What's the difference in Sientra's HSC and HSC+?

The smooth round HSC is the first FDA-approved round, 5th generation high strength cohesive silicone gel implant. The HSC+ is also a 5th generation silicone implant, but it is a bit more form stable; it initially was used in the tear-drop shaped implant, but it is now also available in the round shape (107s). 

The Sientra HSC+ implant is their most cohesive implant and Sientra's newest release.  It tends to be more firm, gives more upper pole fullness and a little rounder look.   

Hi, Boobies4Lifeee.  Congratulations on your breast augmentation! As has already been mentioned, Sientra's HSC implants are 4th generation and HSC+ are 5th generation.  Also, as noted, both are excellent implants.Sientra's HSC and HSC+ round implants have a higher fill ratio, compared to some of the competition.  (Allergan's Natrelle Inspira also has a better fill ration, compared to the regular Natrelle silicone gel implants; I do not know if Mentor has a higher fill option).  Additionally, until very recently, Sientra's HSC and HSC+ implants have had a higher degree of cohesiveness.  (Allergan Natrelle now has round "Soft Touch" that is similar to the HSC and "Cohesive" that is similar to the HSC+; again, I do not know if Mentor has an equivalent implant) -- I describe the regular Sientra (HSC) as "almost gummy bear" and the HSC+ as "gummy bear."The increased cohesiveness provides better shape retention, especially in the upper pole, and less wrinkling, but with more firmness.  The HSC+ implant is more expensive than the HSC.  The Natrelle Inspira is more expensive than the regular Natrelle, the Soft Touch more than the Inspira and the Cohesive more than the Soft Touch.I hope you are happy with your results, and that you have had a smooth recovery!  Dr. Ghafoori

Sientra's HSC implants are 4th generation.  They will be softer and have slightly less upper pole fullness.The HSC+ implants are considered 5th generation.  They will be firmer and maintain their shape more.  Therefore a round implant will have a rounder and fuller upper pole.  Both are excellent implants.  They are both cohesive.