“Gummy bear” is one of the most-searched phrases in breast augmentation, and it comes up almost every week in Dr. Farhad Rafizadeh’s Morristown consultation room. It also appears regularly on his RealSelf Q&A page, usually phrased something like this:
“Are gummy bear implants safer and more natural than regular silicone? Should I be asking for them specifically?”
It is a reasonable question, and the honest answer surprises most patients: the “gummy bear versus silicone” framing is largely a marketing distinction. What actually determines how your breast looks and how safe the implant is over a lifetime are two different choices — the shape of the implant and the surface of its shell. Understanding those two decisions is worth far more than the gummy bear label.
What “Gummy Bear” Actually Means
“Gummy bear” is a nickname for a highly cohesive, form-stable silicone gel. The silicone in the gel is cross-linked, so it behaves like a firm gummy candy: cut it in half and the gel holds together rather than running out. That cohesivity is what gives these implants their two headline advantages — they retain their shape and they resist rippling along the edges.
Here is the part the nickname obscures: modern silicone implants are all cohesive to some degree. Over the last two implant generations, manufacturers moved the entire silicone category toward more cohesive, form-stable gel. So when a patient asks whether they should get a “gummy bear” implant instead of a “regular silicone” implant, the truthful answer is that today’s silicone gel implants sit on a spectrum of cohesivity, and the ones Dr. Rafizadeh uses are already highly cohesive.
Dr. Rafizadeh’s Short Answer
Patients ask me for gummy bear implants because they’ve read that they hold their shape and ripple less — and that’s true. But those benefits come from the cohesive gel, not from a textured, teardrop shape. I use smooth, round, highly cohesive implants for exactly this reason. You get the shape retention and the low rippling, and you avoid the textured surface that has been linked to a rare lymphoma. I have never used textured implants, and I don’t intend to start.
That answer draws the line that matters. The cohesive gel is the benefit. The textured shell and the anatomic teardrop shape — which usually travel together — are where the concerns live.
The Two Decisions That Actually Matter
1. Shape: Round vs. Anatomic Teardrop
Round and teardrop implants both aim for a natural breast, but they get there differently. A round implant is symmetrical; once it’s placed and the tissue settles, it takes on a natural, gently sloped shape and it cannot rotate into a wrong position. An anatomic teardrop implant is pre-shaped like a breast — fuller at the bottom — but it has to stay oriented correctly, so it is textured to grip the surrounding tissue. If a teardrop implant does rotate, the breast can visibly distort.
2. Surface: Smooth vs. Textured
This is the decision with the clearest safety implications. Textured shells were designed to reduce implant movement and, historically, to lower capsular contracture rates in certain positions. But texturing is the feature associated with BIA-ALCL (breast implant-associated anaplastic large-cell lymphoma), a rare cancer of the immune system that arises in the scar capsule around an implant. The risk is tied to textured surfaces, and in 2019 the FDA requested a recall of a widely used line of textured implants. Smooth implants are not implicated in the same way.
Because the anatomic teardrop “gummy bear” implants are textured, choosing them means accepting a textured shell. Choosing a smooth, round, cohesive implant lets a patient keep the gel benefits while sidestepping that concern entirely — which is the whole basis of Dr. Rafizadeh’s approach. For patients who want the deeper background on that lymphoma, he has written a separate explainer on ALCL associated with breast implants.
Why Dr. Rafizadeh Uses Smooth, Round, Cohesive Implants
Put the two decisions together and the logic is straightforward. A smooth, round, highly cohesive implant delivers:
- Shape retention from the cohesive gel — the reason patients want “gummy bear” implants in the first place.
- Low rippling, because the firmer gel doesn’t collapse and fold along its edges — a meaningful advantage for thinner patients.
- Gel containment if the shell ever fails, since a cohesive gel stays put rather than spreading.
- No rotation risk, because a round implant is symmetrical and has no “correct” orientation to lose.
- A smooth shell, avoiding the textured surface associated with BIA-ALCL.
He selects among the implant families he trusts — Motiva, Allergan (Natrelle), and Mentor — and sizes the implant to the patient’s chest width, tissue thickness, and goals rather than defaulting to one size or style for everyone. The implant is chosen for the frame, not the other way around. You can read more about how he approaches sizing on the breast augmentation procedure page.
Do Cohesive Implants Feel Natural?
This is the fair trade-off to name honestly. A more cohesive, form-stable gel feels slightly firmer to the touch than a softer, less cohesive gel. That firmness is exactly what makes it hold its shape and resist rippling — you can’t have maximal softness and maximal shape retention at the same time. In practice, a well-sized smooth round cohesive implant with adequate soft-tissue coverage feels natural to the great majority of patients, and the visible result — a soft, tapered, un-operated look — is what most North Jersey patients are actually after.
For a thinner patient especially, the rippling resistance of a cohesive implant is often worth the modest difference in feel, because the alternative — a softer implant whose edges show or wrinkle — is the more common source of dissatisfaction. Patients weighing implants against their own tissue can also read Dr. Rafizadeh’s take on fat transfer breast augmentation and on what causes implant rippling and how it’s fixed.
What This Looks Like in Real Patients
The cases below were performed in Morristown using smooth, round, cohesive silicone implants. They illustrate the look Dr. Rafizadeh designs around — proportionate, natural, and settled — rather than an obviously augmented shape.
