All U.S. implant companies make great products. Surgeons stick with one or two brands because of volume pricing, consignment agreements at surgery centers, and catalog mastery — not because we're paid to push them. The real money relationships are through KOL and consulting work, which should always be transparent.
A few people in the comments have been asking some version of: "How do plastic surgeons choose which implants to use? Are you being paid by companies to recommend them?"
These are fair, important questions that every patient should feel comfortable asking. Let me answer them honestly — both how implant selection actually works, and the real ways physicians do (and don't) earn money from implant and device companies.
I want to start with this because it matters:
All of the implant companies in the United States make great products.
Mentor, Motiva, Allergan, Sientra — they're all good. There is no "bad implant brand" in the U.S. market.
So when a new implant brand comes out and you see online buzz that "I have to switch to Motiva" or similar — slow down. If you have an excellent result with the implants you have, there's no reason to change. New does not automatically equal better when the existing options are all already excellent.
Most plastic surgeons primarily use one or two implant brands — not all of them. Patients sometimes assume this means we're being paid to push a specific brand. That's not why.
Implant pricing goes down the more we purchase from a single company. Sticking with one or two brands means:
Most surgery centers and hospitals have consignment agreements with specific implant brands:
For example: when I operate at Cedars-Sinai, they have an Allergan consignment. That's what I use there — and frankly, that's all I'm allowed to use at that facility. My private surgery center has Motiva and Allergan on consignment, so I have access to both brands when I'm operating there.
Every implant catalog has its own dimensions, projection options, and shape characteristics. Knowing one or two catalogs inside and backwards lets a surgeon pick the right implant for a given patient quickly and accurately.
You're not a good surgeon because you use one brand and you're not a bad surgeon because you use another. All four brands have strong product lines. Pick the one your surgeon knows best.
Yes, occasionally. We all use all of the brands sometimes — usually because of warranty cases.
If a patient comes to me with a problem involving a Sientra or Mentor implant that's under warranty, I use that brand for the replacement so the warranty applies. The companies are good about supporting warranty claims regardless of which surgeon does the case.
No. Implant makers do not pay surgeons to use their implants. They do not pay us to make social media posts using their products.
That's a pretty firm boundary in our specialty. The way device companies engage with physicians financially is through a totally different mechanism — and I want to be transparent about it, because it's relevant.
If you follow my account, you may already know I'm a KOL — a Key Opinion Leader — for several implant and device companies. Here's what that actually means.
A Key Opinion Leader:
It's essentially a side job for physicians who have a particular expertise in a given area. I'm a KOL for multiple companies in implants, scaffolding, and other device categories.
It's genuinely fun, and I think it's a meaningful part of how I contribute to advancing the field.
There's an important distinction between:
The first is normal and disclosed. The second would be unethical, and I don't do it. My implant selection for any individual patient is based on what's best for that patient's anatomy and goals — not on which company I'm consulting for.
One subtle but worth-mentioning point: KOL roles in plastic surgery are filled by plastic surgeons — not "cosmetic surgeons" who haven't completed plastic surgery training. Device companies want input from physicians with the deepest training and the most extensive case experience. If a "cosmetic surgeon" is claiming to be a KOL for a major implant company, that's worth raising an eyebrow at.
Here's the broader point I want every patient to take from this:
It is never wrong to ask your doctor — any doctor — whether their recommendation is influenced by a financial relationship with a company.
This applies to:
The research on this is sobering. There are studies showing that something as small as giving a pen can shift prescribing habits. That's real, and physicians need to be aware of it.
In my practice, I have medical reps in my office every day. They do an important job — bringing me information about new products, new protocols, new technologies. I want that information. But I have to consciously make sure that those relationships don't influence my recommendations beyond what the evidence supports.
When I recommend a specific implant for a patient, I explain exactly why that implant is right for them:
If your surgeon can't give you a similarly specific reason for the implant they're recommending, that's worth pressing on. You should be able to ask:
These are completely appropriate questions. A good surgeon will welcome them and answer honestly.
For full disclosure, since transparency matters in this conversation:
Consulting is genuinely one of my favorite things I do. I get to see new technology, give opinionated feedback, and then walk away — and the companies use that input to make better products.
Plastic surgeons choose implants based on volume pricing, hospital and surgery center consignments, catalog familiarity, and warranty considerations — not because we're paid to push specific brands.
The real financial relationships physicians have with device companies are through consulting, KOL roles, advisory committees, and clinical trial work — and those should be transparent and disclosed when they're relevant to the conversation.
As a patient, you should always feel free to ask your doctor:
These are good questions. A good clinician answers them honestly.
And just to address the comment that started this whole video: yes, I notice there's no specific factual response to anything I said — just a low-effort "big pharma" jab. That's not an argument. But I'm happy to engage with the actual question underneath it, which is a legitimate one.