastic surgery in the world. Women outside of the U.S. have a choice between three types of breast implants: silicone gel implants, saline breast implants, and cohesive gel implants. Only in the United States is the cohesive gel implant under scrutiny. It may be another twenty years before the FDA approves them for unrestricted use.

Have you ever had the pleasure of holding a saline or silicone gel implant in your hand? Have you ever squeezed them? If you have, then you know that both of these implants use liquid filler inside a silicone shell. The liquid can be squished and squeezed and moved around.

What makes a cohesive gel implant different than a traditional silicone gel implant? The new cohesive gel implant uses what is called a cross linker during its production. This cross linker binds the gel together and makes it form into a solid mass of gel. The solid mass of gel has a consistency similar to the popular candy called Gummy Bears (hence the nickname!).

The solid form of a cohesive gel implant has several advantages. First and foremost, they cannot leak! Silicone and saline implants, when ruptured, leak their filler into the body. In the case of saline implants, the saline solution is eventually purged via urination and the saline is relatively harmless. But in the case of traditional silicone gel implants, the gel leaks into the body, sometimes for years before it is discovered. Unlike both saline and silicone, cohesive gel implants are not made with a liquid - they are a solid mass of gel! You can take a knife and stab one of them and nothing will leak! Or you can slice one in half and you will be left with two halves of a cohesive gel implant but no leakage!

Another advantage of this new cohesive gel implant is they appear to never lose their shape. They are highly resistant to the effects of gravity and aging. Some people are claiming that these implants are the closet thing to a lifetime implant.

Never losing shape might be a negative, depending on your preference. Why? Because they don't lose shape, they will maintain a woman's breast shape regardless if she is sitting, standing, lying on her side, or even standing on her head! The implant maintains its form at all times. Would you prefer a breast that never loses shape or form? Or would you rather the implant move with the direction and positioning of your body?

The first negative to these implants is scarring. Because they are a solid mass of gel, they cannot be squeezed through a tiny incision into the body. The incisions required for these implants are larger than silicone gel incisions and saline implant incisions. In short, the potential for scarring is far great with cohesive gel than any other implant currently available.

The next drawback, which is perhaps the greatest, is the FDA has not yet approved these implants for unrestricted use. A woman who wants these implants must apply to become a part of the clinical trial. She must find an FDA approved surgeon and then schedule an initial consultation. The surgeon may reject her for the trial, and in all likelihood the surgeon will reject her because cohesive gel implants can only be used under certain conditions. If a woman is accepted into the trial, she will have to sign a waiver and agree to approximately 10 years of follow up appointments. On a positive note, she will most likely be reimbursed for the cost of the procedure.

If you would like to learn more about breast augmentation surgery and the types of implants that are currently available, you must speak directly with a licensed, board certified surgeon. It is not the intention of this article to provide medical advice! Only a licensed, practicing surgeon can provide you with sound advice for your health-related questions. Good luck with your research!