With Sientra implants now unavailable, are there increased risks using a gel filled implant vs. a highly cohesive gel implant?

When I planned my surgery we chose Sientra round textured implants for many reasons. Now as we all know, they are unavailable. My PS offers all 3 brands and has chosen to use Natrelle gel-filled implants instead. Should I have any concerns with gel-filled vs. cohesive? When I started this process I was dead set on saline due to my fear of silicone (yes I saw the 20/20 episode in the 90's). I felt the cohesive was the safest silicone option. Should I postpone?

Doctor Answers 11

With Sientra implants now unavailable, are there increased risks using a gel filled implant vs. a highly cohesive gel implant?

All FDA-approved implants have a type of cohesive gel versus older-generation implants from the 1980’s that are no longer sold. The anatomically-shaped implants have a firmer gel that retains its shape in the body to act as an internal breast form (Allergan 410 and Mentor CPG). Round implants also shape the breast, but also fill out the breast to restore volume lost after pregnancy.
The safety profile of round and anatomically-shaped implants is well-characterized. Feel free to discuss your specific concerns with your plastic surgeon regarding their experiences with gel-filled breast implants.

Eugene Plastic Surgeon
4.3 out of 5 stars 14 reviews

Sientra Implant Alternatives

Yes, I am also bummed that Sientra implants are no longer available for my patients. However both Allergan and Mentor have highly cohesive silicone gel choices. You also might want to consider the #IDEALimplant - a saline implant made to feel like silicone and now FDA approved and available. See the below link for details. 

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 159 reviews

Choosing the correct silicone implant

All currant silicone gel implants are cohesive gel.  Allergan and Mentor have been used for years with excellent safety records, are all FDA approved and offer a wide range of implants to fit most any choice.  Textured vs smooth should be decided after in depth talk about the benefits and possible risks/trade offs.  Your plastic surgeon can discuss all details during your visit.

Jeffrey M. Darrow, MD
Boston Plastic Surgeon
5.0 out of 5 stars 102 reviews


Mentor and Allergan both have excellent products that are safe and reliable. You should discuss your concerns with your surgeon. Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

With Sientra implants now unavailable, are there increased risks using a gel filled implant vs. a highly cohesive gel implant?

All available silicone gel implants are cohesive gel-that is the only type FDA approved and available. Mentor and Allergan are excellent. Understand the difference between textured and smooth-read below:


Natrelle (Allergan) and Mentor offer gel and cohesive gel styles. Rediscuss with your plastic surgeon so you are comfortable pre op.

Harry T. Haramis, MD, FACS
Montclair Plastic Surgeon
3.7 out of 5 stars 19 reviews

Silicone implants textures no Sientra

Thank you for your question concerns regarding the use of non-Sientra cohesive gel implants.  Both Allergan and Mentor and Implants are also made of cohesive gel and not liquid gel. I would not be concerned regarding liquid gel leak. I prefer Mentor texturing at this time as a replacement for my previously scheduled Sientra patients. If you have adequate soft tissue, Saline implants are a very good if not a better option especially the TUBA procedure without any incisions. 

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
4.8 out of 5 stars 96 reviews

All contemporary silicone gel implants are cohesive.

Regret that your surgery was scheduled amidst this fracas, however remember that information is power and you now can focus on the two industry leaders.  You should probably also revisit preop planning with your PS.  Textured round silicone gel implants may feel slightly firmer than their smooth counterparts and if your skin brassiere is thin, you may be plagued by palpability of lateral folds or ripples.  Cohesivity is maximal in the Natrelle Style 410 and Mentor MemoryShape, which are anatomical "tear drop" shaped implants.  In the mid 90's there were some "tear drop" anatomical shaped saline implants, which were not widely accepted because of the possibility of malrotation and deflation.  Today's "form stable", highly cohesive gel implants come in a variety of projections and heights, which I have successfully used in breast cancer reconstruction as well as revisional breast. Saline breast implants primary appeal is the unequivocal detection of implant failure, i.e. "flat tire" phenomenon.  There are also some disadvantages: palpability of implant, thinning of overlying tissue, stretch deformity, amongst them.  If you have any misgivings, defer. 

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews


They are ALL cohesive now. A few are more highly cohesive than others but the practical differences are likely overshadowed by differences in tissue characteristics etc. In my opinion, all three manufactures provide high quality implants.                                                        

Robert H. Hunsaker, MD
Miami Plastic Surgeon
4.5 out of 5 stars 82 reviews

Cohesive Gel implants

 In my opinion, the closest thing to the Sientra implant other than their new number 107 is the Allergan textured implants. These days, all of the silicone gel implants from all three manufacturers are deemed to be cohesive. Some of the older gels are more responsive in that they aren't as highly cross-linked which makes the gel not as rigid feeling. I think if you're my patient an Allergan implant would be the way to go. Good luck with your surgery.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 55 reviews

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.