What is the Sientra Breast Implant?
Doctor Answers 26
Which brand of breast implants is best?
I strongly recommend selecting your surgeon based on training, experience and aesthetic sensibility rather than on the basis of which brand of breast implant they typically use.
You can give two chefs the same recipe but the outcome may be very different. Take time doing research on your plastic surgeon. Excellent surgical training and lots and lots of consistent photos are a must.
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Sientra has a more cohesive gel (5th generation which is the latest and greatest) which have less rupture and capsular contracture. Sientra texturing is unique and theoretically prevents bottoming out or lateralization of the implants compared to a smooth device. Though they are a bit firmer, the tradeoff is likely less rippling.
All implants have pros and cons and it is important to discuss these with your surgeon. Sientra does only sell to Board Certified Plastic Surgeons so rest assured, if your surgeon can use them, he or she is not a family practitioner, ER doctor, dermatologist, ENT, gynecologist or general surgeon who took a weekend course or "cosmetic fellowship".
What is the Sientra Breast Implant
I like round sientra implants because they have a more cohesive gel and we THINK that this could mean less risk of gel bleed and capsule formation, though we don't have any data on this.
I also like sientra implants because of their surface texturing, which also can reduce the risk of capsules when placed over the muscle and we THINK below the muscle as well, though we don't have any data on this last part.
They are a firmer implant, but that means its less likely to ripple. It also means it feels more firm. I like the feel of their implants and I like the size range, though if you are looking for an ultra high profile implant they don't have it.
Their shaped implants are comparable to the other shaped implants on the market, and differ mostly based on their texturing. The allergan textured implants make me a little nervous because they are too firm and the texturing has caused some long term problems in some patients (double capsules, and late seromas). But the mentor textured shaped implants I use regularly for reconstruction.
In conclusion, there are pluses and minuses to each implant, and what's more important is the surgeon. THAT SAID, Sientra only sells implants to Board Certified Plastic Surgeons which I think is F-ing Awesome and should be the case for the other implant companies as well, but they are willing to sell to family doctors, ER doctors, dermatologists, ENTs and anyone else who wants them and takes a weekend course in "cosmetic medicine".
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Sientra Breast Implant
1) HSC which Sientra claims is the most cohesive round breast implants in the US.
2) HSC+ silicone gel is designed to look and feel like natural breasts. HSC + provides softness without compromising shape retention.
Consult with 3 experienced and expert board certified plastic surgeons to understand your options.
Sientra makes the only highly cohesive round implants on the U.S. market
Sientra, Allergan, and Mentor all make excellent round silicone gel implants. The Allergan and Mentor implants are cohesive, and the Sientra implants are highly cohesive. I have used round silicone gel implants made by all three manufacturers, and all yield good results.
If you are looking specifically for a "gummy bear" implant (highly cohesive), Sientra is the only manufacturer that makes round highly cohesive implants. All three manufacturers make highly cohesive shaped implants.
Definition of Sientra Breast Implants
Sientra breast implants
Sientra 'Gummy Bear' Breast Implants
In March of 2012, Sientra Corporation Silimed brand implants were made available in the US. Sientra was the first company to obtain approval from the FDA for use of their shaped silicone gel implants. These implants contain a silicone gel that is more cohesive, and has a slightly firmer feel than traditional smooth round silicone gel implants. The manufacturer terms the silicone filler "HSC+" which stands for High Strength Cohesive +. Round implants from this company contain a slightly less stiff and less cohesive implant that is filled with a gel simply called HSC. We can consider the round implants to represent the "4th Generation" of silicone breast implants and the shaped implant the "5th Generation".
Focusing primarily on the Sientra Shaped HSC+ implants, they do appear to have notable differences from the offerings of other companies: Allergan 410 and Mentor CPG implants. These differences relate to variation in surface, filler, and shape options.
The surface texturing of the Sientra HSC+ implants is created by a technique that is different from other manufacturers by avoiding the process of scrubbing, salting or stamping the shell. These methods of creating a rough surface on the shell (necessary to discourage rotation of these shaped devices) are thought by some to have significant negative effects.
Studies have shown that the differences in the amount and design of the cross-linking of the Silicone molecules comprising the silicone gel in the devices produced by the three silicone implant manufacturers leads to variations in several areas. This research has indicated that the Sientra shaped implant had the least cohesive gel when compared to the Mentor CPG and Allergan 410 implant. In the round implant version, the Allergan implant was the least cohesive and the Sientra round implant was the most cohesive. It is important to understand that cohesiveness does impact the amount of wrinkling and capsular contracture rates of the implant: lower rates of these events are seen with higher degrees of cohesiveness. The untoward effect of higher cross-linking and cohesivity is a propensity to gel-fracture and excessive firmness. Therefore a balance must be reached to achieve a soft, stable breast. Sientra implants were constructed to do this by reducing the stiffness through less cross-linking, but maintaining the form stability by increasing adherence of the silicone gel to the implant shell.
Currently, Sientra HSC+ implants are available in 3 footprints: Classic (taller with moderate projection), Round (less tall than the Classic with high projection), and Oval (least tall with low, moderate, and high projection styles). The classic base is preferred for women with long chest and low base of the breast. The oval shape works better in women who want more cleavage with less upper pole fullness and in women with a wide chest and breast width. Lastly, the round shape does a better job of expanding the lower part of the breast in women who want a smoother upper pole breast-chest transition; in women with a tight lower pole of the breast (constricted breasts), this is the best footprint to select.
Finally, contracture rates and rupture rates appear to be the lowest in these 5th generation shaped implants (from all manufacturers). This realization has led to Sientra extending this belief in the longevity of the product in the form of their unique C3 capsular contracture warranty. This provides coverage for two years from the date of the augmentation if the patient develops a Baker Grade III or IV contracture. The patient is provided a free replacement implant if they develop this problem within this period.
Having attended preceptor training with the foremost US surgical authority in Sientra HSC+ implants, I can honestly say that these implants are truly game-changers. They represent a quantum leap in technology and advance the art of breast augmentation in ways that US plastic surgeons could only dream of 2 years ago.