Gummy bear implants are silicone implants that are used for breast augmentation or boob jobs. The phrase “gummy bear” usually means a more cohesive (firmer) silicone gel that tends to hold its shape better if the shell is damaged, and can feel slightly firmer than “standard” silicone gel options. In medical terms, they’re often described as highly cohesive or form-stable silicone gel implants. Almost all of the implants we use now are considered gummy bear or cohesive implants.

Silicone breast implants is the broader category. Within it, gels vary from softer/less cohesive to highly cohesive/form-stable. So the real comparison is usually: Highly cohesive / form-stable silicone (“gummy bear”) vs Softer / less cohesive silicone gel (traditional silicone gel feel)

What is the difference between gummy bear implants and soft gel implants

Feature	“Gummy bear” (highly cohesive / form-stable silicone)	“Traditional” silicone gel (less cohesive / softer gel)
Main idea	Gel is firmer and holds shape better	Gel is softer and often feels “squidgier”
Feel	Often slightly firmer (depends on brand, profile, your tissue)	Often softer (depends on brand, profile, your tissue)
Shape control	Typically more shape-stable	Can be more shape-adaptive
If shell ruptures	Gel may be less likely to spread (but rupture still needs assessment)	Gel may spread within the pocket; “silent rupture” can occur with both [3,4]
Best suited for	Patients wanting predictable shape, especially in some anatomical designs	Patients prioritising softness and a rounder, more “natural movement” feel
Key trade-off	Shape stability vs potential firmness	Softness vs less form-stability

 

What does “cohesive” and “form-stable” actually mean?

Cohesivity describes how strongly the silicone gel “sticks to itself.” Higher cohesivity means the gel is less runny and more likely to keep its form. Form-stable refers to a gel that maintains its intended distribution and shape inside the implant more reliably.

This matters for two reasons:

1. Aesthetic predictability (upper pole shape, “settling”, stability)

2. Behaviour if there is shell damage (how the gel behaves within the pocket)

How each implant type can look in real life

Round implants (can be gummy bear or traditional silicone)

Round implants can produce anything from subtle to more augmented cleavage depending on:

• your chest width and natural breast base

• implant profile (low/medium/high)

• pocket position and tissue thickness

• implant gel cohesivity

Round implants do not automatically look “fake”. Many “natural looking” results use round implants with careful sizing and placement.

Anatomical (teardrop) implants (commonly form-stable)

Teardrop implants are often paired with more cohesive gels to help maintain their shape. A key point is rotation risk: if an anatomical implant rotates, the breast shape can look noticeably different and may need revision.

Gummy Bear Implants Before and After

Safety and complications

The gel type is only one piece of the puzzle. Outcomes are heavily influenced by:

• Surgical technique (sterility protocol, pocket control, haemostasis)

• Pocket choice (subglandular, submuscular, dual-plane, subfascial where appropriate)

• Your tissue quality (skin stretch, thickness, laxity, breast width)

• Implant surface and design choices (smooth vs textured, shaped vs round)

Capsular contracture (scar tightening around the implant)

Capsular contracture is one of the best-known complications of breast augmentation. UK patient information leaflets commonly quote a risk that can be up to around 1 in 10 (10%), though rates vary widely depending on technique, implant choices, and follow-up duration. Broader scientific reviews confirm it remains a leading reason for revision surgery.

Does gummy bear gel prevent capsular contracture?

Not on its own. There’s no “magic” gel that eliminates it. Good technique and appropriate implant/pocket selection are usually more important than choosing a firmer gel. Mr Nassab uses a funnel for implant insertion which can reduce the risk of capsular contracture.

Rupture and “silent rupture”

Silicone implant ruptures can be silent, meaning you may not feel obvious symptoms. Reviews and long-term studies report rupture risks that increase over time, and this is why routine surveillance imaging is discussed for silicone implants.

Imaging and check-ups: what many patients miss

FDA surveillance recommendations

The FDA has recommended that asymptomatic patients with silicone gel implants have ultrasound or MRI at 5–6 years, then every 2–3 years after that. 

We also recommend a scan at 5 years but practices vary, and surgeons may individualise advice based on:

• symptoms (pain, shape change, swelling)

• implant age

• your risk tolerance and budget

• whether ultrasound is adequate vs MRI in your case

The key takeaway: implants are not “fit and forget.” Plan for long-term follow-up and the realistic possibility of future surgery.

BIA-ALCL and implant surfaces 

Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is a rare lymphoma linked primarily with textured implants. UK government and UK surgical association information emphasises:

• it’s uncommon

• it often presents years after surgery, frequently with late swelling/seroma

• treatment is typically removal of implant and capsule, especially when caught early [9–11]

Because “gummy bear” refers to gel cohesivity, it does not automatically mean textured or smooth. You can have highly cohesive gel implants with different surfaces depending on manufacturer and model. This is why a consultation should cover surface type explicitly, not just “gummy bear vs silicone”.

