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Shares of Sientra (SIEN) - Get Sientra Inc. Report , a plastic surgery product maker, were falling hard Wednesday after the company reported a wider-than-expected fourth-quarter loss.

The small-cap stock was down 28.47% to $8.14 a share. 

Sientra lost 87 cents a share in the quarter, wider than analysts' calls for a loss of 67 cents. The company has missed earnings estimates in the last four quarters. Revenue was $19.02 million, beating estimates of $17.56 million. The operating loss in the quarter was $24.39 million. 

CEO Jeff Nugent remained optimistic on the future as the company has innovated its breast products.

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"Last year's accomplishments were pivotal to positioning Sientra for sustainable long-term growth across both our business segments," said Nugent. "I am encouraged by the progress we have made in establishing Sientra as a leading, diversified global partner to aesthetic physicians and I am looking forward to continuing this momentum in 2019." 

Analysts at William Blair downgraded the stock to market perform from outperform. 

Since reaching a level of $14.83 a share on Jan. 9, the stock has shed almost half of its value.