Cogel vs. Traditional Silicone?

[Phenomom]

Welcome Dr. Ghaderi. Thanks for your participation in JBI.

It seems that I've read that cogels are firmer that traditional/ non cohesive silicone implants. Pre breast augmentation I held a saline implant and a traditional silicone implant. While I saw a photo of the cogel, I've never held the implant outside of my body. Do you use cogels in your practice? If so, have you found them to be firmer?

[Admin]

I'm not Dr. Ghaderi, but I have a question for you. Are you referring to "gummy bear" breast implants (the semi-solid implants)? I ask this because ALL silicone implants are cohesive now. The difference is that the gummy bear implants are firmer b/c it's an actual semi-solid). In the US, the only gummy implants available are thru studies. And the gummies are only available (in the US) in anatomical shape, textured surface.

[Phenomom]

Hi Nikki,

I have Mentor HP MemoryGel. As seen on this web site http://www.mentorcorp.com/breastsurg...tion/index.htm

[Ina]

I'm just wondering why your PS would have "traditional" silicone implants with liquid silicone even available for touching at their practice. Liquid silicone hasn't been used (in the western world) since the 70s. So it must've been a really old implant! The "traditional" implants have been cohesive since the 80s. So I would really think the implant you held in your hand was cohesive as well.

[Ina]

viscous liquid = cohesive. That is not liquid. Cohesive implants can range from almost liquid to semisolid, but they are most definitely cohesive these days. Look up the definition of liquid in the dictionary if you have to.

[Ina]

Regular cohesive gels that are used these days are not form retaining either. If a cohesive gel implant ruptures you can still get extracapsular (out of pocket) gel bleeds. But it will remain within the breast area while with the old liquid silicones it might travel up against your spine for example making a ruptured implant very difficult to remove entirely.

The gummy bear implants on the other hand are completely form retaining and will stick together if cut open (they're not on the market in the US yet, only available through studies). Which is why Nikki is asking whether the OP meant gummy bears vs. regular cohesives or cohesives vs. the old liquid ones.

[tiffany]

Originally Posted by Ina

Regular cohesive gels that are used these days are not form retaining either. If a cohesive gel implant ruptures you can still get extracapsular (out of pocket) gel bleeds. But it will remain within the breast area while with the old liquid silicones it might travel up against your spine for example making a ruptured implant very difficult to remove entirely.

The gummy bear implants on the other hand are completely form retaining and will stick together if cut open (they're not on the market in the US yet, only available through studies). Which is why Nikki is asking whether the OP meant gummy bears vs. regular cohesives or cohesives vs. the old liquid ones.

Exactly! The Mentor Memory Gel is cohesive (consistency like Jell-O), but it is not as firm and solid as gummy bears, nor does it retain its shape. It seems that a lot of people who have "co-gels" think that if they cut their implants open, it would stay in place, and this is simply not true. Unfortunately, implant manufacturers use names like "memory gel" which is pretty misleading.

[Ina]

Originally Posted by ********

thanks Ina and i just realized i was posting in the ask a PS forum.which i do apologize for doing that.just realized it now so i am very sorry bout that.i gotta pay more attention next time.feel free to delete my posts w this

No problem about that, I'm sure we can have discussion on the topic here too, if it gets out of hand we can put the debate in a separate thread. I think it would also be great if Dr. Ghaderi could participate, although I'm not sure if he wants to put his nose in our debate but rather just answer the original question!

Tiffany, actually the manufacturers don't use the term Memory Gel, that is a tradermarked name used by the Mentor corporation. Their gummybear implants are also made of their trademarked Memory Gel, only at a different degree of firmness (as Mentor has three different grades for their Memory Gel implants, 1 being the softest, 2 in the middle and 3 being the gummybear consistency).

[Admin]

I have Mentor silicone too. They've been cohesive, but they weren't marketed as "cohesive" until a few years ago. ALL silicone implants are cohesive (except for the pretty old implants).

