Breast augmentation is the most common cosmetic surgery procedure with over 300,000 procedures performed in 2018 alone. For women interested in breast implants, there are 2 main types of implants: Saline and Silicone. However within each of those types are several shapes and sizes, from small 200 ml low profile wide implants to huge 800 ml high profile narrow implants and a host of others in between. Then there are “Gummy Bears”


The Natrelle 410, popularly nicknamed the “gummy bear” implant, is a highly cohesive silicone implant made by Allergan. These implants are tear dropped or “anatomical” shaped in an attempt to mimic the breast’s natural silhouette.  These implants were created with mastectomy patients in mind, since the complete lack of breast tissue would make it more difficult for implants to look natural. While FDA approval was gained in 2012, this type of implant was already available in Europe a decade prior. It is FDA approved for increasing breast size and breast reconstruction in women 22 years of age and older.


There are different stories about how the term “gummy bear” was first coined. One being about a CEO of a breast implant company, who was fond of gummy bear candy and diet coke due to his busy schedule. While in a marketing meeting about breast implants with his staff, he bit into a gummy bear and remarked that it reminded him of breast implants. He noted it was soft but yet able to retain the shape of a bear. Some say it’s just a popular phrase used by plastic surgeons. The fact is, this term has no scientific definition and while it may have originally be used for the highly cohesive gel tear drop shaped implants, it has also been used to describe a range of soft cohesive silicone gel implants and therefore can be misleading.

The million dollar question is “Do gummy bear implants look better than traditional silicone implants?

In 2017, David Hidalgo, a plastic surgeon, conducted a study in which seventy-five patients undergoing primary breast augmentation had a round silicone implant in one breast and an anatomical silicone device of similar volume and optimal shape placed in the other. After intraoperative photographs were taken, the anatomical device was replaced by a round implant to complete the procedure. The pictures were then shown to a panel of 10 plastic surgeons and 10 lay reviewers. Neither group could tell the difference between round implants and the anatomically shaped implants.


The truth is the breast is naturally tear drop shaped and so adding a round implant still gives the breast a tear drop shape. In patients who have had the entire breast removed there is no tear drop shape and so the Gummy bear implants may give a better shape….but that comes with a price.

The anatomic gel implants are firmer than the round implants (necessary to keep its shape) and therefore you lose a lot of the ‘softness’ that silicone implants are famous for.

The anatomic gel implants require a longer incision to place them because of that firmness which may leave a more visible scar.

The anatomic gel implants must be oriented perfectly and if they rotate after placement they can give an undesirable look to the breast.


These factors have led to most surgeons reserving those particular implants for mastectomy patients only but using the soft silicone cohesive gel implants as their “gummy bear” go to implant. 

Chukwuemeka Onyewu MD

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