Who might suit gummy bear (highly cohesive) implants?

You may be a good candidate if you:

• want a predictable, stable shape

• have thin tissue coverage and want an implant less prone to visible wrinkling (not guaranteed—tissue and pocket matter)

• are considering an implant design where shape stability is useful

• prioritise structure over the softest possible feel

Possible downsides to consider

• They can feel slightly firmer in some bodies (especially if you’re very slim or go very large)

• If you dislike a “more structured” feel, you may prefer a softer gel option

• If you choose a shaped implant, rotation risk is part of the conversation [5]

Who might prefer a softer “traditional” silicone gel?

You may prefer softer silicone gel if you:

• prioritise softness and natural movement

• already have good tissue coverage and don’t need extra shape “scaffolding”

• want a round implant result with a softer feel

Possible downsides to consider

• Less form stability may mean less predictability in some edge cases

• If rupture occurs, gel can still remain within the pocket, and imaging is still relevant [4]

The decision framework during your consultation

Step 1: Your anatomy 

• breast width and footprint

• skin quality and stretch marks

• degree of sagging (ptosis)

• tissue thickness (pinch test)

• chest wall shape and asymmetry

Step 2: Your goals (clear, measurable outcomes)

• subtle vs more augmented

• cleavage priority vs side profile

• upper pole fullness vs natural slope

• how you feel about implants being “noticeable”

Step 3: Implant and pocket plan

• round vs anatomical

• smooth vs textured (and why)

• submuscular or dual-plane vs above muscle where appropriate

• realistic sizing that matches your measurements

Step 4: Long-term plan

• surveillance approach

• pregnancy/weight change expectations

• realistic revision likelihood over a lifetime

FAQs

Are gummy bear implants safer than silicone implants?

They are a type of silicone implant. Higher cohesivity may reduce gel spread if the shell is damaged, but they do not remove the need for follow-up, and overall safety depends on multiple factors including surface type, placement, and technique.

Do gummy bear implants look more natural?

They can look very natural, but so can round implants. “Natural” is mostly determined by correct sizing for your chest, pocket choice, tissue coverage, and whether you need a lift.

Which feels more natural?

Many patients find softer silicone gels feel more “breast-like,” but others prefer the supported shape of highly cohesive gels. Your own tissue thickness makes a huge difference. The soft gel may have higher risks of implant rippling.

Can gummy bear implants rupture?

Yes. Any implant can rupture. Silicone ruptures can be silent, which is why imaging is discussed as implants age.

Do I need MRI scans after breast implants?

Internationally, FDA recommendations often referenced are ultrasound or MRI at 5–6 years, then every 2–3 years for silicone gel implants. Your surgeon may tailor this based on UK practice and your personal situation.

Are gummy bear implants linked to BIA-ALCL?

BIA-ALCL is linked mainly to textured surfaces, not to the gel being “gummy bear.” Always ask whether an implant is smooth or textured and why. [9–11]

References 

1. Gabriel A. The Science of Cohesivity and Elements of Form Stability. (PubMed, 2019). https://pubmed.ncbi.nlm.nih.gov/31246755/

2. Shridharani SM et al. Breast Augmentation. (PMC, 2013). https://pmc.ncbi.nlm.nih.gov/articles/PMC3685325/

3. FDA. Breast Implants: Certain Labeling Recommendations… (PDF, 2019). https://www.fda.gov/media/131885/download

4. Hillard C et al. Silicone breast implant rupture: a review. (PMC, 2017). https://pmc.ncbi.nlm.nih.gov/articles/PMC5409893/

5. BAAPS/BAPRAS Patient Leaflet: Breast Augmentation (PDF). https://baaps.org.uk/_userfiles/pages/files/procedures/breast_augmentation_patient_leaflet.pdf

6. BAAPS/BAPRAS Guide to Breast Augmentation (PDF, 2021). https://baaps.org.uk/_userfiles/pages/files/print_bapras_breast_aug_2021_final_revised_3.pdf

7. Headon H et al. Capsular Contracture after Breast Augmentation. (PMC, 2015). https://pmc.ncbi.nlm.nih.gov/articles/PMC4579163/

8. Stevens WG et al. Ten-year Core Study Data… (PubMed, 2018). https://pubmed.ncbi.nlm.nih.gov/29595714/

9. UK Gov (MHRA). Information about BIA-ALCL for people with breast implants. https://www.gov.uk/government/publications/information-about-bia-alcl-for-people-with-breast-implants

10. BAPRAS patient guidance: ALCL and breast implants. https://www.bapras.org.uk/public/patient-information/patient-advice-and-guidelines/alcl-and-breast-implants

11. Joint ABS/BAAPS/BAPRAS statement (PDF): BIA-ALCL (includes UK context). https://associationofbreastsurgery.org.uk/media/zkebc52r/final-alcl-joint-statement.pdf