In your experience, does the Sientra round 107 (HSC+) implant create a soft/natural feel and look?

While the description of a cohesive implant would make you think that they are very hard and unnatural, when utilized correctly they will yield a very natural appearing and natural feeling breast. In particular, the submuscular approach with a conservative size yields a great result. The key, as you have mentioned is going with the appropriate size and width for your breast. As Sientra only sells implants to board certified plastic surgeons, you know that you are getting the best care when utilizing these implants.

If you are looking for the most natural look and feel, I recommend HSC over HSC+. The HSC+ gel is a bit firmer so you will end up with more fullness at the top portion of the breast - which is not as natural.

You are in a difficult situation, not only with regards to rippling, but also overall shape due to your minimal soft tissue coverage. Although they ripple less, the problem with higher cohesive gels is that they resist the forces of gravity that lead to a pleasing teardrop shape caused by gel settling into the bottom of the implant shell. Whatever gel you choose, you should choose a lower profile implant to minimize the bubble look.

In my practice, I use these implants all the time if patients chose silicone. The Sientra 107s still have a natural feel once they are in place but are the high strength cohesive ones have less rippling. My patients are very happy with them and the rupture rate is relatively low. Sometimes it is difficult to tell apart the different implants once they are in place but the long term performance may be more important. I chose the 5th generation silicone implants for this reason.  Sientra implants also have a good warranty. 

As much as I love all of my implant representatives, after 11 years of cosmetic private practice, I still can not appreciate a significant difference in the different types or brands of implants. There certainly is a difference between a saline implant and a silicone implant. But the difference between a Sientra HSC+ and Allergan Inspira or a Mentor Xtra is subtle. I haven't seen a study done on this, but I would suspect that neither surgeons nor patients could really tell the difference between them if one type or brand was placed on one side and a different one placed on the other. In the end, your results will be determined more by your natural tissue coverage, pocket dissection and choice, and surgeon technique. 

Dear Rads214,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD

Thanks for your question. My answer is a definite, "YES!" The Style 107 HSC+ is a wonderful implant. It is very soft, offers peace of mind in terms of silicone in that it is very high-strength and holds together well in the event of a rupture, and the company offers a 20-year warranty (currently, the best warranty you can get in a breast implant). You will be happy w/ this device. Best wishes

I use a large number of the Sientra style 107 implants and the patients love them. The feel is very good, and rippling is minimal to none.Sincerely,Thomas C. Wiener, MDHoustonthis information is not a substitute for a consultation with a board certified plastic surgeon