What is the Sientra Breast Implant?

Doctor Answers 29

Lexus, Mercedes and BMW

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?

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 109 reviews

Great question.

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.

Brian K. Brzowski, MD
Ogden Plastic Surgeon
5.0 out of 5 stars 68 reviews

What is a Sientra breast implant

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 44 reviews

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

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

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
4.8 out of 5 stars 43 reviews

Sientra add implant options for patients.

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.

Sientra Breast Implant

Sientra manufactures cohesive gel breast implants. There are two product lines that they are currently promoting:

1) HSC which Sientra claims is the most cohesive round breast implants in the US.
2) HSC+ silicone gel is designed to look and feel like natural breasts. HSC + provides softness without compromising shape retention.

Consult with 3 experienced and expert board certified plastic surgeons to understand your options.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.4 out of 5 stars 33 reviews

Sientra makes the only highly cohesive round implants on the U.S. market

A: Sientra makes the only highly cohesive round implants on the U.S. market
Sientra, Allergan, and Mentor all make excellent round silicone gel implants. The Allergan and Mentor implants are cohesive, and the Sientra implants are highly cohesive. I have used round silicone gel implants made by all three manufacturers, and all yield good results.
If you are looking specifically for a "gummy bear" implant (highly cohesive), Sientra is the only manufacturer that makes round highly cohesive implants. All three manufacturers make highly cohesive shaped implants.

Ronald Friedman, MD
Plano Plastic Surgeon
4.9 out of 5 stars 36 reviews

Definition of Sientra Breast Implants

Thank you for your question.  Sientra is a brand of Silicone Gel implants that, along with Mentor and Allergan, are FDA approved for use in the United States.  Sientra is the ONLY brand of implants that requires an implanting surgeon be certified by the American Board of Plastic Surgeons. 

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.