Does Breast Implant Texture Really Matter?

Before undergoing breast augmentation surgery, there are many options that one may or may not consider. These can include:

  • What cup size do you desire?
  • Do you want silicone or saline?
  • Round or anatomic?
  • Implants above or below the muscle?
  • What incision do you prefer?

The last four considerations, in particular, may be strongly recommended by your surgeon’s preferences and experiences. This can make the overall process even easier for you.

Another choice that exists but may get little or no mention is whether one prefers a smooth or textured implant. This option only applies for round implants as all anatomic style implants are textured by necessity.

There may be a few reasons for this. Based on data, information and other factors, the overwhelming majority of round breast implants placed by plastic surgeons in the United States are smooth surfaced.

What Is the Difference Between a Smooth Implant and a Textured Implant?

The difference between these two types of implants is just what the names suggest. Smooth silicone implants have a smooth outer surface, whereas the textured ones have a rough or irregular surface. You won’t be able to feel the difference between the two surfaces directly through the skin, but there can be indirect consequences of their different surface characteristics as detailed below.

Years ago in earlier generations of breast implants, it was thought that the texturing of the surface lowered the risk of the development of capsular contracture (the state where the implants feel hard). However, studies of modern day implants reveal little, if any, positive impact on the prevention of this situation. Given known risks and untoward outcome issues associated with textured surfaced implants, most plastic surgeons will largely or exclusively use smooth surfaced breast implants.

Issues to Consider If Selecting Between Smooth and Textured Surfaced Breast Implants

Smooth Implants:

  • These implants tend to last longer based on the nature of the outer shell versus the “thinner” textured ones.
  • They can have more natural movement as they are free to move in the pocket and not restrained.
  • Smooth implants will be associated with a lower risk or extent of rippling versus the textured surfaced ones.

Textured Implants:

  • In rare or high risk situations, such as in breast reconstruction with radiation or a history of recurrent capsular contracture, these may possibly be associated with a lower risk of the development of capsular contracture or the severity of its degree as compared to smooth surfaced ones.
  • These are often associated with a higher risk of rippling and traction effects particularly when they are filled with saline. This can be quite noticeable in thin individuals. Most textured silicone implants have a far lower risk of this happening, though it still will be more than smooth surfaced implants.
  • Though a very rare occurrence, and present in around 400 cases worldwide out of around 12 million or more women, BIA-ALCL (breast implant associated-anaplastic large cell lymphoma) has only occurred in women who have had textured surfaced implants. It has never been seen in patients who have only had smooth surfaced implants. Despite its rarity and an extremely high rate of cure when treated early and properly, this association does make textured surfaced implants less attractive.

For more information on breast implants or to schedule your consultation with me, please call my office at (480) 451-3000 or contact us by email.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona