As you explore breast augmentation, you will find there are many decisions and options beyond just size. One of the choices you will make is choosing textured implants or smooth implants. Both kinds are available for both saline and silicone implants, but only textured implants are available for silicone shaped, teardrop breast implants.

Both textured implants and smooth implants have their pros and cons. Textured and smooth implants both have an outer silicone rubber shell. Textured implants are so-called because they have a rougher, irregular surface somewhat like soft, rubbery sandpaper. The texture helps them adhere to the surrounding body tissue to prevent them from moving. Smooth implants have a smooth outer surface that is shiny and slippery, and they move freely in the sack that forms around the implant, known as a capsule. Depending on the desired results and your body and background, you and your surgeon can discuss whether textured or smooth implants will work best for your breast augmentation.

What Are Textured Implants?

Textured implants were designed in the 1980s to help minimize the risk of developing capsular contracture, the development of scar tissue around the implants. The scar tissue is hard and can be uncomfortable and painful in some cases and can also cause a change in physical appearance as well. Since then, there have been conflicting studies as to whether or not textured implants really help to prevent capsular contracture. As a result, not all plastic surgeons opt to use textured implants.

Textured implants are available with a shape. For this reason, they tend to be the implant of choice for women undergoing reconstruction after a mastectomy due to breast cancer. They can also offer a better result for women who didn’t develop sufficient breast tissue during adolescence.

Many patients wonder if you can feel the texture of the textured implant once it is inside the body. It depends on the patient and the placement of the implant. If the implants are placed underneath the muscle and there is adequate breast tissue coverage, then you usually can’t feel much of a difference between smooth and textured implants.

However, textured implants do have a thicker shell and therefore feel firmer than smooth implants. They also are more likely to have folds and ripples. These folds and ripples can be felt when they are placed on top of the muscle, especially in thin patients who have little breast tissue coverage.

What Are Smooth Implants?

Smooth implants tend to be the more popular choice today. Smooth implants have the same sleek feel all the way around. Although textured implants are unlikely to show under the skin, there is still the possibility of folds and ripples appearing. Thanks to improvements in silicone technology and advancements in plastic surgical techniques, smooth implants provide better coverage. There is little risk of visibility and a reduced risk of capsular contracture than in previous implant models. Even though smooth implants can move around within the capsule, it doesn’t cause a change in appearance the way textured implants do when they move.

Comparing Textured Implants to Smooth Implants

Capsular Contracture

Textured implants are often used to replace smooth implants that have developed capsular contracture. By using textured implants, a smaller sized implant and a different incision, plastic surgeons can sometimes reduce the chances of having another incidence of capsular contracture when replacing breast implants from a prior augmentation. Textured implants are the only option for newer breast implants that have an anatomic teardrop-shape meant to mimic the shape of natural breasts. The texture keeps the shape in place, similar to Velcro, because if they moved around, it would create a distorted appearance.

Life Span and Potential Issues

Smooth implants tend to last longer than textured implants and have less risk of rippling. Textured implants have a higher incidence of leaking, but they stay in place better than smooth implants, which can become displaced if they move outside the capsule. While both smooth and textured implants can get wrinkles, they are less likely to show with smooth implants, because the smooth implant will pull away from the capsule.

Infection

More recently, a newer study from 2014 has found that textured implants may have a higher risk of infection than smooth implants. The likelihood of infection has been linked to the increased risk of failure, as well as discomfort and contracture. The possibility of infection occurs at the time of insertion, so it is very important that you choose a board-certified plastic surgeon who takes care not to introduce the risk of bacterial infection that can cause problems with breast implants down the line.

Both textured implants and smooth implants have their pros and cons, and the above are general guidelines for making a decision. Many surgeons prefer smooth implants because they offer a more natural result and other benefits, while others prefer textured implants. Your plastic surgeon will help you decide which implants are best for you. Both smooth and textured implants look best when placed underneath the muscle.


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About Dr. Cohen

Dr. Cohen specializes in breast lifts, augmentations, revisions and reductions as well as breast cancer reconstructions. A long time dream of Dr. Cohen’s was to travel to developing countries and provide expert surgical care to those who have no other possible access to medical care. This became a reality in 2007 when she became a founding member and Vice President of ISMS Operation Kids.