Dear OncoLink "Ask The Experts,"
Please explain the differences in scars and results if one chooses mastectomy with immediate implants or has tissue expanders with permanent implants placed 4-6 months later. I do not hear favorable comments about saline implants. Can I get silicone? Does HUP offer clinical trials for "gummy bear" implants?
Don LaRossa, MD, Professor of Surgery at the University of Pennsylvania Medical School, responds:
I don't think there would be a difference in scars or results. These factors are more related to the way each individual heals than the timing and method of the implants.
Silicone implants are still available to breast cancer reconstruction patients as an alternative to saline. Women have found that saline implants are associated with more ripples, have a more liquid feel, and do not look as natural as the silicone.
We have access to the "gummy bear" implants (also known as The Cohesive Gel Implant) at Penn. They only come in a tear-drop shape at this time, which is not something that all surgeons like to use. To receive one, the patient would have to enter the research protocol, as with any patient getting a gel implant. They are currently in use in Europe and Brazil.
The "gummy bear" implants have the same advantages of silicone implants, while eliminating the two biggest risks: rupture and silicone leakage. They are made of a semi-solid gel, also called high strength gel. The silicone gel is solid, so if the shell is penetrated, there is no leakage. They are the consistency of a gummy bear, hence the name. Doctors have said they also have a more natural feel than the saline counterparts. These implants are also less likely to have rippling.