Dr. Joseph Russo, a Newton plastic surgeon who has performed hundreds of breast augmentations, says that more than 90 percent of the women who come to his practice for implants choose the “gummy bear” implants.

These days, a number of millennial women are embracing breast augmentation. But they’re avoiding the oversize implants that flashed across TV screens in the ’90s. Instead, a stable silicone implant commonly referred to as the “gummy bear” is gaining popularity.

The “Selfie Generation” is going under the knife.

In decades past, traditional saline and silicone implants dominated the plastic surgery industry. Both had downsides.

“Saline [implants] are basically a bag filled with water. They’re fine, but they don’t feel as natural and they ripple, and they can deflate,” Russo said. “You put them in empty and fill them up.”


Silicone implants can also present obstacles. In 1992, the FDA pulled them off the market over concerns about ruptures from physical trauma like a car accident or even a mammogram, as well as other health concerns. Silicone implants were not used for breast augmentation (only reconstruction) again until the mid-2000s. Meanwhile, from an aesthetic standpoint, if a patient’s breasts were already low, traditional silicone implants could make them droopier.

“Imagine a plastic bag filled with hair gel,” says Russo. “It’s a soft, gooey, amorphous mass.”

In contrast, the gummy implants, which were approved in 2013, can be refined to “take on any shape you put it in.”

Around the country, statistics show that breast augmentation surgery is on the rise. There were 279,413 breast augmentations performed in 2015 — a 30 percent increase from the year 2000, according to the American Society of Plastic Surgeons.

But the look that patients hope to achieve has changed in many cases. The “Baywatch” look is no longer in high demand; many want a more natural look.


“People were going much bigger back then,” said Russo. “We thought we knew what women wanted.”

Now some patients are choosing the gummy bear, or “form stable” implant — a highly cohesive, textured silicone implant inserted from the underside of the breast and placed under the muscle. The implants are soft to the touch without the threat of rupturing.

“It stays where you put it,” said Russo. “We can create breast shapes now that we couldn’t before.”

The gummy bear has caught the attention of some millennials, who seek the long and lean aesthetic presented by celebrities like Taylor Swift. While Swift has not confirmed or denied whether she’s had breast augmentation, her look is an inspiration for many of Russo’s patients.

Katie, a 29-year-old Waltham resident who asked that her last name not be used, came to Russo after she noticed lots of women with breast implants while on a trip to Bike Week in New Hampshire with her boyfriend.

“I told [Dr. Russo] I just wanted to have enough so I would have a good shape to my body where it’s not gonna be like ‘Oh look at her — she’s got fake boobs,’ ” Katie said. “I told him I wanted to go to the biggest I could go with still looking natural.”

Katie paid about $8,000 for her form-stable implants and said her recovery period was relatively quick.

“I did it on a Thursday, took Friday off, and was back to work on Tuesday,” she said.


Haley (who also asked that her last name not be used) was 18 when she decided to get breast implants. About to graduate high school, she had always been insecure about her shape, and chose to consult Russo because he had already done work on her mother, aunt, and grandmother.

“Obviously, there’s stigma around it, and for a while I felt ashamed,” said Haley, who is now a 21-year-old college student. “But I just decided, well [expletive] it. I feel good and it works for me. There’s something to be said about feeling attractive.”

Despite interest in the implants, not all plastic surgeons are enthusiastic about them. Dr. Raymond Dunn, chief of the division of Plastic and Reconstructive Surgery at UMass Memorial Medical Center and a professor at UMass Medical School, doesn’t use so-called gummy bear implants in his practice.

“I have not adopted their use,” says Dunn. “Partly because of cost, and essentially at this point in time, there is no clear advantage to this implant, while there may be some slight downsides.”

In addition to a higher price tag, form-stable implants are more rigid in their shape, Dunn said. When a woman with natural breasts stands up, gravity pulls her breasts down. When she lies down, they move to the side.

But if they’re shaped implants, they’re going to stay in the same position as they were when they were inserted.

“So when she lies down,” Dunn said, “she’s going to look like she’s standing up.”


There’s also the possibility that the implant can move during the healing period, resulting in a crooked set of breasts, Dunn added.

“In my opinion, and the opinion more of a broader group of plastic surgeons, if you look across the country, the rate of adoption of form-stable implants is fairly slow, because they can be challenging,” Dunn said. “So by no means are gummy bear implants changing or taking over the industry. The single most common implant used by plastic surgeons across the country is a smooth, round [silicone] gel or saline implant.”

For his part, Russo says he thinks social media plays a role in motivating people to try plastic surgery, and not just because it spreads information and makes the subject less taboo.

“The selfie generation has created a whole new group that has interest because it magnifies the things that aren’t perfect,” Russo said.

Unfortunately, some patients come expecting plastic surgery to produce major life changes.

“Get a divorce, be in the movies . . . it won’t get them their husband back or something,” he said. “You have to back them way down on that.”

While women like Haley and Katie admit that social media influences them, they both say they know enough to not take it to the extreme.

“If you go Kylie Jenner, where she just changed her whole self-image, that’s to the extreme,” Katie said. But if “you’re just doing one or things,” that’s not changing who you are.

Megan Johnson can be reached at megansarahjohnson@gmail.com.