Sientra Implants

TinaT

Gina - So sorry you're disappointed with your outcome.  But, I thank you so much for your input as it helps others make decisions.  This is exactly what I needed to read right now as I'm having a revision soon.  My PS admitted that he had no personal experience yet with the Sientras, but he wanted to make sure I knew it was an option.  We all have different hopes and expectations going through reconstruction.  At this point it seems our surgeons can only pass along what they are being told by the Sientra company reps until they have enough patient feedback to pass along.

Best wishes to you!

TinaT

Summer - I do not have anatomical implants, but from a few comments I've read across BCO I get the impression that the Sientras are a bit softer than the Natrelle 410s.  Both are firmer than other silicone implants so they don't "move" as naturally.  Also, it sounds like Sientra doesn't offer as many options as far as sizes go so your PS might need to try one that is slightly wider, narrower, etc. than ideal for your implant pocket size.  It's great that there are more options available, but each type has advantages and disadvantages. 

Thanks to everyone on this thread for posting your experiences, it has been really helpful for me!

25weeks

TinaT- did you decide to go forward with a revision?  Did you decide to try to shaped Sientras?  I know you were agonizing over this decision, so I do hope you were able to find comfort in your choices.

Tricia

TinaT

25weeks - Yes, I have decided to proceed with revision (gulp).  It's such a difficult decision, but I'm crossing my fingers and taking the leap.  I have decided against Sientras as it seems the catalog has a bit of lapse right in the size range we would be working in and I don't think I'd be happy with the firmness and the fact that they don't "move".  Also, I have very thin skin, which is why I'm having the revision (ripples) and I am imagining a potential issue with seeing the edge of the implant.  I'd prefer not to have major fat grafting.  It's a gut feeling, but I just don't think they're for me...

MondaysChild

Tina,

I am having the same thoughts on my own desire for revision.  While initially excited about the Sientra shaped implants, I am now concerned with the firmness and other negative aspects.

What are you considering for your revision? A change in size, profile, or both?

TinaT

MondaysChild - The plan is to beef up the skin with a support matrix (like Alloderm), try slightly larger smooth round implants (probably same profile, just slightly more volume), and possibly narrow the pockets a bit.  I currently have the Natrelle Style 15 (moderate plus/midrange) and I'm really happy with them in every way (size and profile are perfect for my frame).  I'm just not happy with the ripples I've developed since losing weight.  Blah...

C-squared

Hi ladies~ I need to look up the exact Sientras that the PS used at my exchange (12/27/12) because whatever they were I would not recommend them.  I am not happy about the likelihood of going through ANOTHER surgery.  Like many of you, I am SO tired of surgeries! 

That said, I don't necessarily want to walk around with this set of boobs.  I should've known when the Sientra TEs failed twice in a 4 month period (first, one of them turned sideways - that was replaced and then the other one sprung a leak!) but I trusted my PS.  Even with all the research I did, I couldn't have been prepared for that!

I'm following along trying to get a feel for what direction to go now.  My primary concern is that I came out smaller than the TEs.  I wanted a solid B (was a large A/small .  I also see some rippling beginning too.  The PS said the textured implants were LESS likely to ripple but here I am defying the odds once again!   Any suggestions??? My next follow-up with PS is Mar.29th and I hope to have some idea by then so we can go ahead and set a surgery date.
 

25weeks

C-squared,



I received the Sientra shaped classic base 450cc implants on 12/18/12 after having the dual chamber TEs filled to 435cc. Luckily, I didn't have any trouble with the TEs. In fact, I got used to the nice projection and size, especially since I was a 32/34 A before I started this whole process.



My disappointment with the implants were several:

1- not enough projection (my boobs seemed flat to me)

2- not enough movement

3- too firm

4- rippling in cleavage area



I don't think the rippling was necessarily the implants, but I'll never know really. My skin was pretty thin I recently came to find out. From all I've read, the only reason to go with a textured implant is if you use the shaped ones. The texture will help keep the implant in place. On the flipside, I read that the texture can cause traction rippling, whereby the tissue on the insides of the breast may "stick" to the textured surface somewhat rather than glide across a smooth surface. Frankly, I think there are many factors that come into play to cause ripples.



