Aesthetic Plastic Surgery

, Volume 31, Issue 6, pp 697–710 | Cite as

Prospective Study Comparing Two Brands of Cohesive Gel Breast Implants with Anatomic Shape: 5-Year Follow-Up Evaluation

  • Igor NiechajevEmail author
  • Göran Jurell
  • Lena Lohjelm
Original Article



The new generation of breast implants has an anatomic shape. These implants are made with a textured shell and filled with a cohesive silicone gel. Available since 1993 except in the United States, these implants are gaining in popularity for breast enlargement and reconstruction. This prospective, randomized, controlled, and blinded study was designed to compare mid- and long-term results with the use of cohesive gel-filled implants from two different manufacturers: Style 410 of the McGhan brand (MG) made by Allergan and Vertex made by Eurosilicone (ES).


From May 1997 to May 1999, 80 women underwent breast augmentation: 40 with Style 410 implants (MG) and 40 with Vertex implants (ES). All surgeries were performed by the same surgeon (I.N.). Another physician (G.J.) interviewed and examined 64 of these women (80%) 4 to 6 years (median, 5 years) after implantation. In addition, 10 patients responded to the same questionnaire and were interviewed by phone, bringing the follow-up rate to 92.5%.


Overall, satisfaction was high, with 98.6% of the patients evaluated after 4 to 6 years “very satisfied” or “satisfied” with the result in general. Approximately 20% of the patients who responded judged their breasts to be firmer than desirable. Breast augmentation classification (BAC) was used to grade the breast firmness of the 64 patients examined by G. J. At examination, 24% of patients had soft breasts, 53% had slightly firm breasts, and 23% had moderately firm breasts. That last category also was classified as capsular contracture. No patient was graded as having very hard breasts (BAC 4). Skin sensitivity of the breast adjacent to the incision was altered for 25% of the patients. The implant rotated in four patients (5%). Breast firmness, implant palpability, nipple sensitivity, and skin sensitivity were further analyzed by implant location (submuscular vs subglandular) and implant size (volume). Frequency of the breast asymmetries and the impact of augmentation on asymmetric breasts also was studied. All these analyses were performed with the entire pool of examined patients who answered the follow-up questionnaire. Data also were analyzed by distinguishing between results of the two each implant manufacturers. The results showed no difference between the Eurosilicone and McGhan implants except for the self-evaluation of “breast consistency” by the patient. A higher percentage of patients with the Vertex implants than with the McGhan implants reported that their breast was “firmer than desired.”


Breast augmentation with anatomic, textured, cohesive silicone gel-filled implants is a reliable procedure with consistently good results. The results also show that candidates for breast enlargement should be informed that their implanted breast may feel firmer than their natural breasts. They also may experience reduced sensation of their nipple or breast skin.


Breast augmentation Cohesive silicone gel Follow-up Mammary implants Prospective study 



We thank Professor Sven Lindskog, Department of Pathology, for the histomorphometric examinations and the production of Fig. 2, and Magister of Philosopy Mikael Eriksson from the Department of Clinical Neuroscience, both at the Karolinska Institutet in Stockholm, for help with the statistical analysis and creation of graphs. We also are grateful to Californian scientists Catherine Gloster, M.S., B.S. and Scott C. Eschbach, Ph.D. for correcting our English.


