Highly cohesive Sientra vs regular silicone. What's the pros and cons?

Thanks for the question. The more highly cohesive silicone in implants like the Sientra HSC implants has a consistency more like a "gummy bear," compared to other silicone implants that have a bit more fluid consistency. In terms of "issues," both implant types have undergone an extensive amount of testing and clinical trials, and complication rates between the two types do not vary significantly. It really comes down to a matter of personal preference. I'd encourage you to have a consult with a board-certified plastic surgeon who can show you the implant types. Actually feeling and seeing them will really help you to understand the differences.Textured implants have a textured outer shell that is designed to discourage implant rotation. This is really only a concern for shaped implants, where you would not want the implant, which has a teardrop shape to simulate an actual breast, to rotate within the breast pocket.

As I've said in other posts, you're picking the person who cuts your hair based on the brand, shape, length, and color of comb that they use.  It ALWAYS most important to pick your surgeon first.  That way, you two can have a candid conversation about all of these considerations.  He or she will detail exactly which implant they suggest for you and why.Texturing is great if you don't want your implant to move (either it is a gummy bear shaped implant or you have a very sloped rib cage).  Otherwise, the texturing is probably not of much benefit and it could put you a risk for some other problems that we've recently discovered.Although I'll make a quick, generic comment about HSC, and HSC+ silicone, none of this matters in your case without an examination and a careful dedicated determination as to your anatomy, personal goals, and realistic limitations in what can be achieved.HSC+ silicone gel is the most cohesive silicone gel available in a round implant. Yes it is firmer, but slightly so.  As an aside, I've never had a patient tell me that they don't like firm feeling breasts.  "Hard" breasts - NO!  But nearly everyone equates "firm" breasts with youthful breasts.  So don't be discouraged by comments that they're firmer.The HSC+ gel in the round implant will likely prove to be the least rippled of all the round implants.  This will likely consequently lead to the lowest risk of rupture.  Furthermore, we have good evidence already that the risk of contracture will be at an all time low.Now, get out there and meet with a caring and trusted plastic surgeon who will take the time to tell you what they suggest in your specific situation.Best of luck.