I am considering a revision from smooth round silicone implants following bilateral mastectomies to the Sientra shaped implants. Which base shape is generally best for breast reconstruction? Does the textured surface of the Sientra implants contribute to higher incidence of rippling compared to smooth round gel? Lastly, just how much stiffer do the Sientra implants feel in vivo? The gel implants I currently have are more firm than breast tissue. I am wondering just how much firmer Sientras are.
Sientra Shaped Implants vs. Smooth Round Gel for Breast Cancer Reconstruction?
Doctor Answers (6)
Formstable (Sientra) vs. round gel implants ?
It is difficult to create the same projection of breasts with Gel implants your tissue expander did. Since I started to use form stable implants I am much more pleased with the results.
Form stable implants (Sientra) are a little bit firmer and look "stiffer". Nevertheless I would think they qualify for "soft" breasts. What Softness means for your breasts is very personal . Round vs. tear drop implants once placed in a breast pocket should not appear very different. Rippling should not be an issue.
I would recommend you look and feel the different implants in your surgeons office. Maybe place even a form stable implant into your bra and feel their softness than.
Shaped implants vs. smooth round for reconstruction
The sientra shaped implants come in a variey of shapes and profiles. I use them in my breast reconstruction practice most often for thin women because there is less rippling (rippling is more visible in thinner women) and they lend a more natural, tear drop shape to the reconstruction. We have Sientra implants in the office for patients to feel. They are a more cohesive gel than the non-Sientra, smooth, round, silicone implants and are, therefore, firmer. I prefer to use the higher profile implants in thin women and the wider base, lower profile implants in fuller figured women. Consult with a plastic surgeon who uses both implants to determine if the switch is right for you.
Individualize implant choice for breast reconstruction revision
There is no single answer to your question but shaped implants such as those from Sientra may help. (See before & after pictures of a revision from smooth round to Sientra shaped implants on the link below.) They do feel firmer than round implants but do not ripple more.
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Breast reconstruction with Sientra Implants
Three basic forms of breast reconstruction exist. You can use your own tissue, implants or a combination of the previous two techniques. Your own tissue can be used in the form of the DIEP flap, PAP flap, SGAP flap or fat grafting. Implants can be done in one stage or two stage. Two stage reconstructions are started by placing expanders at the time of mastectomy. Once they expanders are placed they are able to be inflated as determined by wound healing. The final time consists of combining any of the above techniques.
If you are interested in being seen in Austin please give us a call. I know this is a difficult time for you. The majority of my practice is devoted to reconstruction for women with breast cancer or who are BRCA+