I am a 30 yr old asian, 5' , 86 lbs. 32aa going to a c. My dr. recommended 300 cc , silicone and textured, under the muscle. I know that I keloid and scar pretty easily, would I benefit more from using textured to try to avoid capsular contracture? My dr. made me feel given my race and by viewing other surgery scars that I have a high likely hood of developing cc and should use textured implants as a precaution. What are the pros and cons to be considered?
Textured or Smooth for Asian Known to Keloid and Scar Easily?
Doctor Answers 9
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Implant Choice for Asian who
Racial and ethnic characteristics do not create any risk for capsular contracture. Other poorly understood factors such as textured or smooth implants may make a difference. Implants placed under the muscle probably have a lower rate of capsular contracture than those placed over the muscle.
A person's tendency to form a keloid or thick scar on the skin is not correlated to the risk of developing capsular contractures.
Given your concerns, I would recommend placing it submuscularly instead of on top of the muscle, if your body shape is suitable for that. I agree with silicone because it feels softer and is more gelatinous than saline, but there is some evidence that saline has a lower contracture rate than silicone -- so on this point I would ask you to delve into the matter more deeply with your plastic surgeon.
Textured vs. Smooth remains a controversial issue. I personally have a preference for smooth implants, but in some studies textured implants have been shown to have a lower rate of capsular contracture.
Sometimes we raise more questions than we answer, but I hope this dialog helps you dig into these issues a little bit better . : )
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Best implant for Asian skin
There are no definitive studies that prove textured implants have lower capsular contracture rates then smooth implants. Also, textured implants are more apt to cause puckering and contour irregularities particularly in petite frames where the skin coverage is thinner, More importantly you need an implant with an appropriate footprint to match your frame. Lastly, people who have scarring issues are best augmented through the axilla, or armpit to keep the potential scar off the breast.
Encapsulation Risks Higher for Keloid Former?
Thank you for the question.
There is no evidence that abnormal skin scarring necessarily increases the risks of breast implant encapsulation. I personally prefer smooth implants although it is likely that you will do well with either type. Most important will be your selection of plastic surgeon; do your due diligence carefully.
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Textured breast implants
I do not believe that there should be any difference between textured and smooth surfaced implants in a person who has keloids and is concerned about capsular contracture. There are anecdotal reports that textured implants have less capsular contracture but the evidence is not very convincing in my opinion. It is recognized that textured implants rupture more easily though. Hope that helps.
To my knowledge there is no connection between skin scars and keloid formation with capsular contractures from breast implants. Given your history the most important issues are picking an implant with a small base diameter so it fits your obviously petite frame and postoperative measures to prevent formation of keloid or hypertrophic skin scars. You should know and understand the skin scar control measures to be performed after surgery before you have the surgery.
I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
Implant Choice for Asian Patients...
Asian patients seem to do very well with breast augmentation, and I haven't noticed a greater tendency for capsular contracture. Keloid formation has also not been a problem, regardless of the location of the breast incisions.
My preference is to use smooth round silicone implants, either over or under the muscle depending on a variety of considerations. This is a decision I always permit my patient to make after hearing the information I provide during the consultation.
I'm not convinced that textured implants are very effective in preventing capsular contracture, and I know them to be associated with more likelihood of other problems. For that reason, I rarely recommend textured implants.
Best of luck with your decision!
Questionable Relationship Between Cutaneous Scar & Capsular Contracture
I personally have not seen a direct relationship between patients who have a history of forming poor cutaneous scars and the development of capsular contracture. It would seem that such a relationship would exist, but I have not seen it in my practice. I, too, use smooth implants pretty much exclusively and would favor their use in your case as well.
Asian breast augmentation
It is not true to our knowledge that Asian individuals have a higher rate of capsular contracture, and wear characteristics are better for a smooth breast implant so that would be our choice. The scar is an issue so we use an under the arm or transaxillary approach. The under arm seems to have a very low capsule rate, and will not show or Keloid in an individual of Asian descent.
Best of luck,
Textured or smooth implants
I personally use smooth implants only, and 99% of the time under the muscle. I do not think it matters at all regarding capsular contracure whether you are asian and keloid externally. Do some research on line and see if you see a difference in smooth vs textured. Trust your surgeon but you should be comfortable asking them why they pick one over another type of implant.