[Admin]

Originally Posted by ********

im questioning the dates Ina.when i saw DrDewire for my breast augmentation in 2001 traditional liquid silicone was most indeed still around. there wasnt anything else.mind yu there was the ban on silicone back then but he did have a silicone implant for me to see and it was definately viscous liquid.as much as that ban was in effect there were still alot of women getting those silicones.they were not cohesive

Silicone was cohesive when I got my first set in 2000, but Mentor didn't "market" them as "MemoryGel" implants until a few years ago. But they were indeed cohesive, just like the ones I have now.

I'm sure you've felt of that greasy-feeling Dow implant Dr. DeWire has in his office. That's the "old" silicone (much less viscous, and a LOT more watery/runny).

[Admin]

Actually, even the Mentor HP's aren't gummy bear implants. They're just more cohesive then the mod hps and the regular mods. There aren't any gummy bear implants that are FDA approved right now. Plus, the gummies are all textured anatomical implants. Mentor and McGhan (which is now Inamed/Allergan) had studies for them. http://www.justbreastimplants.com/im..._gel_study.htm and http://www.justbreastimplants.com/im...mentor_cpg.htm are links to those studies and implants.

From the Mentor website at http://www.mentorcorp.com/global/phy...gel-myths.htm:

Let's clear up the "cohesion confusion" that is prevalent today. Simply put, all Mentor silicone gel implants are cohesive polymers, not liquids. This means that the gel filler acts as a solid unit rather than a liquid. Our gels hold together uniformly, while retaining the natural "give" that resembles actual breast tissue.

The word “cohesive” is a new term being used today to describe the nature of the fill compared to the more liquid fill that may have been used in silicone implants in the early 1970’s. This is not new science, this is not new technology – cohesive is simply a word that’s being used today to describe the “sticking together” nature of the gel. All of Mentor silicone gel-filled breast implants are all cohesive, all the time.

The inside of Mentor's gel implants is filled with our proprietary Memory Gel™. It is our own cohesive gel formulation that makes sure the gel acts as a unit rather than a liquid - it holds together uniformly and retains the natural give that resembles actual breast tissue. It also helps prevent migration, or running, of the gel in the event of a rupture. We have been using this type of gel since 1985.

Cohesive I - The standard cohesive level gel used in Mentor's implants. This is Mentor's softest gel and has been preferred in Round Moderate, Moderate Plus, and High Profile and Round Becker expander/implants.

Cohesive II - A slighly firmer gel, for surgeons wanting a firmer feeling implant. This gell is used in Round MOderate, Moderate Plus, and High Profile implants, as well as Contour Profile Becker expander/implants.

Cohesive III - Mentor's most cohesive gel, providing shape retention with a pleasing level of firmness for optimal aesthetic results. [B]This gel is used in Mentor's Conour Profile gel implant family.

In other words, unless you're in a study for the McGhan 410 Cohesil implants, or the Mentor CPG implants, you don't have gummy bear implants. (I'm referring to people in the US.)

[tiffany]

Originally Posted by Ina

Tiffany, actually the manufacturers don't use the term Memory Gel, that is a tradermarked name used by the Mentor corporation.

Isn't Mentor an implant manufacturer? I don't get it.

[Admin]

Originally Posted by tiffany

Isn't Mentor an implant manufacturer? I don't get it.

Yes, they are. I think that's what Ina was trying to say. Implant manufacturers don't use it. Only Mentor.

[drghaderi]

The cohesive gels are the one approved for use by the FDA last November. The "gummy bear" implants are only available through a study. I have not used one yet as I have been very happy with the cohesive gels. I think the more solid implants will have a more significant role for breast reconstruction. The softer feel of the cohesive gels is more beneficial for breast augmentation.

[Fruitbatjellybean]

Originally Posted by Nikki

unless you're in a study for the McGhan 410 Cohesil implants, or the Mentor CPG implants, you don't have gummy bear implants. (I'm referring to people in the US.)

