David B. Reath, MD
Knoxville, TN (865) 450-9253
HKB Knoxville Staff

Silicone Breast Implants

Over 98% of the women we see in our Knoxville office decide to use silicone breast implants rather than saline. We recommend Natrelle Inspira silicone breast implants from Allergan.

Four Advantages of Silicone Breast Implants

  •     They are softer and have a more natural feel.
  •     They have a slightly lower deflation rate.
  •     They don’t ripple.
  •     They are more easily used above the muscle (subglandular).

The Downside of Silicone Breast Implants

  •     It is harder to detect when they rupture.
  •     They require a longer incision.
  •     They cost more.
  •     The filler could be considered “less physiologic”.

Do Gummy Bear Breast Implants Feel Real?

Highly cohesive silicone gel implants, often called gummy bear breast implants, feel firmer than regular cohesive silicone gel implants. For most breast augmentation patients, Dr. Reath and Dr. Walker prefer regular cohesive gel silicone implants because they are more natural feeling and less expensive.

Video Demonstration

The best way to illustrate the properties of a silicone cohesive gel implant is by watching this brief video. In it, Dr. Reath and Mandi cut a Natrelle cohesive gel silicone implant in half so you can see what’s inside the outer shell. (Not easy to do, by the way. Thank goodness they got it done in one take.)

You can see how the silicone gel material holds together uniformly (no leaking) while still retaining the natural give of breast tissue.

Now available: “SoftTouch” silicone implants

All of the silicone implants plastic surgeons work with are cohesive gel implants, but some are more cohesive than others. Breast implant manufacturers have been using cross-linking technology to create more implant options that may work well in different circumstances.

Recently, Allergan has introduced round implants with greater cohesivity. Our favorite of these are the SoftTouch implants. The advantage of this increased cohesivity is to have greater fullness in the upper breast (referred to in medicalese as “upper pole fullness.”)

Soft touch implants

In breast lift patients, maintaining this upper pole fullness is always a challenge depending upon the amount of natural breast tissue present. These newer implants may well help with this desired fullness, which is why he has started using them in most breast lift patients.

Dr. Reath & Dr. Walker

David B. Reath, MD is renowned for his surgical skills and his commitment to public education. Practicing in Knoxville, Tennessee since 1986, his personal approach with patients is what truly sets him apart. He is proud to welcome Jessica V. Walker, MD to the practice.

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Dr. Reath and Dr.Walker

Trans-Umbilical Breast Augmentation: Never an Option with Silicone
Recently we have gotten some questions about breast augmentation through the belly button which is known as trans-umbilical breast augmentation or “TUBA”. This is a procedure that our surgeons do not perform or recommend. In fact, this approach is not even an option for silicone breast implants. To understand more, read our recent blog post:

Breast Augmentation: The Incision Decision

There are many important questions to answer and decisions to be made when considering breast augmentation. Such as saline or silicone? Over or under the muscle? What size implant? And, where to place the incision. This last question is one that I have been asked a lot, but as of yet I haven’t explained my … Read more »

The History of Silicone Breast Implants

Silicone breast implants were first introduced in 1962 (first produced by Dow Corning). Both the outer shell and the silicone used to fill the implants have been much improved over the generations. For example, changes in the shell have proven to decrease the silicone “bleed,” (the amount of silicone that is shed by the implant) while the silicone fill has become more cohesive during the development and generations of implants. These changes explain why in a recent study, scientists found more traces of silicone in canned infant formula than in breast milk from augmented patients with silicone implants!

We currently use the round Fourth generation (1993 to present) silicone breast implants for most of our patients. They contain a cohesive silicone gel in a thick, low bleed shell. Although the FDA approval for cosmetic breast augmentation is recent, don’t be concerned that the Fourth Generation implants are new to us. They are the same ones we have been using in the study patients. So you can be confident that they are safe. Also, Dr. Reath has been using silicone implants since 1986 (even longer than this if you consider his training) he has an extensive history with silicone implants.

A fifth generation of shaped highly cohesive form stable implants (gummy bear implants) is now available for our patients. They are more expensive than our regular silicone breast implants (our cost is $510 more for each implant). Although they are highly promoted by the implant manufacturers, we are not convinced that they make much of a difference in most women.

At the recent meeting of the American Society of Aesthetic Surgeons, Dr. Reath was in a meeting where a group of about 250 board-certified plastic surgeons was shown before and after photos of patients and asked to vote electronically on whether patients had shaped or round implants. They got it right 46% of the time, and they are the experts. Here is a link to the blog where he reveals the inside story:

Shaped vs Round Breast Implants: Can You Tell The Difference?

Highly cohesive breast implants are getting a lot of play in the media and at the meetings I attend. I’ve also noticed a real push from the breast implant manufacturers to persuade us to use these in our practice. They even have a cute, catchy nickname: gummy bear implants. But the question in the minds … Read more »

Now that you know the differences in the implants themselves, you can understand that there are not inserted the same way and they behave differently after the surgery too. Especially if you are considering silicone implants, make sure your doctor has experience working with them.

Breast Augmentation (Silicone)
 Before & After Photos


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Have a question about silicone breast implants?

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Breast Augmentation: Helpful Pages On Our Site

The Latest Breast Implants Posts from Dr. Reath's Blog

  • Introducing Jessica V. Walker, M.D.

    From the Blog

    Introducing Jessica V. Walker, M.D. Click here to get the latest on Dr. Walker! As most of you know, there have been some big changes in my practice. We are now HKB Knoxville, and I will be retiring in January 2023. But the biggest news is that we have a new plastic surgeon, Dr. Jessica … Read more »
  • Important Letter From Dr. Reath

    From the Blog

    For the last 35 years, I have enjoyed the practice of plastic surgery in Knoxville, Tennessee. It is my pleasure and privilege to have been entrusted with your care. In order for my practice to move ahead, I am partnering with a group of plastic surgeons in Charlotte, whom I respect and admire. This change … Read more »
  • My Top 10 Most Important Blog Posts (So Far)

    From the Blog

    Back in November of 2009, I started my Facebook page, got my first smartphone, and wrote my first blog post. Since then, we have been honored with over 11,500 facebook fans, and our practice YouTube channel has 276 videos with over 950,000 views. Pretty amazing, right? Now, twelve years later, I have written over 300 blog … Read more »


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