Silicone, saline, and gummy bear implants each carry meaningful differences in feel, form, and long-term behavior. All three are FDA-approved and extensively studied; what sets them apart is how each one performs for you. The right choice depends on factors that are genuinely individual: your anatomy, your tissue coverage, your lifestyle, and the specific result you're envisioning.
At Liu Plastic Surgery, home of SVIA® Plastic Surgery in Los Gatos, San Mateo, and Sacramento, Dr. Jerome Liu and Dr. Tom Liu are both board-certified by the American Board of Plastic Surgery and fellowship-trained in aesthetic surgery. Additionally, Dr. Tom Liu serves as Co-Medical Director of the Plastic and Breast Program at El Camino Hospital. That depth of training informs every implant recommendation we make.
In this guide, we walk through what sets each implant type apart so you can arrive at your consultation with real clarity.
Breast Implant Basics
All three implant types are built with either a smooth or textured silicone outer shell and are FDA-approved for both breast augmentation and reconstruction. Here’s what actually sets them apart:
- Filling material: Saline uses sterile saltwater solution; silicone and gummy bear implants use cohesive silicone gel of varying density and cross-linking.
- Consistency and feel: Ranging from firmer and more structured (saline) to soft and natural-feeling (silicone) to form-stable and shape-retaining (gummy bear).
- Behavior in the body over time: How each one responds to movement, ages gracefully, and maintains its integrity over the years.
Saline Breast Implants: Classic and Adjustable
Saline implants are filled with sterile saltwater solution, the same fluid your body naturally uses, and have been used safely in breast augmentation for decades. They are inserted as an empty shell and filled to the desired volume once in place, which offers a degree of intraoperative flexibility that can be valuable for patients with mild asymmetry or those hovering between sizes.
What patients love about them:
- Often require a smaller incision, since the shell is placed before filling
- Simple to detect if a rupture occurs, as the saline is absorbed harmlessly by the body
- Volume can be fine-tuned during surgery
- Typically the most accessible price point among implant types
A few things to consider:
Saline implants tend to feel firmer than silicone alternatives and can be more susceptible to visible rippling, particularly in patients with thinner breast tissue. For this reason, they are generally best suited to patients with adequate natural coverage.
Silicone Gel Breast Implants: Soft, Natural, and Time-Tested
Silicone gel implants have been the most popular choice for breast augmentation in the United States for years. Filled with a cohesive silicone gel that closely mimics the density and movement of natural breast tissue, they offer a result that is difficult to distinguish from the real thing by look or touch.
What patients love about them:
- A soft, natural feel that moves and responds like breast tissue
- Significantly less prone to rippling than saline, especially in slender patients
- Available in a wide range of profiles, projection levels, and sizes to suit virtually any frame
- Decades of safety data and one of the most extensively studied medical devices in history
A few things to consider:
Because silicone gel is not absorbed by the body the way saline is, a silent rupture (one with no noticeable symptoms) is possible. This is why the FDA recommends periodic MRI screenings after placement to confirm shell integrity. Silicone implants are FDA-approved for elective breast augmentation in patients 22 and older.
Gummy Bear Breast Implants: Advanced Cohesion, Lasting Shape
Gummy bear implants, also known as highly cohesive, form-stable silicone gel implants, represent the most advanced implant technology currently available. The gel inside is more cross-linked and thicker than traditional silicone, which means it holds its contour even when the outer shell is compromised. The nickname comes from exactly the property that makes them so appealing: just as a gummy bear retains its shape when cut in half, these implants maintain their form under pressure.
What patients love about them:
- Shape retention that remains consistent over time
- A naturally contoured, proportional result, particularly appealing for patients seeking an anatomic teardown silhouette
- Lower risk of rippling or wrinkling compared to other implant types
- An excellent option for patients prioritizing long-term predictability
A few things to consider:
Form-stable implants are more rigid by design, which means they require precise pocket placement and a slightly longer incision than traditional silicone. Because they hold a fixed shape, correct orientation matters; rotation, though uncommon, can affect the result. Like all silicone implants, periodic imaging is recommended after placement.
How SVIA® Plastic Surgery Finds The Right Fit for You
It all starts with a consultation, during which you’ll meet with Dr. Jerome Liu or Dr. Tom Liu and discuss:
- Your natural anatomy: Breast tissue thickness, skin laxity, chest wall shape, and existing volume all influence which implant will look and feel most natural on you.
- Your aesthetic vision: Whether you're drawn to subtle enhancement, a more dramatic transformation, or something beautifully in between.
- Your lifestyle: Activity level, future pregnancy plans, and how you want to feel in your clothes and in your own skin.
- Your priorities: Some patients lead with feel; others with shape consistency or longevity.
We use TouchMD interactive displays in our consultations to visualize proportions, compare options, and ensure that every decision you make is completely intentional. Our goal is never to rush you toward a choice, but to give you the clarity and professional guidance you need to do what’s best for you.
The Right Implant, Placed By the Right Surgeon, Creates the Best Results For You
When evaluating any provider, we encourage you to ask directly: Are you board-certified by the American Board of Plastic Surgery? How many breast augmentations do you perform each year? A surgeon confident in their training will answer without hesitation.
At Liu Plastic Surgery, that transparency is a given. Dr. Jerome Liu and Dr. Tom Liu are both board-certified by the American Board of Plastic Surgery (ABPS) and fellowship-trained in aesthetic surgery—credentials that require completing an accredited plastic surgery residency and passing a rigorous board examination, a standard that "cosmetic surgeon" alone does not meet. Our more than 718 patient reviews, averaging 4.7 stars across our Los Gatos, San Mateo, and Sacramento locations, reflect what it looks like in practice.
We’re here to answer all of your breast implant questions. Contact us today to book your consultation and learn more!
