The Difference between Cohesive Gel & Highly Cohesive Silicone Implants

There are so many different kinds and names of silicone breast implants out there. But when we zoom out, there’s really only 2 different types.

There are two types of silicone breast implant: cohesive gel and highly cohesive gels.

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Silicone Breast Implant ‘types’

The breast implant ‘type’ refers to the filling inside the breast implant. Or, put another way, the material it is made from. All breast implants have an outer shell made from silicone regardless if it’s saline or silicone.

Silicone gel-filled breast implants have a silicone outer shell that is filled with silicone gel. They come in different sizes and have either smooth or textured shells. Silicone gel-filled breast implants are approved for breast augmentation in women age 22 or older and for breast reconstruction in women of any age.

FDA, 2019


Silicone gel breast implants have been through 5 generations of evolution to get us to the breast implants US Board Certified plastic surgeons use in their practice today.

The 4th generation of silicone gel implants is called a cohesive gel implant.

The cohesive bit refers to how the silicone gel (the implant filling) is stuck to itself. Scientific explanation below :

Cohesive gel is formed by increasing the number of cross-links between gel molecules, which results in an implant that has better retention of shape and is less likely to fold or collapse, especially in the upper pole. Plast Reconstr Surg. 2005 Sep;116(3):768-79

If we move on to the 5th generation of silicone gel implants we get to the highly cohesive gel implant.

If the cohesive gel breast implant is sticky and stretchy, the highly cohesive gel implant is much stronger and form stable.

This is because it has a higher cohesiveness.

The 5th generation/highly cohesive silicone gel implant is also known as the gummy bear breast implant! The filling is much more stuck to itself (the higher cohesiveness of the silicone gel molecules) and therefore it genuinely resembles a gummy bear!

Cohesive gel breast implants = like jello

Highly cohesive silicone gel implants = like gummy bear candy

The more cohesive the silicone gel, the more it is stuck to itself inside the shell and typically the firmer it will feel.

Highly cohesive silicone gel implants hold their shape well and, if the implant shell developed a tear, the implant filling would basically stay put.

If you’re choosing a silicone gel implant for your breast augmentation you have two options in terms of the cohesiveness of the filling: cohesive or highly cohesive. Your Board Certified plastic surgeon will expertly guide you to the right silicone gel implant for your breast augmentation to help meet your aesthetic goals.