Question 1

What are Sientra breast implants?

Accepted Answer

Sientra offers two different FDA-approved silicone gel breast implant options: round implants and teardrop-shaped implants.

Both come in a variety of sizes, projections (how far forward they protrude from the chest wall), and surfaces (textured or smooth), to suit different body proportions and desired results, from a very natural look to a more dramatic enhancement.

They’re also available in two types of highly cohesive silicone gel.

Cohesiveness, often explained as “gumminess,” refers to the silicone gel’s level of firmness—a result of how the silicone molecules are bonded. All Sientra breast implants are considered “gummy bear” implants (“form-stable” or “highly cohesive,” in medical language). This firm yet pliable form of silicone gel bounces back to its original shape after being touched, like gummy bear candy.

Highly cohesive silicone gel implants were once thought to carry less risk of gel leakage and rippling, but this belief has not been supported by data, according to Dr. Kamakshi Zeidler, a plastic surgeon in Campbell, California. “The studies show equal rupture rates.” Dr. Zeidler also notes that “firm implants do not necessarily look or feel less natural,” another common myth about cohesive gel implants.

Sientra implants are approved for breast augmentation patients who are at least 22 years old, as well as for breast reconstruction patients of any age. They’re available only through board-certified plastic surgeons.

Sientra’s round implants are available in:

six projections: low, low plus, moderate, moderate plus, high, and “Xtra” high
two surface types: microtextured or smooth
two types of silicone gel: HSC (high-strength cohesive) and the slightly firmer HSC+

This cohesiveness provides shape retention and fullness, especially in the upper pole (the area above the nipple).

Teardrop-shaped Sientra implants are filled with HSC+ silicone gel and have a lightly textured surface, which is thought to help maintain the position of the implant. They come in:

two base shapes: the classic (curved) base and a round base
a wide variety of widths, heights, and projections, to help customize your result

Teardrop-shaped implants provide a natural look on patients with minimal breast tissue, as the tapered top can blend into the appearance of the chest wall.

RealSelf Tip: Sientra round gel implants were approved for distribution in Canada in summer 2022, making Sientra the third silicone gel breast implant manufacturer to be approved for use there.

Question 2

What are the pros and cons of Sientra breast implants?

Accepted Answer

Pros

Sientra implants add fullness, project, and shape to breasts, augmenting your natural breast tissue.
Sientra offers a warranty that many surgeons on RealSelf consider the best in the industry. It includes free lifetime replacement if your implant ruptures and free replacement if you develop capsular contracture within 20 years of getting your breast implant surgery.
Their implants can also be used in breast reconstruction, for patients whose breasts are affected by cancer.
Sientra implants have two levels of gel cohesiveness, both designed to look and feel like natural breast tissue. Ask to feel each option during your consultation.
This is the only brand of silicone gel breast implants that’s offered exclusively through board-certified or board-eligible plastic surgeons, a policy that helps ensure patient safety and results.

Cons

Breast implants aren’t expected to last a lifetime; breast augmentation is generally not a one-time procedure, and revision procedures have a higher risk of complications than an initial breast implant surgery.
All implants come with risks and potential complications. In fall 2021, the U.S. Food and Drug Administration (FDA) announced the requirement of a black box warning and “patient decision checklist” that outlines these risks, which your plastic surgeon should review with you during your consultation.
Mammography for detecting breast cancer (or cancer recurrence) can be more difficult with breast implants in place. Be sure to notify the technologist that you have breast implants prior to the procedure.

Question 3

How much do Sientra breast implants cost?

Accepted Answer

Your price will depend on the type of Sientra implants you choose, the complexity of your procedure, your surgeon’s level of experience, and their practice location.

Breast augmentation for cosmetic reasons is not covered by health insurance, but insurers are legally obligated to cover breast reconstruction with implants after cancer treatment, if that's your reconstruction method of choice.

You can finance your treatment with CareCredit.

Question 4

Sientra breast implant before and after pictures

Accepted Answer

The Sientra breast implant photos in our gallery have been shared by the surgeon who performed the procedure, with the patient's consent.

Question 5

Are Sientra breast implants safe?

Accepted Answer

All breast implants, including Sientra implants, must undergo at least one 10-year clinical study to demonstrate their safety and efficacy to the FDA, followed by “post-approval studies” to show that they continue to be safe. Clinical trials have shown that Sientra implants have some of the lowest rupture and capsular contracture rates among breast implant brands offered in the United States.

Textured implants have been linked with breast implant–associated anaplastic large-cell lymphoma (BIA-ALCL), a rare form of cancer. However, Sientra textured implants are much more lightly textured than Allergan Natrelle BioCell textured implants, some of which were recalled in July 2019. Sientra implants were not recalled.

The risk of developing BIA-ALCL is very low, and Sientra implants reportedly pose the lowest risk of all textured implants—1 in 80,000 patients with “microtextured” implants like Sientra, versus 1 in 5,000 with more highly textured implants, according to Dr. Christopher Pelletiere, a plastic surgeon in Inverness, Illinois.

Another potential concern of breast augmentation surgery is breast implant illness (BII). This condition is not yet well understood, but patients have reported a wide range of symptoms, from fatigue and muscle pain to hair loss and respiratory distress. There is limited research on BII, and it is not yet recognized as a true medical diagnosis.

All breast implant brands now feature black box warnings disclosing the risks of both BII and BIA-ALCL.

Be sure to thoroughly discuss your medical history, especially autoimmune disorders, and any concerns related to these breast implant-related conditions with your surgeon ahead of your plastic surgery procedure.

Question 6

What does the Sientra implant warranty cover?

Accepted Answer

Sientra offers the most robust breast implantwarranty program of any company in the U.S. It applies to any breast augmentation surgery, revision surgery, or reconstruction procedure using the brand’s products, regardless of whether a patient has selected a round implant or teardrop-shaped implant.

Here’s what it offers:

A lifetime warranty for free replacement in the event of implant rupture.
In the case of complications relating to BIA-ALCL, double capsule, late-forming seroma, and advanced capsular contracture, patients are eligible for free replacement of their Sientra implants for up to 20 years.
This 20-year warranty also offers financial assistance for uncovered fees and costs relating to implant rupture and BIA-ALCL.
Finally, Sientra will provide up to $2,000 of financial assistance for uncovered fees and costs due to late-forming seroma, double capsule, and advanced capsular contracture for two years.

Learn more in our guide to breast implant warranties.

SIENTRA BREAST IMPLANTS

Kamakshi Zeidler, MD

Karyn Repinski

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Kamakshi Zeidler, MD

Karyn Repinski

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