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| Cohesive Gel Implants Disadvantages | Shape
In view of the fact that it will give its shape upon the breast, the patient and surgeon had better be certain that they are considering an implant shape that they want the breast to have. At the same time as implant picking out certainly matters with old style silicone gel and saline implants, since their shape so influenced by gravity and forces of the breast, there is a great margin for error.
In the reality this is not a problem, it is rather a subject in which one must be aware of. For example, women giving her preference “Baywatch”-grapefruit appearance breasts may discover the teardrop shape of this implant will not provide her with expectations. It seems this problem becomes important only in “disproportionate” augmentations, cases in which the implant size chosen exceeds what is best for a patient's soft tissues.
Feel
These implants do feel a little bit firmer than old style silicone gel implants, though if the old ones get a capsular contracture, they will feel firmer…some think that the cohesives are less likely to get such a contracture, but that is not yet known. Very seldom happens that patients complain about the firmness, but mostly patients, especially those getting implants that are not oversized, this is not a topic.
Cost
These implants cost considerably more than saline, and several hundred dollars more per pair than old style silicone gel implants. On the other hand, if part of the study, patients will be reimbursed most of the implant cost over a period of ten years.
Size of Incision
Because these implants are not deformable, they cannot be pushed through little incisions. Incision length must be among 4.5-5.5 cm; all depends upon the size of the implant. It also can make insertion from around the areola difficult. Armpit incision is possible, but extremely difficult.
Rotation
These implants presented only in anatomical shapes, meaning that they project more on the bottom than they do on the top. One of the risks of such a design is that if the implant rotates in the body, it will cause a distortion. Care is taken during pocket dissection and insertion in order to reduce this. It is a very uncommon, but very possible complication. The only way to attach it if it happens is to take away them and put back them with a round implant. Rotation is at superior risk when the tissue is loose, for example in a revision when a patient wants to go smaller.
Gel Fracture
Because of the fact that the gel is almost a solid, it can actually crack. No one knows if this can really happen, or what the consequences would be if it were to happen.
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