There are two types of implant filling material for breast implants. There is the saline implant, which is filled with essentially water, and the silicone implant, which is filled with medical-grade silicone gel. It is universally accepted that silicone implants have a higher rate of capsular contracture compared to saline implants. Some attribute this difference to what is called silicone gel bleed. On the molecular level, the silicone molecules will slowly travel across the silicone bag, creating a chronic inflammation that stimulates fibrosis and contributes to contracture. Companies continue to design new low-bleed implants and deep cohesive implants to decrease the level of silicone bleed. This does not occur with saline implants because the water in them does not react in the body.
If we look at the evolution of breast implants, most recently, companies have brought “gummy bear” implants to the market. This are highly cohesive implants with low bleed rates, and early studies have shown that the capsular contracture rate for these implants within three years is close to the rate for saline implants. This highly cohesive implant does not bleed like the standard liquid gel implants that we used in the past. This can improve patient satisfaction and decrease the amount of capsular contracture that the patient might have in the future.