I had decided early on that if I was going to have to endure all of this, then I wanted larger foobs. I could have been happy with the Sientra implants in terms of overall appearance, but I chose to have a revision. My revision was just this past Tuesday, and it was much more involved than my initial exchange. I wanted to address the concerns above and my PS did his best to do so. I changed the implant to a Mentor HP smooth round, 500cc. He placed alloderm along the tops & centers of the pockets to hide any rippling, which he sutured externally to help prevent scar tissue buildup, which I had already developed with the initial alloderm slings. Given all this, he some challenges with skin integrity on my right/cancer side. I honestly hadn't considered skin integrity going into this revision, so I was a bit surprised to see areas of damage after surgery. I'm hoping it heals and there is no skin loss. I can say at this early stage that these are much softer/squishier and have the projection I was looking for.



I think we each have to weigh what's important to us, and assuming I heal ok in the coming weeks, I think I made the right decision to have the revision - even though the placement of alloderm required more drains (which I also hadn't considered).

TinaT

25weeks - Yes, my PS told me that the body creates extra fluid in response to Alloderm so drains are necessary to prevent seromas. 

Please keep us posted on your progress.  Best healing wishes!!!

C-squared

25Weeks~ that is so much good information that I need to digest it and get back to you.  In the meantime know that I truly appreciate your sharing your knowledge and experience.  We all benefit from that! 

Minicoopergirl

25weeks- thanks for the response.. I went in for my appointment on Thursday with plans to make my final choice on implants.  I chickened out and now have a few more days to think about it.  Before my surgery I was a 34b- that was on a good day! I didn't mind my small breast size, I actually liked them. They were natural and fit into my busy and active life.  They also fit my small frame as I'm 5'6 and my weight floats between 110-120.  Therefore, it makes the most sense for me to go for the Sientra around 325cc (size recommened by my dr).  The  issues I have with those are the fact that cleavage cannot be created and I worry they will begin to look saggy.  My doctor tells me if I am interested in cleavage Sientra are not for me and I need the round gel implants.  I have reservations about the round implants because I have very thin skin, and really boney breast bone (chest).  I worry the round implant will look "bun" like.  I'm trying to be pro-active so I don't need to have them exchanged because I'm unhappy... I currently have TE around 350cc they feel huge and in the way to me (just had them filled from 300cc) I'm in a ton of pain and don't feel my skin can stretch anymore!  One more thing... If I pick Sientra I will be in the study group- by PS orders 1 set of implants, I get the size he orders no going back.  If I select the round gel implants he has more liberty during surgery to pick a size that would look good for my body type.  Anyone with Sientra, can you wear a push up bra if wanted, will they hold up a strapless dress? I'm the type of person that has a hard time making up their mind.  I want something pretty yet comfortable -not as easy as picking out shoes!

25weeks

Minicoopergirl-

I have a similar frame to you.  I am 5' 7 1/2" and weigh about 112 lbs right now.  I was a 34A before all of this and wanted some boobs for once.  Do you currrently have Sientra TEs, or do you know specifically which TEs you have?  Which specific Sientra shaped implants is your doctor recommending.  There are no shaped (teardrop) Sientras that are specifically 325cc.  I ask because all of this comes into play when trying to figure out which way to go.  I wish I had asked and known the answers to all of this prior to even having my TEs placed!  If you don't know, call your PS and find out tomorrow.  I had the Sientra dual chamber TEs, then the Sientra textured shaped (teardrop) classic base implants at 450cc.  I can say that the implants didn't move much.  I could not grab my breast and move it around so to speak.  It was softer than the TE, but not nearly as soft as I was expecting.  I also felt it was a bit flat, but had I been able to move it more and mold it into a bra cup, I could have lived with the projection.  I also have very thin skin (especially on the cancer side as I think my BS really took as much tissue as possible).  Not sure if the thin skin is the only factor, but I already had rippling with the shaped Sientras in the center/cleavage area on both sides.  The shaped implants are textured to help prevent rotation in the pocket, so that texture may also be a factor in rippling (traction rippling).  I had the Sientra implants for two months.  I had a revision just this past Tuesday to Mentor HP smooth rounds.  I'm still swollen, have external sutures, etc., so I can't say how my final overall look will be compared to the Sientras, but I can say that they are WAY softer/squishier and have much more movement.  My PS also took the opportunity to place more alloderm in the areas I was experiencing the rippling.  So far, no ripples.  Also, I don't feel that they look too big for me, and I don't anticipate having any trouble with excercise and lifestyle.  The TEs were so firm that I did feel I was always bumping them on things, but the implants are much different in that regard.

