silicone gel resulting in a more solid material. If a cohesive gel implant is cut open, it is similar to
cutting into a gummy bear. The implant maintains its shape and integrity and does not result in
any leaking of the silicone gel.

Are cohesive gel implants available to anyone in Canada?
Cohesive gel implants have been available in Europe since approximately 1995 and available in
Canada since November 2000. They are presently available through a special access program at
The Medical Devices Bureau of Health Canada. It is necessary for your surgeon to send a form to
Health Canada requesting approval for use of the cohesive gel implant. Once approval has been
given, the implant can be ordered directly from the manufacturer.

What are the advantages of the cohesive gels over saline?
Cohesive gel implants tend to have a more soft and natural feel than saline implants. There are
a large variety of shapes and sizes of cohesive implants, allowing breast augmentation to be
performed in a manner that provides a natural and proportionate looking breast augmentation.
Because cohesive gel implants have a thicker material on the inside, they tend to maintain their
shape in an upright position. This makes the cohesive gel implant much less likely to produce
rippling.

Do cohesive gels come in smooth, textured, round, anatomical and high profile?
Cohesive gel implants presently come in both round and anatomical varieties. The round varieties
come in a standard profile and a high profile. The anatomic varieties come in nine different styles
each varying with respect to height and projection. Of each style there are a variety of sizes to choose
from. Presently, all cohesive gel implants are textured. Texturing the surface of the implant is
particularly important when an anatomical shape implant is being used.

What happens if a cohesive gel implant ruptures?
The silicone gel within a cohesive gel implant has a consistency similar to that of a gummy bear.
If a cohesive gel implant were to rupture, the implant maintains its integrity. The silicone gel does
not run as it would with a regular gel implant. The implant would be able to be removed in its
entirety and replaced.

Due to the consistency of the cohesive gel, how do you know if the implant has ruptured?
It may be very difficult to know if a cohesive gel implant has ruptured. When any implant is inserted,
the body responds by forming a thin capsule around the implant. If a cohesive gel implant were to
rupture, it is likely that it would be maintained within the capsule and there would be no change to
the shape or consistency of the breast. If both the implant and the capsule were to rupture, it is
possible that some of the implant could herniate through the hole in the capsule resulting in a
change in the shape of the breast or an abnormality on mammography (breast X-rays). If this were
to happen, the implant would need to be removed and replaced with a new implant.

Will silicone leak into the body if the cohesive implant ruptures?
Because of the cohesive nature of the implant, it is unlikely that any silicone would be released
into the rest of the body if the implant were to rupture. With any implantable device, it is possible
that some of the material could be shed by the device and taken up by other areas of the body.
A very large number of research studies looking at silicone breast implants have failed to
demonstrate increased incidence of any disease process in women with silicone gel breast
implants. Q & A continued

Please note: The answers in this section are for general information purposes only and do not replace a
consultation with a plastic surgeon.