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

The primary reason to choose a highly cohesive form stable round implant is to achieve upper pole fullness.

All of your questions are excellent and I'm pleased to see that you are doing your research.  The more highly cohesive or "gummy bear" implant is definitely more firm, but ultimately once implanted, usually doesn't have a  great difference in feel.  Sientra has just introduced a line of round implants with the more firmly adhesive gel (their 107 line) with the thought that the implant can help to reshape the breast in a similar manner as the shaped implant. The shaped gummy bear implants are always textured to prevent rotation of the implant while the round implants can either be smooth or textured.  There is some thought that the texturing of the implants decreases the risk slightly of developing hard scar tissue around the implant (capsular contracture), especially if the implant is placed under the breast tissue (over the muscle) rather than under the muscle.  Feeling the implants in person in a plastic surgeon's office may be helpful for you as well.  Best of luck and kudos for your thorough research!

Thank you for the question. All currently FDA approved silicone gel breast implants are “cohesive”. This “cohesiveness” makes it so that the silicone material is less likely to leak, if/when there is a failure of the surrounding shell.The “gummy bear” silicone material is a more dense material chemically. The term “gummy bear” has been used, almost as a slang term, to encompass all silicone gel breast implants; thus the confusion. None of the types of breast implants you mention are necessarily “better”; there are pros/cons associated with each type of implant.Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant type/size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of know words such as “natural” or "small D cup” etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.

I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.