I think the first thing to figure out is what TEs you currently have and specifically which Sientra shaped implants your PS plans to use.  Oh, and I'm happy to email you some pics of my Sientras.  I want to do all I can to help others make the choice that's right for them.

Tricia

GreenCowgirl

HI Tricia, I am really following what you and minicooper are deciding with the sientra implants, as my ps intends to use them for me.  What i have read in reviews and comparisons the pluses for sientras were longer life span, very low rupture rate, less rippling as they keep their semi-solid shape, and the texture was to stop roatationa and thought to prevent contracture(especially in radiated skin).  This sounded great to me, but looks like many ladies here are not happy with the fact they don't move and are quite firm. I am not sure i understand the not moving part, i guess i have spent my life buying bras to make my huge breast not move/bounce/jiggle, i thought that would be a positive thing??  I will be getting the largest size in the teardrop(anatomical) 700 cc i think.  I am large breasted and will actually be down sizing at the surgery from 34F to hopefully 34D.  I also reas that sientra has a 10 year guarantee on the implants if you are not happy with the size/style, they pay a $amount for a revision.  I am a ways from making a final decision but getting so much conflicting info my brain is gonna pop.

Nancy

25weeks

Hi Nancy-

There is so much information to digest.  It's overwhelming to say the least.  I think a lot of the information regarding implants in general is geared toward augmentation rather than reconstruction.  When it comes right down to it, I assumed I was going to get something that were pretty darned close to real breasts.  I know now that that is not the case unless you have one of the procedures that uses your own tissue.  The implant route can only provide so much realism.  My Mentor rounds are cohesive gel, so even if something did poke it or cause it to tear, no silicone would go leaking through my body.  I'm not too worried about that.  I'm more worried about my cancer coming back!   I had ripples almost immediately with my shaped/textured Sientras.  I think whether you have ripples will be a product of your skin, the pocket size, the implant itselft, and whether anything was used to potentially hide the ripples, such as an ADM (e.g. Alloderm) or fat grafting.  Texture is definitely needed to help prevent rotation in the shaped implants.  The one thing I can't speak to is radiated skin, but I do know that can be a challenge.

I'm certainly no expert, nor am I in the medical field, but I've read a lot lately and done a lot of research during this whole ordeal and you say you were a 34F before?  If you were only wearing a 34" banded bra and the PS wants to use the 700cc shaped Sientras for you, the width of that particular implant is 16.9cm.  I was wearing a 34" banded bra prior to this too.  My current implant is 13.2cm wide.  What is your current measurement under your breasts?  I'm about a 28.5.  Have you talked to Whippetmom?  If you truly do wear a 34" banded bra, then I can't imagine how your frame could handle a 16.9cm implant.  It seems they'd be in your armpits.  What TEs is your PS going to use?  I just noticed that you are due for surgery in 4 days!

Tricia

sherry67

Greencowgirl,

I have the Seintra HP shaped oval 550's and so far no problem though still in the healing process but I can say they are much softer than the expanders and the iron bra feeling is gone and the projection is perfect for me.. Good luck with your decision...

