What is the Sientra Breast Implant?

Doctor Answers 30

Lexus, Mercedes and BMW

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There are 3 main breast implant companies in the United States - sort of like Lexus, Mercedes, and BMW.

Sientra has a more cohesive gel (5th generation which is the latest and greatest) which have less rupture and capsular contracture.  Sientra texturing is unique and theoretically prevents bottoming out or lateralization of the implants compared to a smooth device.  Though they are a bit firmer, the tradeoff is likely less rippling.  

All implants have pros and cons and it is important to discuss these with your surgeon.  Sientra does only sell to Board Certified Plastic Surgeons so rest assured, if your surgeon can use them, he or she is not a family practitioner,  ER doctor, dermatologist, ENT, gynecologist or general surgeon who took a weekend course or "cosmetic fellowship".  

Which brand of breast implants is best?

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In my opinion Sientra , Natrellle and Mentor breast implants are somewhat  similar in profile, performance and durability.  No single company provides every size I would like to use for my patients, so I use more than one brand. I feel like it is my responsibility to know about all the implants,their sizes, shapes and unique characteristics.

I strongly recommend selecting your surgeon based on training, experience and aesthetic sensibility rather than on the basis of which brand of breast implant they typically use. 

You can give two chefs the same recipe but the outcome may be very different. Take time doing research on your plastic surgeon. Excellent surgical training and lots and lots of consistent photos are a must.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Great question.

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The implant that you are asking about has a long history of successful use outside of the United States.  They are available in both round, smooth and textured varieties as well as textured shaped styles.  

In March of 2012, Sientra Corporation Silimed brand implants were made available in the US.  Sientra was the first company to obtain approval from the FDA for use of their shaped silicone gel implants.  These implants contain a silicone gel that is more cohesive, and has a slightly firmer feel than traditional smooth round silicone gel implants.  The manufacturer terms the silicone filler "HSC+" which stands for High Strength Cohesive +.  Round implants from this company contain a slightly less stiff and less cohesive implant that is filled with a gel simply called HSC.  We can consider the round implants to represent the "4th Generation" of silicone breast implants and the shaped implant the "5th Generation".

Focusing primarily on the Sientra Shaped HSC+ implants, they do appear to have notable differences from the offerings of other companies:  Allergan 410 and Mentor CPG implants.  These differences relate to variation in surface, filler, and shape options.

The surface texturing of the Sientra HSC+ implants is created by a technique that is different from other manufacturers by avoiding the process of scrubbing, salting or stamping the shell.  These methods of creating a rough surface on the shell (necessary to discourage rotation of these shaped devices) are thought by some to have significant negative effects.

Studies have shown that the differences in the amount and design of the cross-linking of the Silicone molecules comprising the silicone gel in the devices produced by the three silicone implant manufacturers leads to variations in several areas.  This research has indicated that the Sientra shaped implant had the least cohesive gel when compared to the Mentor CPG and Allergan 410 implant.  In the round implant version, the Allergan implant was the least cohesive and the Sientra round implant was the most cohesive.  It is important to understand that cohesiveness does impact the amount of wrinkling and capsular contracture rates of the implant:  lower rates of these events are seen with higher degrees of cohesiveness.  The untoward effect of higher cross-linking and cohesivity is a propensity to gel-fracture and excessive firmness.  Therefore a balance must be reached to achieve a soft, stable breast.  Sientra implants were constructed to do this by reducing the stiffness through less cross-linking, but maintaining the form stability by increasing adherence of the silicone gel to the implant shell.

Currently, Sientra HSC+ implants are available in 3 footprints:  Classic (taller with moderate projection), Round (less tall than the Classic with  high projection), and Oval (least tall with low, moderate, and high projection styles).  The classic base is preferred for women with long chest and low base of the breast.  The oval shape works better in women who want more cleavage with less upper pole fullness and in women with a wide chest and breast width.  Lastly, the round shape does a better job of expanding the lower part of the breast in women who want a smoother upper pole breast-chest transition; in women with a tight lower pole of the breast (constricted breasts), this is the best footprint to select.

Finally, contracture rates and rupture rates appear to be the lowest in these 5th generation shaped implants (from all manufacturers).  This realization has led to Sientra extending this belief in the longevity of the product in the form of their unique C3 capsular contracture warranty.  This provides coverage for two years from the date of the augmentation if the patient develops a Baker Grade III or IV contracture.  The patient is provided a free replacement implant if they develop this problem within this period.

Having attended preceptor training with the foremost US surgical authority in Sientra HSC+ implants, I can honestly say that these implants are truly game-changers.  They represent a quantum leap in technology and advance the art of breast augmentation in ways that US plastic surgeons could only dream of 2 years ago.

Sientra implants

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as noted below   this is the newest company in the US but has been one of the largest distributers of implants internationally for over 30 years.

they also have anatomic implants that have been available to compete with the allergan natrelle 410 implant just made available by the FDA

Sientra implants are only sold to be used by Board Certified Plastic Surgeons

unlike the other companies who sell to any surgeon irregardless of training.


Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

New Silicone Breast Implant Available from Sientra

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New Silicone Breast Implant Available from Sientra
My experience is that both Mentor (made by J&J) and Natrelle implants (made by Allergan) are excellent implants with ethical back up from their parent companies. That is all that has been available in the USA until now. Starting in 2012, patients will have another option for  silicone breast implants from another solid company. Silimed. Competition is always great for patients. Patients can choose an implant from Sientra (Silimed) a world leader in breast implant (and other silicone implants). Prospective breast augmentation patients should now be aware that the FDA has approved a new silicone gel-filled breast implant made by Sientra, Inc. Being FDA approved means it is a safe product equal to the standard for Natrelle and Mentor. The Biggest Difference which was just announced by Sientra at the American Aesthetic Meeting in Vancouver May 2012, is that they will only be sold to Board Eligible or Board Certified Plastic Surgery.This is not true for Allergan or Mentor who sell their products to anyone, whether trained or not. This is a great safety factor for patients.
The implants will be available for women at least 22 years old seeking augmentation surgery, and women of any age seeking breast reconstruction surgery.
Silicone gel-filled breast implants are medical devices implanted under the breast tissue or under the chest muscle for breast augmentation or reconstruction. These implants have a silicone outer shell that is filled with silicone gel. They come in different sizes and have either smooth or textured shells.
This approval introduces a third company into the U.S. breast implant market, which previously consisted only of Allergan and Mentor.
The deputy director for for science at the FDA’s Center for Devices and Radiological Health, Dr. William Maisel, commented that although silicone gel-filled breast implants have demonstrated consistent safety, “It’s important to remember that breast implants are not lifetime devices. Women should fully understand risks associated with breast implants before considering augmentation or reconstruction surgery, and recognize that long-term monitoring is essential.”
The approval of these new implants follows a 3-year study involving clinical trials of the implants on 1,788 women.
As a condition of the approval, Sientra will carry out five- and ten-year studies into the long-term health effects of their implants.
Source: FDA – FDA approves new silicone gel-filled breast implant

Sentra breast implants

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There are three manufacturers for breast implants available to Plastics Surgeons in the US.  Sientra is one of the manufacturers that we commonly use for our patients who decide to get a breast augmentation. Our office was one of the research sites that helped Sientra get FDA approval, so we have an extensive  history with Sientra implants.  Sientra offers 5th generation highly-cohesive and high-strength silicone gel implant with a wide range of projections, shapes and bases.  Best of luck to you and I hope you find the perfect implant to match your aesthetic goals!

What is a Sientra breast implant

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A Sientra breast implant is the name of the breast implant manufacturer.  It is the most common implant that I use because I feel it provides the most shape stable product on the market.  It incorporates the 5th generation silicone fill that provides a truly amazing feel and shape.

Gregory DeLange, MD
Palm Beach Plastic Surgeon
4.9 out of 5 stars 58 reviews

Sientra's "gummy bear" implant is a highly cohesive silicone breast implant.

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The Sientra Corporation Silimed-brand breast implant is an FDA-approved silicone gel implant that is more cohesive and slightly firmer than traditional silicone implants. The increased cohesiveness and firmness of Sientra's HSC and HSC+ implants earned them and others like them the nickname "gummy bear" implants, and they tend reduce the risk of rippling, gel leakage, and capsular contracture when compared to less cohesive and softer implants.

What you need to know about Sientra

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Sientra is the US distributor for implants made by Silimed in Brazil.  I have used them since 2004.  Their quality in every way is at least as good as Allergan and Mentor.  They are distinguished by making the only round implant available in the US that is filled with a highly cohesive gel, thereby making it the most ripple resistant and form stable round on the market.  That is not the perfect implant for all occasions, but that implant is of immense desirability in many situations, and neither Allergan nor Mentor make such an implant.

Steven Teitelbaum, MD
Los Angeles Plastic Surgeon
4.6 out of 5 stars 49 reviews

Sientra add implant options for patients.

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A large variety of breast implants are currently available for breast augmentation in the United States. These implants come in a multitude of styles, shapes and sizes.In addition, they may be filled with either saline or several different types of silicone.Each type of implant offers advantages and disadvantages.For this reason, the choice of implant needs to be tailored to the patients’ specific needs.
There are currently three companies that manufacture breast implants in the United States.These include Mentor, Allergan and recently Sientra.Each of these companies offer a variety of implants.
In 2012 Sientra introduced a form stable cohesive gel implant.Although approved by the FDA in 2012, this implant has been in use in Europe for over thirty years.These implants are available in smooth texturized, round and contoured styles.
Theoretically, they offer several advantages over standard silicone gel implants including lower rupture rates, less capsular contractures, less silicone bleed and less rippling.Their main disadvantages appear to be their firmness and their expense.
These implants increase the number of options that are available to prospective breast augmentation patients.It’s important to understand that only board certified plastic surgeons can use this type of implant.For this reason, it’s important to consult a board certified plastic surgeon if you’re considering Sientra breast implants.This surgeon should be able to discuss implant options and help you decide which implant is best for you.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.