Textured Breast Implants Best Choice After Capsular Contracture?

I had breast augmentation with cohesive silicon (smooth) over the muscle December 2008. My original plastic surgeon stated that I do have capsular contraction of both breasts and recommends revision surgery. He recommended under the muscle this time with textured implants. I've read that textured implants may be firmer and may be more easily visible as well. Is there really a significant difference between textured and smooth unders with respect to capsular contraction? From the research I've done the advantages of using textured implants seems inconclusive.

Doctor Answers 11

Help for Breast Capsular Contracture

The risk of capsular contracture is dramatically increased with subglandular placement of breast implants. This is why virtually every plastic surgeon places them under the pectoralis muscle. The rate of capsular contracture for both saline and silicone implants decreases dramatically under the muscle. In addition texturing also decreases this rate.

So I agree that the best solution would be textured implants placed under the muscle. The implants are slightly thicker but I think it would be worth not having to undergo another surgery for capsular contracture.

Breast augmentation revision whth capsule contracture

The most effective way to reduce capsule contracture in your case would be to replace the implants  beneath the muscle. I would still use smooth silicone gel implants . Textured implants tend to cause rippling and there is no proof that they reduce capsule contracture. We use Singular 10 mg twice daily starting one week before surgery to help even more to  minimize capsule contracture  rate.

Burr von Maur, MD
Orange County Plastic Surgeon
4.5 out of 5 stars 13 reviews

No Advantage to using Textured Implants Aside from Reconstructive Surgery

The placement of gel implants in the subglandular position, everything else being equal, is known to be associated with capsular contracture. Many of us have moved away from using textured surface breast implants because their claimed ability to prevent contracture has not materialized while their greater rippling and higher deflation rate have been widely seen. Subpectoral smooth walled implants with a minimal capsulectomy IS the answer.

Good Luck!

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 78 reviews

Capsular contracture silicone breast implant saline breast implant smooth implants textured implants

I would suggest removing your implants and replacing them with new breast implants. Your new breast implants should be placed underneath muscle.  In your situation, I think silicone breast implants are the best type of breast implant. Silicone breast implants can lead to reduced incidences of breast implant capsular contracture. In addition, when placing breast implants underneath the muscle, I believe smooth implants are better than textured implants.   I believe they give a more natural look.  

J. Timothy Katzen, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 56 reviews

Capsular contracture surgery in Los Angeles

Textured implants provide one more theoretical benefit in the prevention of capsular contracture. Textured implants will not prevent CC, but may further your longterm results. In my practice, I use the textured implants selectively.

Raffy Karamanoukian MD FACS

Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 61 reviews

Textured implants after capsular contracture

If you have subglandular implants and a capsule, and your surgeon is going under the  muscle with textured that is OK. I am not a big fan of textured, because they tend not to move as freely as smooth.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 19 reviews

Textured Breast Implants Best Choice After Capsular Contracture?

Although textured implants are reportedly associated with a lower risk of CC many patients do not like the feel of the texutred surface

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 55 reviews

Textured implants in capsular contracture

I agree with your plastic surgeon that your implants should be moved to a submuscular location. I do not use textured implants and would not in your case. I agree that they are more likely to cause rippling and my incidence of capsular contracture is very low using smooth silicine implants.

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Implant surface vs contracture

There is a significant difference between smooth and textured implants over the muscle. Over very long period of time, this may not be as great as initially.

Under the muscle, the difference between the two is less significant. When you change from over to under the muscle you will start from scratch regarding the contracture issue. The silicone implants have historically had a higher contracture rate.

I agree with putting them under the muscle. You my want to consider staging the re-implantation to a later date to minimize contracture rate, and also to see how the skin shrinks and re-drapes.

There are no advantages to textured breast implants


1) Your research is correct. Textured breast implants have more problems (more frequent rippling, for example), and they do not prevent capsular contracture. We do not use them.

2) Capsular contracture after breast augmentation in New York City is largely avoided by preventing sub clinical infection ( no touch technique, intravenous antibiotics, irrigating wounds with antibiotic solution) and by preventing even a tiny hematoma ( absolute stopping of all bleeding during surgery). A few women will get contrature for reasons we don't understand. And I am afraid there is a real risk of contracture coming back inspite of all precautions.

3) Do the contractures bother you ? Because there is no reason to treat mild contractures (Class II).

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.