Patient Before & After
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Both patients were treated in Morristown with smooth, round, cohesive silicone implants sized to the individual frame. Individual results vary; these images are shown for education, not as a promise of any specific outcome.
Questions Worth Asking Any Plastic Surgeon in North Jersey
If you are comparing surgeons in Morristown, Summit, Chatham, Madison, Short Hills, Bernardsville, or anywhere across Northern New Jersey, the implant conversation is where a lot of the important detail lives. Useful questions to ask:
- Do you use smooth or textured implants — and why?
- Will you use a round or an anatomic teardrop implant for my case?
- Which implant brands do you work with, and how do you decide among them?
- How do you size the implant to my chest width and tissue thickness?
- What is your plan for monitoring the implant for silent rupture over time?
- How do you counsel patients about BIA-ALCL and textured surfaces?
A surgeon who has thought carefully about implant safety will answer each of these directly. Vague answers, or a push toward textured teardrop implants without a discussion of the trade-offs, are worth noting.
Common Questions Patients Search About Gummy Bear Implants
Do gummy bear implants still jiggle?
A little, but less than a softer, less cohesive gel implant. The cross-linked cohesive gel is more form-stable, so it moves as a single unit and holds its shape rather than sloshing. Most patients describe smooth round cohesive implants as having natural, gentle movement — without the exaggerated jiggle some people associate with older or saline implants.
What are the cons of gummy bear implants?
The main trade-offs are a slightly firmer feel than a very soft gel, a modestly higher cost, and — for the anatomic teardrop versions — a textured shell and the possibility of rotation. Choosing a smooth, round, cohesive implant removes the texturing and rotation concerns while keeping the shape-retention and low-rippling advantages, which is why Dr. Rafizadeh favors that configuration.
Who is a good candidate for gummy bear implants?
A good candidate is a healthy adult who wants a natural, shape-retaining result and who has enough soft-tissue coverage to hide implant edges. Cohesive-gel implants are an especially strong choice for thinner patients at higher risk of visible rippling, and for revision patients correcting a prior result. A consultation and hands-on sizing session determine the right implant for each frame.
Can a gummy bear breast implant rupture?
Yes — any implant can rupture over time — but a highly cohesive implant behaves differently when it does. Because the gel is cross-linked, it tends to stay in place rather than spread, so a rupture is often silent and confined. The FDA recommends periodic imaging to screen for silent rupture of silicone gel implants, and Dr. Rafizadeh reviews a monitoring plan with each patient.
Are round implants safer than teardrop implants?
In the way that matters most for long-term safety, yes: smooth round implants avoid the textured surface used on teardrop implants, and texturing is what carries the BIA-ALCL association. Round implants also cannot rotate out of position and distort the breast. For both reasons, Dr. Rafizadeh uses smooth round cohesive implants rather than textured teardrop implants.
Why do some surgeons say gummy bear implants are better?
Because the cohesive gel holds its shape, resists rippling, and keeps the gel contained if the shell fails — all real advantages, particularly for thinner patients and revision cases. The key point is that those benefits come from the cohesive gel itself, not from a textured teardrop shape. Dr. Rafizadeh captures the benefits by using a smooth, round, highly cohesive implant.
Sources & References
- de Boer M, van Leeuwen FE, Hauptmann M, et al. “Breast Implants and the Risk of Anaplastic Large-Cell Lymphoma in the Breast.” JAMA Oncology. 2018;4(3):335–341. PubMed
- Clemens MW, Jacobsen ED, Horwitz SM. “2019 NCCN Consensus Guidelines on the Diagnosis and Treatment of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL).” Aesthetic Surgery Journal. 2019;39(Suppl_1):S3–S13. PubMed
- U.S. Food & Drug Administration. “Breast Implants — Risks and Complications.” fda.gov
- U.S. Food & Drug Administration. “FDA Requests Allergan Voluntarily Recall Natrelle BIOCELL Textured Breast Implants and Tissue Expanders” (2019). fda.gov
- American Society of Plastic Surgeons. “Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL).” plasticsurgery.org
Related Reading From Dr. Rafizadeh’s Blog
Patients researching implant choices for breast augmentation in Northern New Jersey may find these articles useful:
- ALCL Associated With Breast Implants, Explained
- Capsular Contracture: Signs, Prevention & Treatment
- Breast Implant Rippling: Causes & Fixes
- Breast Implants Over or Under the Muscle?
- How Long Do Breast Implants Last?
- Fat Transfer Breast Augmentation: Bigger Without Implants?
Bottom Line
A patient who walks in asking for “gummy bear” implants usually wants three things: a natural shape, minimal rippling, and a safe long-term result. All three are achievable — but the label doesn’t deliver them. The cohesive gel delivers the shape and the low rippling; a smooth, round shell delivers the safety. Together, a smooth, round, highly cohesive implant gives North Jersey patients everything the gummy bear reputation promises, without the textured surface that has driven implant recalls.
If you are considering breast augmentation, a breast lift, or an implant exchange in Morristown, Summit, Chatham, Madison, Short Hills, or anywhere across Northern New Jersey, Dr. Rafizadeh is happy to walk through implant shape, surface, sizing, and your specific goals during a consultation.
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