What's the difference between HSC and HSC+ gel filling of the Sientra implant? Online demos seem to be of textured shaped ones

On the Sientra site, it says that the shaped textured impl. are filled with HSC+ gel and round(textured and smooth) filled with HSC gel. So my question is, What's the difference between HSC and HSC+? is one more cohesive than the other? Seeing as I'm considering round smooth, how does the Sientra HSC filling compare to Natrelle style 15 gel filling? How do the outer shells on both these implants compare? which is stronger? Is silicone seepage to be expected from either of these implants' shells?

Doctor Answers 4

Differences in Gel

I can understand why you are confused.  Sientra uses their High Strength Cohesive (HSC) in their round implants.  It is a fifth generation gel.  Allergen and Mentor use a slightly less cohesive fourth generation gel in their round implants.  However, they are still excellent implants and widely used. Sientra's shaped implants are filled with a slightly more cohesive gel they call HSC+ which is still a fifth generation gel.  Mentor and Allergan use fifth generation gel in all their shaped implants as well.  All three companies use silastic shells of comparable strength all of which are felt to be very low bleed when tested.  Knowing exactly if an implant is leaking once it's in your body can really only be determined by taking out the implant and looking at it. MRI scans are helpful in larger ruptures, but even they are not 100% accurate. So there is no study that can accurately measure the true rate of leakage.  We do know that if the implants do leak they do not lead to alleged autoimmune diseases. Hope this helps.

San Diego Plastic Surgeon
4.3 out of 5 stars 27 reviews

What's the difference between HSC and HSC+ gel filling of the Sientra implant?

Thank you for your excellent question.  The Sientra shaped implants are filled with HSC+ gel, which is slightly more cohesive than the round Sientra implants.  I feel that the Sientra implants, both styles, are slightly more cohesive than Natrelle, i.e. they are a little more "gummy" feeling.  Choosing between the two is largely up to patient preference, guided by the information supplied by your plastic surgeon.  Both outer shells are similar, and current silicone implants are all very resistant to silicone seepage due to the cohesiveness of the gel.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 38 reviews

Sientra High-Strength Cohesive (HSC) vs. HSC Plus

The difference between the Sientra High-Strength Cohesive (HSC) vs. HSC Plus are that in the textured and especially, because they are shaped, the "Plus" means that they are little stiffer (harder) than the regular HSC.  This is to help them maintain there shape!

All silicone gel used in breast implants is cohesive

The term "cohesive" means that the gel holds together as a semi-solid, so more cohesive doesn't necessarily mean better or safer. Shaped implants have a higher degree of cohesivity because they have to be firmer in order to hold the shape. Softer gels are used in round implants and may feel more natural. I use shaped implants (also called form-stable) in about 15% of cases where the patient's anatomy is such that this type of implant fits better.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 45 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.