Follow-Up: Rupture rate - Sientra vs Inspira Soft Touch? 5’4, 118lbs, 32C, mom of 2. Looking to go 300-355cc silicone moderate.

Question

Having my BA in November 2017. They are both comparable in feel and cohesiveness. My PS will typically chose the implant that works for the patient, but I really want to have an opinion about which brand is used. It’s my body after all and I have to live with it. He said he tends to use the Soft Touch more because it gives better results. However, I hear that sientra has the lowest rupture rate. I haven’t be be able to find any data on the new Inspira soft Touch.

David R. Stephens, MD · Answer

Hi flycm; It is important to consider that quoted failure rates come from limited patient studies that the manufacturers send to the FDA, and often the data is manipulated statistically to provide rates of events. Just look at any prescription package insert and you see that the information is highly technical and comes from limited clinical trials. Those are the quoted numbers. Even more bizarre, a Canadian study for their health regulator of American data on Mentor implants showed a failure rate of over 24 percent but we know that isn't the case in real life!! If you look at most failure rate studies among implants sold in the US, their failure rates are less than 10 percent over 10 years and all within 1 to 2 percent of each other. The companies even source their gel from the same supplier. It's like asking which is the better car, a BMW, Audi or Mercedes. It depends. We recommend MRI to asses failure at 5 and 10 years and then at 3 year intervals after 10 years as we don't have data after 10 years but it is going to climb. I do not recommend replacing implants at the 10 year anniversary as that would mean more than 90 percent of them would be okay and didn't need to be replaced. Implant quality control has improved substantially over the past 10 years so they are just not that much different from one another. Consider other important factors such as the firmness of the implants. BTW, there is NO data that implant firmness is correlated to less rippling when comparing implant softness and cohesiveness. Also, all implants sold are cohesive, some are just more cohesive or firmer than others. Firmness will cause more upper pole firmness and roundness in the round implant. Personally, if I were a woman I wouldn't want a gummy bear round implant as they are too firm and round. The "Soft-Touch has been a popular implant in Europe but they also like the shaped implants there. When I trained, we wanted the softest implants possible to best resemble natural breast tissue. There is less "wear and tear" on the tissue as well. Shaped implants are much softer from Sientra than the Allergan, "Gummy Bear", "Form Stable" implant. Equally if not more important, the amount and quality of your breast tissue, implant placement below muscle and how the breast interacts with the implant are important considerations to achieving a great, long lasting result.

Richard Baxter, MD · Answer

The differences in rupture rates  is very small though long term numbers are not yet available for the Soft Touch specifically. There is no one type that is best for all patients; for example the cohesive "gummies" are very firm and ripple less but feel unnatural. The Soft Touch implants are slightly less firm but not as soft as first generation Inspira. Sientra implants have a good track record.

Dallas Buchanan, MD · Answer

Thank you for your questions. In the end, the rupture rate for the two implants is probably roughly equivalent. A rate of 7% vs 8% for example does not really mean that much to you. Further, just because you choose the implant with the lowest rupture rate does not assure you that you will not have a rupture. I would choose the implant you feel meets your goals and not lose too much sleep over rupture rates.Hope this helps!

Urmen Desai, MD, MPH, FACS · Answer

I would not be so concerned with the rupture rate, as the risk of rupture is so minimal.   I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified Beverly Hills Plastic Surgeon

Brian K. Brzowski, MD, FACS · Answer

I feel qualified as a high volume user of both these styles of implants to answer this question.  In fact, I'm working on my manuscript to get the experience I have published in our Plastic Surgery Journal so I can share this information with my colleagues.
Mostly, you won't notice very much difference between these devices besides a little wider range of profiles and volumes with the Inspira Soft Touch.  Contracture rates, rupture rates, etc are pretty equivalent overall.
 I do think they are very comparable when it comes to maintenance of upper pole volume (top of the breast), and smoothness (lack of rippling). My "on the table" feeling is that the Sientra Style 107 is a little bit softer because of the technology they use to attach the gel to the shell, allowing them to use a soft silicone gel.  However, neither of them feel hard.
These implants are the Goldilocks of breast implants - just about right for about 95% of patients.  You should really love whichever one you use.
It is most important that your surgeon be thoughtful and considerate of your goals, your anatomy, and precise in the execution of your surgery.  Choose wisely.
Best of luck.

Tim Sayed, MD, MBA, FACS · Answer

All silicone breast implants in the US are manufactured with cohesive gel; some implants have a firmer feel to them, particularly certain shaped implants when compared to round ones. These issues have been outlined nicely by Dr. Stephens in this thread. I'll just add that the right implant for you is a combination of selection of shape based on your dimensions and the question of whether a lift is required, as well as some surgeon judgment on what is likely to work best given your aesthetic goals. If you are in the very small percentage of patients who were to develop a leak, even had you picked the implant with the lowest published rate, the net result is you'd still need implant replacement. The statistical differences among implants in leak rate is relatively minor and is rarely the deciding factor for a given patient. Consider that if all patients just wanted whichever implant had the absolute lowest published leak rate, why are there so many popular implant choices available? Have a candid discussion with the surgeon about your concerns but the surgeon may tell you (s)he is going to recommend whichever implant company and style is within the surgeon's "sweet spot" for getting the best results.

Robert S. Houser, DO · Answer

Personally, I prefer Sientra.  You aren't realistically going to see a difference between to 2 and the feel is based on how much breast tissue you have.  Sientra's recently reported rupture data was under 10% at 10 years.  There is no data in the US for the SoftTouch implants yet because they haven't been here long enough.  The Natrelle Inspira implants are also under 10% for 10 years.  The only implant I recommend people avoid right now are Mentor -- a 24% rupture rate at 10 years! I prefer Sientra because they have a great product and I like the company's ethics -- they only sell to board certified Plastic Surgeons.  Good luck!

Marc J. Salzman, MD, FACS (retired) · Answer

The rupture rates between Allergan and Sientra breast implants are almost identical in the first 10 years. It's like comparing a BMW to an Audi. Hope that's helpful.

Brian Windle, MD (retired) · Answer

Congratulations on your decision to have a breast augmentation.  Both the Sientra highly cohesive and the Inspira Soft Touch are so called gummy bear implants and the rupture rate is exceedingly low for both implants as a result.  Sientra’s implant is stronger in bench research tests but ther is little clinical difference in rupture rates.  The big difference in in how the two implants perform.  Sientra implants have a significantly lower capsule contracture rate and focus groups of women with implants have consistently determined that Sientra implants feel more natural.  There is also less chance of rippling according to studies.  Additionally, Sientra implants, because they are textured, can be placed above the muscle to avoid the problem of breast animation or movement when you flex your pectoralis
  
You should know exactly what size and shape you are getting well before your surgery and many surgeons let you determine what size you are getting by trying on implants in a sports bra in advance.  This avoids one of the reason for reoperation in breast augmentation and that is the patient not liking their size because the surgeon chose it.
  
I have added a web reference about breast implants for you as well as a video. I hope that helps.  
  
Best regards.

Thomas C. Wiener, MD (retired) · Answer

The rupture rates are similar, although I favor Sientra implants. The important issue is that even with a ruptured cohesive gel implant, the implant maintains its shape. Sincerely,Thomas C. Wiener, MDHoustonthis information is not a substitute for a consultation with a board certified plastic surgeon

Follow-Up: Rupture rate - Sientra vs Inspira Soft Touch? 5’4, 118lbs, 32C, mom of 2. Looking to go 300-355cc silicone moderate.

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