GreenCowgirl

Tricia, Many of your questions i cannot answer, as i do not know.  I am in Des moines iowa and I am having the surgery at mayo-rochester, so i have only had one appt with both surgeons.  I meet them briefly again the wed before surgery and i have so many questions.  NOt sure what TE's, but they showed me a new kind that was very soft, close to the look/feel of the implant.  I have always worn a 34 bra band, i do have very broad shoulders , believe it or not my real boobs, though huge are very pretty and fit me well.  I prefer to downsize, as this amount of breast has been hard on my shoulders/neck and buying bras is impossible.  I told my PE i would like to downsize to a D cup.  He talked about the 650/700 and those were the largest in sientra and would only get me to a full c/small D and he would use fat grafting to enhance size/shape/cleavage as needed.  My right affected breast had radiation /lumpectomy almost 3 years ago, and it has stayed similar in size to the left.  This year i noticed a difference, my right is now a 34ddd and left still a 34F.  As you can guess my boobs are my entire chest and yah, they go clear to my armpits.  I would feel naked if i had smaller foobs.  I ride/train/show horses  and have 2 sons that tackle/wrestle me daily, so I  want the strongest version available, plus i hope to be pleased witht he first set and not need more surgery/revisions.  ugg.  Yes i leave tomorow for this and am getting really freaked out about alot of details.

I think you are right that implants are focused on augmentation ,not recon, It would be great if a company would introduce a special line with us girls in mind.

GreenCowgirl

Sherry67,  So good to hear some good news on sientra!  Whoa, your surgery was only a fes days ago, how are you doing? Did you use TE by sientra?  I also see you had radiation, so this gives me hope that i too can get a good result from te/implants.

TinaT

GreenCowgirl - It's important to be well-informed, of course, but probably more important to be sure that your PS really hears your hopes and wishes.  They often don't like to discuss cup sizes because they can make no guarantees and the TEs and implants aren't the same as breast tissue.  Using terms relating to projection, cleavage, and comparing to your natural breasts (larger, smaller) gives them a better idea than saying something like, "I want to be a 36D".  

Regarding the "moving" of implants - smooth round silicone implants drape more naturally than the firmer anatomical implants (like Natrelle 410s and Sientras); it's not better or worse, just a choice to be made.  For instance, when you lie on your side the smooth rounds will drape to the side with gravity while the anatomicals tend to stay put and will still project forward.  The smooth rounds will "smoosh" if you squeeze or poke them while the anatomicals will remain fairly firm with less give.  Again, one isn't better than the other, it's just what you prefer.

If you haven't checked out the "Implant Sizing 101" thread you might find some helpful basic information there.

Good luck with your surgery.  Keep us posted!

sherry67

Greencowgirl,

No I didnt have Seintra TE...so far I like the implants but the only thing I don't like is the radiated side is a little smaller then the other side..but am very happy not to have the excessive tightness that I had prior to surgery...that iron bra feeling ...

TinaT

Sherry - So glad you finally are on the other side of exchange.  I hope the Sientras work well for you and I look forward to reading your updates.  It's great to have all these choices, but it can be so overwhelming!

SimplyAudrey

Have to chime in here since I'm a Sientra woman now.....

Oval HP 270 cc bilateral reconstruction.  I have a ridge on the upper pole of left side that will be filled in with a fat graft, but otherwise I LOVE the outcome!  I don't look like a q tip with 2 olives (I have NO fatty tissue on my upper body - round implants would not have given me the outcome I wanted.  I only had expanders for just short of 7 weeks.

I look natural.  34 C with no Secrets or Wonders needed. I am 3 months out from exchange, and the fat graft will be on 4/1 of this year.  Do they feel different?  Yep.  But I went in knowing I wouldn't be the same. 

I'd do it all over again in a heartbeat.

sherry67

SimplyAudre,

I agree I have Oval shaped HP 550..I knew going in to nothing would be the same ..but better than the TE

TinaT

SimplyAudrey - Yay!  It's always good to hear success stories.  So great that we have more and more choices.  I have read on other threads that the Allergan/Natrelle 410 anatomicals were just FDA approved last week so more women should have access to those as well.