  1. 1.
    Baeke JL: Breast deformity caused by anatomical or teardrop implant rotation. Plast Reconstr Surg 109:2555–2567, 2002CrossRefPubMedGoogle Scholar
  2. 2.
    Boer HR, Arnido G, MacDonald N: Bacterial colonization of human milk. South Med J 74:716–718, 1981PubMedGoogle Scholar
  3. 3.
    Brown MH, Shenker M, Silver SA: Cohesive silicone gel breast implants in aesthetic and reconstructive breast surgery. Plast Reconstr Surg 116:768–779, 2005CrossRefPubMedGoogle Scholar
  4. 4.
    Coleman DJ, Foo IT, Sharpe DT: Textured or smooth implants for breast augmentation? A prospective controlled trial. Br J Plast Surg 44:444–448, 1991CrossRefPubMedGoogle Scholar
  5. 5.
    Fagrell D, Berggren A, Tarpila E: Capsular contracture around saline-filled fine textured and smooth mammary implants: A prospective 7.5-year follow-up. Plast Reconstr Surg 108:2108–2112, 2001CrossRefPubMedGoogle Scholar
  6. 6.
    Gylbert L, Asplund O, Jurell G, Olenius M: Results of subglandular breast augmentation using a new classification method: 18-year follow-up. Scand J Plast Reconstr Hand Surg 23:133–137, 1989Google Scholar
  7. 7.
    Hakelius L, Ohlsén L: A clinical comparison of the tendency to capsular contracture between smooth and textured gel-filled silicone mammary implants. Plast Reconstr Surg 90:247–253, 1992PubMedCrossRefGoogle Scholar
  8. 8.
    Hammond DC: Discussion of Rohrich RJ, Hartley W, and Brown S: Incidence of breast and chest wall asymmetry in breast augmentation: A retrospective analysis of 100 patients. Plast Reconstr Surg 111:1520, 2003Google Scholar
  9. 9.
    Heden P, Jernbeck J, Hober M: Breast augmentation with anatomical cohesive gel implants: The world’s largest current experience. Clin Plast Surg 28:531–552, 2001PubMedGoogle Scholar
  10. 10.
    Heitmann C, Schreckenberger C, Olbrisch RR: A silicone implant filled with cohesive gel: advantages and disadvantages. Eur J Plast Surg 21:329–332, 1998CrossRefGoogle Scholar
  11. 11.
    Maldick RA: “No touch” submuscular saline breast augmentation technique. Aesth Plast Surg 17:183–192, 1993CrossRefGoogle Scholar
  12. 12.
    Niechajev I: Anatomical breast implants: Different experience (letter to the editor). Plast Reconstr Surg 112:1186, 2003CrossRefPubMedGoogle Scholar
  13. 13.
    Niechajev I: High-cohesive gel silicone implants: Advantages and disadvantages (in Swedish). Hygea 108:102, 1999Google Scholar
  14. 14.
    Niechajev I: Innovative augmentation: Body language. Plast Cosm Surg 11:16–18, 2003Google Scholar
  15. 15.
    Niechajev I: Mammary augmentation by cohesive silicone gel implants with anatomic shape: Technical considerations. Aesth Plast Surg 25:397–403, 2001CrossRefGoogle Scholar
  16. 16.
    Niechajev I, Jurell G: Cohesive anatomic shaped silicone gel implants for mammary augmentation. Edited instructional video 15’. Eurosilicone, Apt, France, 2001Google Scholar
  17. 17.
    Rohrich RJ, Hartley W, Brown S: Incidence of breast and chest wall asymmetry in breast augmentation: A retrospective analysis of 100 patients. Plast Reconstr Surg 111:1513–1519, 2003CrossRefPubMedGoogle Scholar
  18. 18.
    Spear SL: Discussion of Rohrich RJ, Hartley W, Brown S: Incidence of breast and chest wall asymmetry in breast augmentation: A retrospective analysis of 100 patients. Plast Reconstr Surg 111:1521–523, 2003CrossRefGoogle Scholar
  19. 19.
    Spear SL, Baker JL Jr: Classification of capsular contracture after prosthetic breast reconstruction. Plast Reconstr Surg 96:1110–1123, 1995Google Scholar
  20. 20.
    Tebbets JB: Dual-plane breast augmentation: Optimizing implant–soft–tissue relationships in a wide range of breast types. Plast Reconstr Surg 107:1255–1272, 2001CrossRefPubMedGoogle Scholar
  21. 21.
    Tebbetts JB: Patients’ acceptance of adequately filled breast implants. Plast Reconstr Surg 106:139–147, 2000CrossRefPubMedGoogle Scholar
  22. 22.
    Tebbetts JB: McGhan’s biodimensional augmentation system cohesive gel mammary implants. Instructional video, 55’, McGhan Medical Corporation, 1993Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  1. 1.Lidingö ClinicLidingöSweden
  2. 2.Department of Reconstructive Plastic SurgeryKarolinska HospitalStockholmSweden

Personalised recommendations