500hp Sientra Textured? (photo)

So I went for my pre-op today and ps decided 465-505cc sientra HP textured (possibly due to chest wall irregularity on left breast). I am nervous about that size and the brand. I was thinking smooth mentor memory gel...is there much difference? I don't want to look large and matronly. Maybe I should stay in the C-cup range? Also are sientras as soft as mentors? Please see my previous question on sizing question.

Doctor Answers 28

Sientra vs Mentor or Allergan: Smooth or Textured decisions

The first place to start with your questions is with your surgeon.
All three implant companies make great implants, though I prefer Sientra for the following reasons - see below.
Of interest is that about 90% of the world outside the United States prefers textured breast implants, where as almost the reverse is true in the USA. I think this trend will change as textured implants such as Sientra's use more highly cohesive silicone gel so that there is less likelihood of rippling. The big advantage is that a primary augmentation patient will qualify for a free replacement implant if she requires revision surgery to correct a significant capsular contracture within the first two years after implantation. Perhaps most importantly from a patients perspective is that breast implant "massage" is not needed with textured implants, and they don't drift to the side when you lie down.

Sientra’s TRUE Texture™ implants were found to carry a significantly reduced risk of capsular contracture compared to its smooth implants, according to a study published in Plastic and Reconstructive Surgery. The analysis looked at more than five thousand implants over a five-year follow up process, providing a very robust set of data as a foundation for this finding. It is with this statistical confidence in the resilience of their textured implants against capsular contracture that Sientra introduces the C3 Program.
As with the implants themselves, Sientra’s C3 Program is only available through plastic surgeons certified by the American Board of Plastic Surgery. This is done to improve patient confidence even further — it ensures that surgical procedures using Sientra implants are only done by the most qualified doctors.


Orange County Plastic Surgeon
5.0 out of 5 stars 64 reviews

Sientra high strength silicone gel implants

Sientra has the highest strength silicone gel with excellent gel to shell bonding and if you choose either a round or a shaped implant ( my preference) it will afford the best and softies, natural result. Softness comes from meticulous operative technique combined with avoiding the nipple approach and using a textured implant placed beneath the muscle. Shaped implants give more volume and projection for the cc and a shaped oval or round base in the mid 300- 400s should match the 500 ccs. Wouldn't believe the smooth mentor option is the  best - we used to use Mentor and now opt for Sientra for essentially all patients

Christopher S. Verbin, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 13 reviews

500 HP Sientra Implants

While I agree with my colleagues it's always best to speak directly with your Board Certified Plastic Surgeon since they will manage your care. I am happy to share my views on how I do things in my practice. I do like the Sientra implants. They are slightly firmer than Mentor...but I bet I could put a Sientra in one breast and Mentor in the other and you wouldn't tell a difference. So, I wouldn't worry about that. Sientra makes a great implant and early studies show they "may" last longer. Personally speaking I'm not a big fan of high profile implants because they tend to look "more fake."  Again, that is just my opinion. I do use them in my practice but typically for patients with very small chest widths. Bottom line I think you'll have a great result.

Jeffrey Hartog, MD
Orlando Plastic Surgeon
4.5 out of 5 stars 50 reviews

Sientra textured implants

I think the Sientra textured implants are great and I often use for the appropriate patients.  This will most likely take you to a D or DD though depending on your current cup size.  Different size implants are commonly used to address asymmetry.  If you really want to stay in a C-cup range you may want to go down a size to 400-410 and 440-450.  It is best to try on a variety of implant sizes and also use 3D imaging via VECTRA.  If you are at home and want to try on some different sizes... fill a measuring cup with rice and measure mL's (same as cc's) - put rice in a ziplock back and stick it in a non-padded bra and try on some different tops.  Add and subtract rice until you have determined your perfect size. 

Implant worries

The size may be too large. Stay with being proportional with your frame.  The cups are for bras and Victoria Secret would like to say everyone is a D cup.  If you desire a C cup, the 465 will likely be too large.  The rupture rate is higher for Mentor's, so Sientra has a better deflation risk AND a warranty for that as well as contracture.  As a co-author on the Sientra paper recently published, I would recommend a textured round gel or if you have very little breast shape or tissue a textured round base shaped gel implant. My guess is that a 355-385 textured round gel or 370 round based shaped gel would be excellent choices.  After 600 of the highly cohesive gels, I have yet to see a deflation or a contracture for cosmetic breast augmentation.

Sientra textured imants

I use Sientra implants and like the textured implants the best. I think your surgeon has made a good choice on brand and texture. Your photos lead me to think your chest width is average and the 500 High profile may be ok. You will be a D-DD size most likely. If you want to be a fuller C to smaller D- a size of about 400cc is more typical. 
Since your surgeon is offering you a Sientra implant you can feel
secure in knowing they are a board certified plastic surgeon as they are the only ones who can purchase this brand of implants.
i usually select the profile and volume of the implant using your chest measurements and size interest.
I like the textured implants best as they offer several advantages over smooth implants. These advantages are that they are less likely to get firm,
more likely to stay more centered on your chest over time and are soft and natural feeling.
Many US plastic surgeons were not trained to use textured implants so they may not be as familiar. I was one of those surgeons as well.
I have learned from the European plastic surgeons of the benefits of textured implants and like them best.
Good luck with your procedure.

Sientra

The published data on the Sientra implants is very good - so you don't need to be worried about the brand.  However, it sounds like the implants that you and your surgeon have chosen are a bit large for your frame size... it would give a pretty "obvious" implanted look, IMO.

But, of course, it depends on what you like and what you've asked for... speak to your plastic surgeon if you are having doubts.

What is your breast base width?

Matronly and implants

Your pictures are difficult  to interpret because you are taking your own and the lifting of your arms elevates the breasts, making them look more lifted.  Sientra makes round silicone implants that are textured and smooth.  They also make anatomic (or form stable implants) that are textured.  I think the anatomic ones may not look the best if you have much ptosis (or breast hang).  But a good examiner can help guide you because, the surgeon should also look at skin quality, breast volume, chest projection, etc. 

Sientra Implants? and sizing concerns?

All good questions!

I think sizing my patients is my biggest challenge. If you are at all unsure I would visit your Plastic Surgeon again for further discussion. It can be a very difficult decision to make.

I tend to use smooth round implants for most of my patients. Every patient is an individual, and it's important that you express your expectations with your surgeon to help him/her choose the right implant specifically tailored for you!

I am one of the principal investigators for the Sientra FDA study that was published late last year. I really like their product.  I think their implants ripple less, and have more cohesivety than the others on the market.  I strongly recommend them without any reservation.

Best of luck,

Jennifer Harrington MD

Retry sizing

Sizing is really where YOU get to pick YOUR implants. If you are not sure about the size, redo the sizing in the office. I think you have some stretch to your skin, so while a larger implant like a 505cc textured implant may fill up the envelope, it may also lead to more pulling and stretching of the skin long term. It is something to consider. I think those implants will probably work well in your frame and breast, but YOU should choose them, not the other way around. If you wanted smaller implants, that could also work, but you may benefit from a dual plane 2 aug or perhaps a lift around the nipple. Speak to your doctor about your concerns and the pros and cons. I do like the sientra implants, they only sell to plastic surgeons, their surface texturing is better (in my opinion and based on data) than allergan, and their gel is more cohesive (less liquid) than mentor or allergan, so the possibility is there that gel bleed and capsules are also less likely with sientra implants. They have the best warranty on the market, so I choose them more often than not and I am moving towards only using sientra implants.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.