Cohesive gel implants are silicone gel implants. But unlike their predecessors, the filler in cohesive gel implants has a higher amount of "crosslinker," resulting in a firmer, gummy-bear consistency that does not wrinkle or deflate like saline, nor leak as easily as the more fluid filler of earlier-generation silicone implants.
Dr. Mark Solomon, a plastic surgeon and a spokesman for the American Society of Plastic Surgeons described it by saying that even if you cut through it, the gel does not leak out.
The cohesive gel implant has a more stable shape, and works well when implanted above the pectoral muscle. This eases post-operative pain. However, because of the firmer shape, it is necessary to make a larger incision to insert the implant, which is most often made under the crease of the breast. Cohesive gel implants are not recommended for those seeking especially large implants.
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