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    Dr. Jejurikar's Blog

    Common questions from women who want breast augmentation with silicone implants:

    • How likely is it that my breasts will harden?
    • Will my breasts encapsulate?
    • Will I get capsular contracture with silicone implants?

    All valid questions, given the bad press that older generation silicone implants received. The current data looked at 2560 breast augmentation patients who underwent breast augmentation for the first time with Sientra implants (November 2013, Plastic & Reconstructive Surgery). The authors looked at a variety of factors over a 5 year period to determine their effects upon capsular contracture, including implant placement in front of or behind the chest wall muscle (subglandular versus submuscular), different incisions, and textured versus smooth implants.

    The investigators had some very interesting findings:

    • Placing an implant in the subglandular position (in front of the muscle) versus the submuscular position (behind the muscle) increased the risk of a capsule by 4.6 times
    • Placing the implant through a periareolar incision (at the edge of the nipple-areola complex) versus an inframammary incision (in the crease at the base of the breast) increases the risk of contracture 1.5 times
    • Sientra smooth implants had a greater rate of developing contractures than Sientra textured implants, particularly when placed in front of the muscle.

                  Implant Shell                                 Pocket                                       Capsule Rate

                       Smooth                                  Subglandular                                          21%

                     Textured                                 Subglandular                                           5%

                      Smooth                                  Submuscular                                            5%

                     Textured                                 Submuscular                                           2%


    Based on this data, Sientra has rolled out a unique guarantee program. If any patient who received Sientra textured implants develops capsular contracture within 2 years of surgery, they will replace the implants for free. No similar program exists with any of the other implant manufacturers.

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