I just wanted to mention that I am also very slender with very thin skin and a bony, prominent sternum and ribcage.  I am currently deciding what to do about rippling, but overall I am really thrilled with my smooth, round silicone implants.  I can only discuss Allergan/Natrelle.  My PS used Style 15 rather than the more commonly used Style 20 or 45, which have more projection.  They are a moderate-plus profile and don't make me look like two olives on a Q-tip   That was a big concern of mine as well. 

Anyhoo, just wanted to throw that out there.  Smooth rounds can look very natural if the PS selects the right style for a particular body type and ribcage configuration.

Best wishes!!!

summerm

I have Allergan TEs, and am considering the Allergan 410s. My last fill appointment is March 1. I hope to talk with my PS then about the best options.



If anyone has feedback for me about the Allergan 410s I'd love to talk more.



Thanks

Anonymous

I am 11 days post-op with Sientra Textured Shaped Round Base High Projection implants-and yes, I had to get that from the online catalog to get the wording right!  I am 425cc, my TEs were filled to 400cc.  I am 5'11", 150 lbs, with a very thin upper body.  My PS did fat grafting at the exchange and took some from each thigh to place around the upper part of the implant in my chest area.  I'm really glad she went ahead and did this, too, since I looked rather skeleton-ish up there.  This gives me a much more natural look.  Well, as natural as we can be at the point, anyway.

So far so good with the implants.  My swelling is starting to go down and I'm seeing some nice shape.  I was really upset the first 3-4 days because I thought they looked so freakish (huge, swollen, full) but as the days have passed, they have really started to take shape nicely.  My radiated breast is doing well, too.  

Implants, and finding the right ones for each of us, is such an individual decision.  I really just went into it explaning to my PS what I wanted and was looking for and trusted her judgement as to what she ultimately chose as far as brand or whatever.  I'm thinking she did great!

Best of luck to each of you as you take the next step. 

summerm

25weeks



Sorry to hear you weren't happy with your Sientra shaped implants. Have you considered the Allergan 410 implants? I was about your size pre bmx and am considering the 410s for some of the same reasons you mentioned when talking about the Sientras.

summerm

Still Snarky,



Did you end up going with the Sientra implants?

25weeks

Greencowgirl-

I sincerely apologize for throwing so much at you at once and overwhelming you.  I'm sure everything will turn out beautifully.  I just want to make sure everyone understands what's going to transpire and how this all works.  I wish I had asked more questions and been more assertive to some degree.  Best of luck with your surgery tomorrow!! Hugs!

summerm-

I actually just had a revision last week.  I ended up going with the Mentor HP smooth round at 500cc.  So far so good.  I'm much happier with the softness and projection I have now.  To be honest, I think where my PS went wrong was expanding my upper pole too much with the Sientra dual chamber TEs.  My TEs were filled to 435, but I wish he hadn't filled the upper pole quite so much, and I think the lower pole could have used a bit more expansion.  With that said, I think I would have been very happy with the Sientra round base shaped implant at 425cc.  But, since my PS widened my pocket from the 12.2cm TE to accomodate a 13cm implant on the first go-round, the Sientra round base shaped 425cc was too narrow (12.5cm) for the existing pocket.  He could have done extensive work to make the pocket smaller, but that would have involved a lot of internal suturing, so I'm glad he didn't do that.  He had the round base 425ccs in the OR last week.

Hindsight is 20/20 of course, and I have some regrets as far as not educating myself to the fullest extent before I even had the TEs placed.  But, this is such an overwhelming process and we trust that the doctor knows best.  Well, I've changed my tune on that one, but that's for another thread.

I don't want anyone to think I'm knocking Sientra.  Like I said, I think the shaped round base 425ccs would have been perfect for me, but it was too late to make that happen.

I do have pictures of myself with the Sientra shaped classic base 450ccs if they would be helpful to anyone trying to make a decision.

Minicoopergirl

This past few days I had to do some soul searching about what I really wanted out of this surgery, what I wanted my implants to look like and how I wanted them to make me feel. Those questions led me to my decision...

