As noted in our previous blog, gummy bear breast implants have long been anticipated, partly because it was believed they would be safer, but also some believed they might give better results. Looking at the results of the pre-approval clinical studies and comparing the results of the Sientra gummy bear breast implants with previous studies of Mentor silicone gel breast implants, it seems the results don’t justify those expectations. The only real indications we get from the studies about the quality of results comes from the “benefits” section of the studies. This section attempts to justify the use of breast implants in terms of the benefits patients receive from them. Both look at the breast implants from perspectives of patient satisfaction and measure Quality of Life (QoL) as well as self-esteem. Sientra’s gummy bear breast implants seem to have a significant edge in self-esteem. While only 45% of women receiving Mentor implants reported improved self-esteem, 85% of women receiving Sientra implants reported an improvement. It’s unlikely this is the implant itself, more likely a measure in the changing attitudes toward breast augmentation in the nearly six years between the two studies, as the procedure has become more acceptable, leading women to be less conflicted about their breast implants. Sientra also reports that 90% or more of women reported they felt more feminine or more attractive after receiving breast implants. Mentor doesn’t have a comparable measure. The place where Sientra’s breast implants seem to have a problem is in patient satisfaction. Sientra studies do not report a percent satisfied number, saying only that “The majority of primary augmentation patients were satisfied with their results.” This is the phraseology used in both the patient and physician labeling. Their reluctance to give figures here is telling, indicating the split is probably less than 60/40 satisfied/unsatisfied. By comparison, Mentor measured satisfaction using the question ““Would the patient have this breast surgery again?” to which 98% of patients answered “Yes” at their 3-year follow-up. The disparity of satisfaction may also be due to the time between the two studies, time that allowed for increased expectations perhaps to unrealistic degrees, especially for the hyped-up gummy bear breast implants. However, it may also be due to the characteristics of gummy bear breast implants. According to a large survey of breast implant patients published by the American Society for Aesthetic Plastic Surgery in 2004 the only area where silicone gel breast implants were significantly favored over saline breast implants was in giving a natural-feeling breast. Gummy bear implants are too hard to give a natural feel, even without capsular contracture. However, the study did not drill deeper into patient attitudes, so this remains conjecture. One area where gummy bear breast implants may offer significant advantages, however, is in the reduction of ptosis (sagging). Even at the 3-year mark, the Sientra studies showed less sagging (1.8% vs 2.3% in Mentor). Although the difference is not yet statistically significant, it may become significant with time. Making decisions about breast augmentation can be challenging. To learn more about your breast implant options, please contact Dr. David A. Bottger in Philadelphia for a consultation.