Sientra shaped round HP 425cc or Natrelle 475cc style 20? (photos)

Thanks for using one of our patients as your goal photo (first one on the left). But your third goal photo shows a woman wearing a push-up bra giving her a high, round, Baywatch coconut look. That is the effect of the bra, not the implant.You do not need shaped implants since smooth round implants are teardrop-shaped when standing up, and flatten and round out when reclining, just like natural breasts do. Form-stable implants remain teardrop shaped even when reclining, which is decidedly NON-anatomic! Further, textured implants adhere to tissues, and therefore do not move as naturally as smooth round submuscular implants do.I'm also a bit concerned that your surgeon doesn't offer all sizes to try on. Does this mean he has to order implants in advance of surgery? In our surgical facility we stock multiples of each implant size and each implant profile, so they are always in stock and we never have to tell a patient "Sorry, we didn't have that size available."That being said, I agree with his comments about sizing--50cc is 3 tablespoons and 1 teaspoon (not a lot, and not even a visible difference in most cases.But yet he also allowed a misconception about silicone cohesive implants to go unmentioned. Both Sientra and Natrelle silicone gel implants are cohesive, and often mistakenly called "gummy bear" implants. However, the actual true "gummy bear" implants are the Allergan style 410 "highly cohesive" textured-surface form-stable (teardrop-shaped) implants. These are more firm than the Sientra or Natrelle silicone implants. All are cohesive, but the 410s are "highly cohesive" and are therefore more firm to touch. Just so you know.Choose the larger Allergan Natrelle implants in the widest width that matches your actual pocket width. If you are really that narrow, then high profile it is! Best wishes! Dr. Tholen

Hi Isamom,I already know you
are seeing a board certified plastic surgeon because Sientra only sells to BC
plastic surgeons (by ABPS - The American Board of Plastic Surgery)
who are members of ASAPS (The American Society for Aesthetic Plastic
Surgery) and or a member of ASPS (The American Society of Plastic Surgeons). So that is great!I would simply focus on what size you want to be, not on a specific shape.  All companies have many, many sizes and dimensions to meet your needs. Also Sientra is the only implant company who has a warrantee if
you develop a capsule after receiving their textured implants. They have
a special process which makes the texture. This implant shell
is unavailable elsewhere.Here are a few tips for you as you are still wrestling on your size.This is perhaps the hardest decision for
a patient to make, as well as the surgeon. Cup size estimates can be
misleading, but I generally advise patients that they will experience an
increase of approximately one cup size per 200 cc. You can try on implants in
the office by placing them into a special bra.Approximately 50 cc (1-2 oz.) is added to the final volume to account
for flattening of the implant in the partial submuscular pocket. Once you
decide on a size you like, then add on about 25-50 cc, because in real life the
implant will be flattened slightly by your tissues.Multiple measurements need to be taken to fit
an implant to your exact anatomy. Have your surgeon's office show you the
charts of the implant dimensions for the various profiles of silicone and
saline from the manufacturer. Then you and your surgeon can piece
together the puzzle by matching your measurements, with your wishes, versus
your tissue cover and the available implants to arrive at a surgical plan.Keep in mind larger implants tend to have
more problems over the years.Since
silicone implants wrinkle less than saline implants, they might be your best
bet.You can also approximate this at home by measuring out an equivalent
amount of rice placed into a cutoff foot of old panty-hose, and put this in
your bra.Wear this around the house for
a while, and see what you think.Implant
size must square with assessments of tissue cover, breast diameter, and chest
wall width. Multiple measurements of your chest wall are taken (seven in
total). Implant size selection has been
an issue of much discussion. Therefore, I use a wide variety of methods, but the implant size is
always established preoperatively.Also,
patients are advised to bring reference photos demonstrating their ideal size
and shape. A photo album of patient pictures is maintained to assist them.
These photos ultimately help in determining where the implants will be placed,
since they can be shifted inside (to provide more cleavage), to the outside, up
or superiorly, and down or inferiorly during surgery. In determining the final
size selection, I always place the highest priority on the preoperative
measurements and potential tissue cover. Then, the patient’s verbal requests
are factored into the analysis.Our
average size over the last 6,000 implants was 350.

