What is the difference between smooth and textured breast implants?

All breast implants are initially manufactured with a smooth silicone surface.  Some implants will have an additional textured surface added to the smooth outer shell.  The purpose of surface texturing is to try and reduce the risk of capsular contracture.

In the late 1980’s, there was a very popular breast implant which had a rough textured surface.  It was felt that the rough surface allowed the in-growth of scar tissue around the implant into the shell reducing the incidence of capsular contracture.  That surface was a polyurethane foam which was subsequently taken off of the market by the FDA.  Since then, both major breast implant companies have tried to mimic that textured surface by adding a rough silicone shell.

At this time, it is generally accepted that a textured silicone surface does not have an effect on capsular contracture when the implants are placed under the muscle and are of questionable benefit when placed on top of the muscle.

There are several downsides to textured implants.  First of all, they are about 30-35% more expensive than smooth implants.  Secondly, since the textured surface is added to the smooth shell, the result is a thicker implant wall which is easier to feel than a thinner shell so they tend to be more palpable and feel less natural.  Finally, textured implants tend to have a higher rupture rate than smooth implants.  It is hard to justify paying a higher fee for an implant that is of questionable benefit, easier to feel and has a higher risk of deflation.

When a group of over two thousand board certified plastic surgeons at a recent national meeting of the American Society of Plastic Surgeons were asked what type of breast implants they used, the overwhelming majority of them answered that they use smooth round implants.  Very few surgeons now use textured implants for breast augmentation.

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