Ideal breast implants vs Sientra?

Question

I am considering my 4th breast augmentation over a 15 year period. I've had capsular contracture each time. After my last pair, I had them taken out without replacing and had full capsulectomy. That was 3 years ago. I'm considering the Sientra implant and the Ideal implant. Which is better for my situation? I also have an autoimmune condition.

Sam M. Sukkar, MD · Answer

I think you need to strongly consider placement of acellular dermal matrix such as Strattice or its equivalent to help protect you from a recurrent contracture.Implant choice is less of a factor vs sterile technique, pocket placement, and meticulous hemostasis.Your autoimmune condition may play a role if you are on immunosuppressant medication.Good luck!

James F. Boynton, MD, FACS · Answer

I agree with my plastic surgery colleagues below.  Revision breast surgery can be quite complex as can recurrent capsular contracture after breast augmentation. I do not think the brand of the breast implant has much to do with the capsular contracture; however, I do prefer smooth round silicone gel breast implants compared to saline-based breast implants, which is what the Ideal implant is.  I devote a large part of my practice to revision breast surgery, specifically recurrent capsular contraction.  I think there are a number of things that can be done for this depending on what has been done before. Oftentimes in addition to new breast implants and a capsulectomy being performed, pocket or site changes need to be incorporated to provide a fresh new "tissue interface" to be in contact with the breast implant.  Site changes in conjunction with an ADM (acellular dermal matrix) can really improve recurrent capsular contraction.  I hope this helps.  Good luck!

Nathan Eberle, MD, DDS, FACS · Answer

I would not get stuck on a brand of implant as much as pocket position position(under the muscle) and use of a internal bra/mesh(such as alloderm or strattice) along with using a textured implant if possible. These are the things we know that decrease the rate of Cap con. If you want only a modest increase in size(1 cup size or so) and you have some fat to donate from your abdomen or elsewhere, fat grafting to your breasts may be a good option for you also with your hx of breast capsule problems.

Richard Baxter, MD · Answer

The choice of implant type is probably the least important aspect of success with your next procedure. Features such as texturing and under muscle placement might help, but the most important thing is to have a different strategy than what you have already had done. Consider using an ADM such as Strattice, which is probably the most effective protection against recurrent contracture.

David Finkle, MD · Answer

With 3 previous contracture problems, you are at a very high risk for capsules once again.  You might want to consider fat grafting to your breasts and stay away from implants completly, especially with your history of autoimmune disease.

Ideal breast implants vs Sientra?

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