In my opinion, the biggest difference between shaped and round implants is the fullness in the upper pole of the breasts.  If you want a more full look in the upper pole, go with the 475cc round implants.  If you want a more natural look in the upper pole, go with the 425cc shaped implants.Don't get hung up on the term 'gummy bear'.   It not a real term and is used so many different ways that it isn't even really clear what it means anymore.

Determining breast implant size can be very confusing to the patient. There are several different manufacturers and different style of implants. The most important factor in picking an implant are the patients chest and breast measurements. After these dimensions are known, the woman has options as to the type of implant she desires. Each implant has different characteristics. For instance, shaped implants are slightly firmer than the round gel devices. However, the shaped devises are more natural appearing with less fullness in the upper pole. Round gel devices are very close in appearance and each manufacturer has slight changes in the consistency of the gel. A patient can't go wrong with choosing any of the implant manufactures, they are all good.

Thank you for your question.Here are two details which may help you make your decision:The textured shaped implants have a more natural slope on the top half of the breast.  They don't give the augmented "bubble look" up top. If you want to maintain a more natural shape, choose the textured shaped Sientra Breast Implants..The textured shaped implants are more firm than smooth round gel breast implants. If softness and feel is very important to you, then choose the Style 20 Natrelle.  Sientra and Mentor also make soft smooth round breast implants comparable to the Natrelle Implants. They give great results.Also, your surgeon is right.  Whichever implant you choose, pick the size that you want.  I agree that you shouldn't compromise the size you want, just to get the textured anatomically shaped gummy bear implants.The Sientra Shaped Classic Base Implant comes in a 450cc, but the BWD is 13.0 which is wider than your 12.5 cm width measurement.I hope this helps.

Both implants you chose can be reasonable options. 50 cc difference is not that much, just slightly bigger than a shot glass. Shape is probably more important for you.

It is often fairly hard to make an implant decision.  Because of the variety of brands and types the process can get quite confusing.  This is why it will be important for you to prioritize what you are trying to accomplish.  The size of the implant, both volume and width is critical.  If you have a certain size in mind anything bigger or smaller than that will not provide the ideal result for you.  The shaped implants are the best implants for most patients in terms of providing the most natural shape, but some patients actually prefer the look that a high profile or extra high profile implant provides.  If you are thin and going on top of the muscle definitely consider the shaped implant.  Under the muscle with some breast tissue you can likely go with either and so I would guide you toward choosing the ideal size and width of the implant.All the best,Dr. Remus Repta

Go with the highly cohesive. It has a lifetime warranty and a 2 year capsular contracture warranty. If you're going under the muscle, why would you need the shaped implant? Even the round implant under the muscle has a great look.

This is a great question since it can be very confusing to patients and physicians.  Sientra makes a tremendous breast implant but their sizes can be a little limiting.  Your surgeon is limiting you on width in order to prevent so much side breast and keep the implant centered under your nipple.  I have found however, that going a little wider to get the desired size is not a problem.  I have gone up to 2 cm wider to get a bigger size and that has worked very well.  The advantage the Sientra breast implants have for breast augmentation is that they produce such a natural feeling breast with a very low incidence of capsule contracture and as a result I prefer then to Allergan.I hope that helps.Best regards

 Either implant may be reasonable for your breast size and it really comes down to your personal preference.  The Sientra shaped implant will result in less upper pole fullness and therefore a more natural look.  The Natrelle round style 20 will result in more upper fullness (similar to the photo you posted).  Some consider this look less natural, however, many women like the accentuated upper pole.  However, I would not loose sleep over this decision.  You will have a very nice improvement with either implant.  Best wishes, Dr Lepore.