To answer the question in your title, the difference between the Sientra high strength cohesive (HSC) and high strength cohesive plus (HSC+) implants is the thickness, firmness, smoothness, upper pole stability, and life span.The HSC+ silicone gel from Sientra is available in a round and a shaped implant. The HSC gel is only available in a round device.HSC+ implants have a slightly firmer feel due to the more cohesive (sticky) silicone material; they are smoother; they support the upper pole of the breast better; and they likely have the longest lifespan of all the currently available round implants.In order to obtain the most "natural" look, you will first want to consider the implant volume. Any implant material, (whether saline or silicone), variation in gel cohesivity (HSC vs HSC+), and shape (round vs tear drop/gummy bear) can give you an unnatural result. A implant that is too large for your body and/or one that develops a contracture is more likely to create an unnatural look. If you select a Board Certified Plastic Surgeon who is experienced in breast augmentation and who uses these new and wonderful options in breast implants, you should get the closest result to the one you desire.Hope this helps.