But let me first do a quick review...I'm an active, married 34 year old without children, I'm 5'6 and my weight ranges from 110-120. I had a double mastectomy Aug. 17, 2012 due to grade 3, stage 2a breast cancer in my right breast.  I went through 8 rounds of chemo and am now beyond ready for my TE exchange.  My TE-(type unknown) filled to 340cc on the right and 360cc on the left. I wore a 34b before mx which was the wrong size for me because the cups were baggy, my breasts were full at the bottom empty at the top- and saggy!  

After my mx and until about a week ago I had planned to go the natural route wanting to looking as close to the same as I did before-natural. That being said, my PS and I looked at both the 410 and Sientra teardrop shaped implants (his office only carries Sientra in the teardrop) he felt something in the 300cc range would look good for my shape and frame-I was leaving the size up to him as he is the expert.  I thought I had it all figured out... Then, I scheduled my surgery date and I started getting nervous!!!

Did I really want my new breasts to look like my "born with" breasts? I would often curse those old things because they were flat and empty. That was when I started thinking... Hmm, maybe I want to have a little bit fuller cup!  That's when I changed my mind from the Sientra to the round gel implants. I really want my new breasts to have more of a round top compared to a slope like my "born with" breasts.  I still plan on sticking around 300-325cc which will hopefully give me a size like before-nothing too big that will get in the way just a more round filled out shape.  Ultimately, I really want to have breasts that will look good in a t-shirt, bikini, and hold up a strapless dress-none of which my born with breasts did very well. 

Although my mind is made up, I do still have concerns with the gel implants. Like many of you, I too am thin on top (plus thin skin covering TE).  You may call me skeleton-ish in the breast bone, chest area.  I kind of worry that the round gel (mentor) implant will make things look worse.  At this point I know that my PS will be using Alloderm to help with the thin skin on both breasts. I wonder, did you know going in that your PS was going to fat grafting before the surgery?  I just worry about the unnatural edge that I have on the cancer breast.  I think filling it in with fat might help- The other concern, what if I hate them!!! Will insurance pay to replace the implant if they look bad? I've read that some of you have had them replaced, have you had to pay for that out of pocket or does insurance pay for that? I assume there has to be some type of defect to have them replaced-correct? If someone could pass any info on that would be great-

Well, to those reading I hope this made sense.  After going between the implant types I feel that the round gel will be a good fit for me(i hope!).  I go tomorrow for my final appointment with my PS before surgery-I'm not sure if a fill will happen because my breasts are still sore from last weeks fill.. I'll continue to post info as I get closer to my date-each surgery/event brings on a different set of emotions!  Thanks you to all that have responded and have posted their stories.  It has been helpful in making my choice.  I found a lot of info on breast implant sizing 101, it was really helpful..

25weeks

Hi Minicoopergirl-

I'm so happy that you've come to a decision you are comfortable with.  I know it's so hard and overwhelming.  How are you liking the size of your TEs under your clothing?  Do you like the way they look?  Remember that your implants will look smaller, and even more so if your PS plans to use a smaller volumed implant.  I also decided I wanted to go bigger than my native 34A boobies.  I had considered augmentation before the BC diagnosis, so I figured why the heck not?   Where all does your PS plan to use the Alloderm?  At my revision, my PS used it on the insides & tops to hide any potential rippling.  I'm very thin too and thin-skinned.  So far, no ripples, but I'm only a week out of my revision surgery. 

As far as revisions are concerned, insurance will cover if they deem it medically necessary.  I think if you can get to the right person at the insurance company and the doctor is willing to plead your case, then they will generally cover it.  My insurance initially denied my request.  My doctor had sent pictures and all his medical notes, etc. That same day, my PS's office called the insurance co and asked to speak to a supervisor.  They again explained the situation and that this was all related to breast cancer and the next morning, they found a fax approving my revision.  Maybe ask your PS how he/she handles revision requests with insurance if you're worried about it.