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A San Francisco Surgeon Explains

Leonard W. Gray, MD is a double board-certified plastic surgeon in San Francisco, CA, with over 20 years of experience and more than 10,000 breast procedures performed. Read Dr. Gray’s full bio.

Quick answer: Motiva, Mentor, and Sientra are all FDA-cleared silicone breast implants I offer in San Francisco. Motiva’s Ergonomix2® technology gives the most natural in-motion feel; Mentor offers a proven, consistent gel and shell; Sientra’s more cross-linked “gummy bear” gel holds its shape most firmly. The right choice depends on your anatomy, activity level, and how natural vs. firm you want the result to feel.

One of the most common questions I hear from patients considering breast augmentation is some version of “which implant is best?” The honest answer is that there is no single best implant, only the implant that is best for a particular patient’s anatomy, goals, and lifestyle. That is exactly why I offer three distinct implant technologies at Bay Area Plastic Surgery: Motiva, Mentor, and Sientra.

Each of these brands takes a genuinely different approach to gel formulation, shell design, and surface engineering. Understanding those differences is the foundation of a good sizing consultation, so let’s walk through them.

Motiva: The Newest Technology in My Practice

Motiva implants are 6th-generation silicone implants built around three proprietary technologies: Ergonomix2® adaptive shaping, SmoothSilk® nano-surface engineering, and ProgressiveGel® fill. The defining characteristic of Motiva is positional adaptability, the implant shifts from a fuller teardrop contour when a patient is upright to a softer, rounder shape when she reclines, mimicking how natural breast tissue responds to gravity.

SmoothSilk® is also worth calling out on its own. It is a nano-engineered smooth surface designed to encourage more favorable tissue integration and reduce the risk of capsular contracture, the scar-tissue tightening that is one of the most common reasons patients return for revision surgery.

I recommend Motiva most often to patients who prioritize the most natural possible movement and feel, especially those with an active lifestyle who want results that hold up in every position, not just at rest.

Mentor: A Proven, Consistent Choice

Mentor has used the same gel and shell design for years, and that consistency shows in the results. Across my own patients, I have seen approximately a 1% deflation rate with Mentor implants, and patients consistently describe them as soft and natural feeling. Mentor’s newer “Xtra” line overfills the implant slightly, which creates additional fullness in the upper pole for patients who want that specific look.

I recommend Mentor to patients who want a well-established, predictable option with a long track record and who like the slightly fuller upper-pole profile the Xtra line can provide.

Sientra: The Firmer, “Gummy Bear” Option

Sientra implants use a more highly cross-linked silicone gel, often described as a “gummy bear” consistency. This gel holds its shape more firmly than Motiva or Mentor and does not compress as easily, which appeals to patients who want a perkier, more form-stable result. To date, I have experienced a 0% deflation rate with Sientra implants in my practice.

I recommend Sientra to patients who prioritize firmness and shape retention over the softest possible feel, and to patients with thinner soft tissue coverage who benefit from a more structured implant.

Side-by-Side: How the Three Compare

• Feel: Motiva and Mentor are both soft and natural feeling; Sientra is firmer and holds its shape more assertively.
• Movement: Motiva is the most position-responsive of the three, thanks to Ergonomix2®.
• Shape retention: Sientra’s cross-linked gel holds its shape most firmly; Motiva and Mentor are more pliable.
• Capsular contracture risk: Motiva’s SmoothSilk® surface is engineered specifically to reduce this risk; Mentor and Sientra also carry strong long-term safety records.
• Track record in my practice: Mentor at roughly 1% deflation, Sientra at 0% deflation to date, and Motiva as the newest addition to my practice, backed by its own FDA clearance and clinical data.

How I Help Patients Decide

During your sizing consultation, you will have the opportunity to try on real implants across all three brands, in a range of profiles and volumes, so you can feel the differences for yourself rather than relying on a description alone. I will also evaluate your existing breast tissue, skin quality, and chest wall anatomy, since the right implant is always a combination of your goals and what your body can support.

If you are exploring breast augmentation in San Francisco and want to compare Motiva, Mentor, and Sientra implants in person, I invite you to schedule a consultation at Bay Area Plastic Surgery.