Gel Fracture of Highly Cohesive Gel Implants on Insertion: Diagnostic Difficulties

We highlight a case that questions the prevalence of undiagnosed gel fracture or shell deformation following insertion of a highly cohesive gel implant. While it is known that gel fractures can take place after insertion, we generally do not routinely check if the implant has retained its pre-implanted form. Following Food and Drug Administration (FDA) approval in 2013, highly cohesive, fifth generation gel implants have been used by US surgeons.1 The development of increased silicone cross linking, leading to stiffer, “gummy-bear” implants, has created implants that claim to maintain their shape and resist the deforming pressures and forces of surrounding breast tissue.2 However, can these implants withstand the forces required for insertion of the implant? A recent experience in using a highly cohesive anatomical gel implant for breast augmentation in our unit is outlined. A 300 cc Mentor MemoryShape (Mentor …