Ok...now I'm totally confused. I was under the impression that "gummy bear" was just a slang term that covers cohesive implants in general. I thought you had to participate in the study to have silicone in the US. period.

I have mentor memory gel implants and I am participating in the 10 year study..it doesn't say "CPG" on it anywhere...what the heck do I have??

[mama2twingirls]

Originally Posted by Fruitbatjellybean

Ok...now I'm totally confused. I was under the impression that "gummy bear" was just a slang term that covers cohesive implants in general. I thought you had to participate in the study to have silicone in the US. period.

I have mentor memory gel implants and I am participating in the 10 year study..it doesn't say "CPG" on it anywhere...what the heck do I have??

It can seem a little tricky. Ok let me see if I can explain. You DO have cohesive gel implants. Gummy bear is not a slang for cohesive silicone gel. The gummy bear implants you hear people speaking of is still made of cohesive gel, it is just a firmer cohesive gel, (CPG) and it is NOT FDA approved yet, although there are studies going on with its use. You must be a part of the study to have gummybears. The study that you are a part of after getting your silicone implants, if you got them after they were FDA approved is a POST APPROVAL study. I have tons and tons of information on that. You can also decline to be a part of the study if it is a post approval study, but not if it is a study to determine if that implant will be approved (ie the gummybear study right now) Clear as mud huh?
Don't worry, I was confused by it all when my ps first mentioned using silicone with me...
Mesha

[Fruitbatjellybean]

Originally Posted by mama2twingirls

It can seem a little tricky. Ok let me see if I can explain. You DO have cohesive gel implants. Gummy bear is not a slang for cohesive silicone gel. The gummy bear implants you hear people speaking of is still made of cohesive gel, it is just a firmer cohesive gel, (CPG) and it is NOT FDA approved yet, although there are studies going on with its use. You must be a part of the study to have gummybears. The study that you are a part of after getting your silicone implants, if you got them after they were FDA approved is a POST APPROVAL study. I have tons and tons of information on that. You can also decline to be a part of the study if it is a post approval study, but not if it is a study to determine if that implant will be approved (ie the gummybear study right now) Clear as mud huh?
Don't worry, I was confused by it all when my ps first mentioned using silicone with me...
Mesha

Arg!

Ok, The thing I have says post approval study so then they are not "gummy bears". So how do I know if I have cohesive I or cohesive II? I guess I should have known this before and asked...All I know is that I got to play with one and I loved the way it felt, so that's what I got.

[Admin]

Ditto what Mesha said. The difference NOW is that you don't HAVE to participate in the study in order to get implants. I had a redo in June and switched back to silicone, but I'm not in the post-approval study. Prior to the FDA approving implants last year, there were certain requirements that had to be met in order to get silicone. If you met those requirements, you were entered into a study. I hope this makes sense.

[Ina]

Originally Posted by Fruitbatjellybean

Arg!

Ok, The thing I have says post approval study so then they are not "gummy bears". So how do I know if I have cohesive I or cohesive II? I guess I should have known this before and asked...All I know is that I got to play with one and I loved the way it felt, so that's what I got.

You'll know if you look at your implant device card. At least mine says "Siltex Round High Profile Gel Breast Implant Cohesive II" right on the top.

Regarding the gummy bears, since they are completely form retaining all gummy bear implants are TEXTURED ANATOMICAL. So when you see someone talking about gummy bears and rounds they've just gotten the terms mixed up!

[tiffany]

Originally Posted by Ina

Regarding the gummy bears, since they are completely form retaining all gummy bear implants are TEXTURED ANATOMICAL. So when you see someone talking about gummy bears and rounds they've just gotten the terms mixed up!

I read that ROUND gummybear implants are available in the U.K. I don't know what company makes them. I have a theory that those are what Victoria Beckham has...