Cohesive Silicone Gel Implants: The Pros and Cons

This is going to be a quick flyover of the pros and cons of different aspects of Cohesive Silicone Gel breast implants.

Be sure not get Cohesive Silicone Gel and Gummy Bear implants (medically referred to as highly-cohesive silicone gel) confused with one another. For the sake of brevity and impartiality, I will withhold my personal opinions on which implant I feel is best.

Overall Feel

Cohesive silicone gel breast implants are the most natural feeling of all the implants currently on the market. Both saline and Gummy Bear implants have a firmer feel.


Silicone breast implants tend to settle into a little bit more of an anatomical shape than saline implants; however, if a women prefers to have "upper-pole fullness," ultra-high profile silicone implants will often do the trick.

Incision Size Since cohesive gel breast implants are pre-filled, they typically require a 1.5" to 2" incision.


Without getting into whether or not silicone gel breast implants are safe or not, it's clear that these implants have the highest likelihood of toxicity.

Sizing/Fill Volume

Some silicone gel implant types don't currently come in as high of fill volumes as saline breast implants do, typically ranging from 125cc's up to 800cc's.

Rupture Awareness

More often than not, if a cohesive gel implant ruptures, it will undergo a "silent rupture" where the women isn't even aware there is a problem. This is why plastic surgeons recommend women have an MRI scan, typically, every 2 years to ensure the breast implants are sound.

Most Common Complication

The most common complication with cohesive gel implants is called capsular contracture where the capsule that forms below the implant become hard and squeezes the implant. This can cause it to look or feel hard and distorted. Depending on what grade it is (1 through 4), a revision breast surgery is likely.


Cohesive silicone gel breast implants typically run about $1,000 more than saline implants.