Breast Implant 101: What to Know Before Choosing Yours

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Opting for breast augmentation surgery is not a matter to take lightly. Between finding the right board-certified plastic surgeon to perform the procedure to selecting the right implant for you, there are many factors to consider.

“The process of a breast augmentation includes the critical partnership between the patient and their plastic surgeon to map out a surgical plan that meets the patient’s goals and is executed with the expertise of their board-certified plastic surgeon,” says Louisville, KY plastic surgeon and Sientra Advisory Board Member Brad Calobrace, MD.

While implant size, shape and types are commonly considered factors in the breast implant selection process, a keen understanding of the manufacturer is also crucial. One of the key players in the industry is Santa Barbara–based Sientra, who manufactures state-of-the-art breast implants with an unrivaled safety1 profile here in the United States.  As such, the brand is highly regarded among countless plastic surgeons and, in turn, their happy patients.

With this in mind, we tapped Dr. Calobrace to walk us through exactly what it takes to select the best implants for your individual needs—including what to know about top breast-implant manufacturers—and some major considerations to keep in mind.

Why are silicone breast implants preferred over saline? 

There are two types of implant fills: silicone or saline. According to the American Society of Plastic Surgeons, nearly 85-percent of implants used in the U.S. today are silicone2, but before deciding there are some key considerations to take into account.

“Saline implants are used much less frequently today compared to 20 years ago,” explains Dr. Calobrace, adding that saline implants are good for women under 22 years of age, as silicone-filled implants for breast augmentation are only FDA-approved for those 22 and older.

“However, silicone implants feel softer, have less palpability and wrinkling, and stretch the skin much less than saline implants. Someone wanting the most natural implant would more likely choose a silicone implant. Very thin patients, or those at risk for wrinkling, would also do better with a silicone implant,” says Dr. Calobrace.

Sientra silicone gel implants are designed to hold their shape while maintaining a remarkably soft feel. Their exclusive cohesive gel is strong but soft to touch so it feels like natural breast tissue.3   

What are the differences in breast implant shapes and projections?

Breast implants are available in either a round or teardrop shape. Round breast implants offer more lift and fullness overall, especially in the upper portion of the breast. A teardrop shape offers a gentler contour in the upper portion and fullness in the lower portion of the breast, below the nipple. “Round, smooth implants are by far the most popular breast implants used in the U.S.,” says Dr. Calobrace. “A teardrop shape may look natural in very thin patients with minimal breast tissue or fat. Teardrop-shaped implants are also used in patients with more challenging breast characteristics such as constricted or tuberous breast deformities.” 

An implant’s projection refers to how much it projects forward from the chest wall. Sientra offers a wide range of implant profiles: low, moderate, moderate plus, high, and Xtra high. 

Sientra offers a curated selection of implants with over 250 round implant options with five projection levels and over 90 teardrop shape implants with two projection levels. “Sientra’s portfolio of choices is outstanding and they continue to add more and more choices each year,” adds Dr. Calobrace.

What should patients look for when choosing a surgeon?

Selecting the proper board-certified plastic surgeon to trust with your breast augmentation surgery is just as important as choosing the right implants. It’s critical to choose a surgeon you feel comfortable with and whose work you admire, but also one that is properly accredited and board-certified in plastic surgery. Not all surgeons who perform breast augmentation are board-certified in plastic surgery, which requires the highest level of surgical training and education, and as a result, is shown to minimize complications related to breast surgery.4

Sientra only sells implants to board-certified plastic surgeons, making the selection process seamless. “This ensures all patients that if they are getting Sientra implants, their doctor is board-certified in plastic surgery,” says Dr. Calobrace.

Does the breast implant brand matter?

Absolutely. When it comes to patient safety, not all breast implants are created equal. “Sientra provides the most advanced breast implants on the U.S. market with unrivaled safety data.1 Because of this, Sientra provides the most comprehensive protection on their implants with a 20-year warranty—not 10 year like the other manufacturers. Sientra’s Platinum20™ warranty also offers the most financial assistance and the least amount of warranty restrictions amongst all implant brands,” says Dr. Calobrace.

To learn more about Sientra and to find a Sientra board-certified plastic surgeon near you, visit sientra.com/breast-augmentation. 

1. Stevens WG, Calobrace MB, Alizadeh A, Zeidler KR, Harrington JL, d’Incelli RC. Ten-year core study data for Sientra’s Food and Drug Administration—approved round and shaped breast implants with cohesive silicone gel. Plast Reconstr Surg. 2018;141(4S):7S-19S.

2. American Society of Plastic Surgery. 2020 Plastic Surgery Statistics. https://www.plasticsurgery.org/news/plastic-surgery-statistics

3. Calobrace MB, Schwartz MR, Zeidler KR, Pittman TA, Cohen R, Stevens WG. Long-term safety of textured and smooth breast implants. Aesth Surg. 2017;1-11.(4S):7S-19S. 

4.  American Society of Plastic Surgery.  ASPS Member Qualifications: https://www.plasticsurgery.org/patient-safety/asps-member-qualifications. Accredited Facilities: https://www.plasticsurgery.org/patient-safety?sub=Accredited+Facilities

Important Safety Information

Sientra’s Silicone Gel Breast Implants are indicated for breast augmentation in women at least 22 years old and for breast reconstruction. Breast augmentation includes primary breast augmentation to increase the breast size, as well as revision surgery to correct or improve the result of primary breast augmentation surgery. Breast reconstruction includes primary reconstruction to replace breast tissue that has been removed due to cancer or trauma or that has failed to develop properly due to a severe breast abnormality. Breast reconstruction also includes revision surgery to correct or improve the results of a primary breast reconstruction surgery. Breast implant surgery is contraindicated in women with active infection anywhere in their bodies, with existing cancer or pre-cancer of their breast who have not received adequate treatment for those conditions and, who are pregnant or nursing. 

Key complications include capsular contracture, implant removal, rupture and reoperation. For more detailed information about the risks and benefits of Sientra breast implants, please visit sientra.com/resources or call Sientra at 888.708.0808. Sientra breast implants with High-Strength Cohesive silicone gel are only available through board-certified or board-eligible plastic surgeons.

Sientra® and Platinum20™ are trademarks of Sientra, Inc.

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