What is your opinion on textured implants verses smooth implants ?

Is their any information about textured implants that you are aware of that can cause any possible problems ? Do you think that creating a pocket for the smooth implant is a better technique than the pocket created for a textured implant ? What is your opinion ?

Doctor Answers 10

Texturized implants are seldom indicated in my opinion.

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Having use texturized implants for many years I found them to have a higher failure rate and much more likely to create contour irregularities. They do not appear to have a significant impact on capsular contracture.

Texted implants versus smooth implant

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The majority of implants placed or smooth round. Text implants in my opinion are good for revision cases where you have had capsular contracture. They technically produce a less organized/softer capsule.

Textured advantage is with a shaped anatomic implant

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My fist choice for implants is a smooth round one.  Textured can be beneficial if there is a risk of implant mobility.  This type of implant sticks where you put it.  The only advantage I see is when using a shaped anatomic implant.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

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Textured vs smooth

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This is a great question.
one particular brand of textured implants has been associated with problems but this is extremely rare.
Worldwide, textured implants are more commonly used. In America, the trend is starting to also lean towards textured devices.
Smooth implants can move about in the breast pocket which can be both a good and bad characteristic. Textured devices tend to stay put better. Since most women tend to want upper pole fullness and higher, rather than lower breasts, oftentimes a textured device works nicely for this.
The pocket creation does not differ significantly for either device, although an under dissected pocket could cause a textured device not to fall into place properly, while an over dissected pocket could cause a smooth implant to fall to much.

You should discuss your concerns in person with a plastic surgeon, who should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS).

All the best!
Sam Sukkar, MD

Sam M. Sukkar, MD
Houston Plastic Surgeon
4.6 out of 5 stars 40 reviews

What is your opinion on textured implants verses smooth implants ?

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The surface of the outer shell of breast implants can be either smooth or textured. There are pros and cons of each and the best implant for any particular patient depends on many factors including individual anatomy and desired outcome. Smooth implants usually have thinner shells and move more freely in their pocket than their textured counterparts. Many plastic surgeons believe that the thinner shell allows smooth implants to feel more natural. Implants with smooth surfaces are less likely to ripple. Textured implants were designed to lower the risk of capsular contracture, but whether it achieves that is open to debate. The textured implants may have a greater chance of leakage or deflation. One type of implant, known as the anatomical or teardrop-shaped implant ("gummy-bear" or form-stable), is only available with a textured surface, because this surface helps keep these contour shaped implants in position and diminishes the risk of rotation and distortion. Some of the differences of the implant surface characteristics depend on whether the fill material is saline or silicone gel.

Good results can be achieved with both type of implants. What is far more important than the type of the implant is your plastic surgeon's training artistry, skill, and experience.

Currently, most plastic surgeons in the U.S. prefer smooth implants. You should discuss your concerns in person with a plastic surgeon, who should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAP).

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 22 reviews

Questions about incisions and implants

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I have seen several of your questions on this site relating to different aspects of implants as well as incisions for secondary breast lift. Your questions represent what I feel is a growing problem within the internet educated generation and that is a hyper focus on techniques and technology as opposed to qualifications and experience. It's almost as if the prospective patients in many cases feel that the surgeons are all equivalent and it's up to them to filter out the best choices in techniques and technology. While I fully support attempts to gather as much data as possible to give yourself an informed decision , on the other hand, what we as surgeons are seeing more commonly in our office is patients showing up with predetermined , and sometimes rigid ,ideas about what they feel is acceptable or best for them based on their internet research. I can assure you it is impossible for you to accumulate enough information which would give you the peace of mind you are looking for for several reasons.
1. It would require a medical and plastic surgery education for you to be able to fully assess your situation and the proper techniques and technology necessary to address it.
2. Even among fully certified surgeons there is (a)a competency factor, (b) an experience factor,  and (c) an artistic factor that must be accounted for.
a.The competency factor starts with their training. Did they train in a world class center or did they train at a less revered program, or even in another country? Then you move on to certification. Are they certified in Plastic Surgery or cosmetic surgery, or even something else? Then you have to look at outcomes. Have you spoken to previous patients that THEY did, not not those done by other surgeons, and not gone by questionable online reviews which can be fake, or even relate to such issues such as whether or not the assistant was polite which has nothing to do with your eventual outcome?

b.The experience factor speaks for itself in most cases. While there are very talented younger surgeons and older surgeons who never quite get it, in general, having been to the dance numerous times makes the experience better for the patient in most cases. If I were to go to the moon in a spaceship, I would want the pilot to be the astronaut driving the ship to be the one who has gone there the most.

c. The artistic factor can vary even among very good surgeons so just because you get a different approach at two different sites doesn't necessarily make one wrong. I realize it can be confusing and even anxiety provoking to hear different opinions, but it is not like a car where the mechanics should all be on the same page about a specific mechanical issue. The human body is an extremely complex organism and we see at meetings every year that not always just one approach is best or achieves good results. About 10 years ago the Aesthetic Society had four different surgeons do two sets of twins and the entire society met a year later and evaluated the results to determine whose technique was best. The outcome was that all the patients had good results, despite having four different techniques. Thus the "artists" were all good, but all had their particular methods, and all of them thought their way was best. Yet, you can see that a patient who had seen all four in consultation, and then tried to figure out for themselves which technique is best would have just been through an exercise in futility. Any of them would have done a great job based on their experience, training, skills, previous excellent outcomes, and then chosen artistic methods, even though different.

So, I would recommend the following.

1. See a board certified plastic surgeon who is extremely experienced and recommended by people you KNOW have had a good outcome for the type of surgery you seek.

2. Check out their credentials. Where did they train? What has been their career path? Have they been recognized by their peers? Do they put up fake awards on their site such as "The Patients Choice Award" or other awards that are sold to doctors or awarded for internet activity to make them look good? Do they lecture or teach to other plastic surgeons? Have they developed any techniques themselves that are recognized by their peers? How long have they been doing breast surgery?

3. Be sure they are not paid for using certain type of implants. That way you will be sure they are selecting what is best for you.

4. From a safety standpoint it would be best if they operated with you under the care of a board certified anesthesiologist, who is another doctor, and generally this is done at a hospital. It is usually also more expensive than a procedure done in just a clinic with a nurse doing your anesthesia. Be sure to ask.

5. Remember that in all things you tend to get what you pay for.

Then - make your decision based on the above criteria which relates to the quality of the surgeon , and not on all the data you have accumulated in regard to techniques and implants. Then you can just relax and trust the one you have chosen because you will have confidence that they are going to take good care of you, and make good choices in technology for you ,and they will do another skilled operation for you in the long line of ones they have done for others. You will feel much better about things and it will be a much better experience. I wish you all the best.

Grady B. Core, MD
Birmingham Plastic Surgeon
4.6 out of 5 stars 13 reviews

Textured vrs. smooth implants

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I am not a big fan of textured implants.  The idea of the textured surface is to decrease the risk of capsular contractures.  Textured implants DO decrease this risk vrs. smooth implants when the implants are located above the chest muscle but, statistically, there is no difference when they are located below the chest muscle.  Other than that, I find the textured implants to be stiffer than smooth implants.  The textured surface is also like Velcro.  Where you put the implant is where it will stay.  If it sits too high then it will not settle like a smooth implant.

Edwin C. Pound, III, MD
Atlanta Plastic Surgeon
4.6 out of 5 stars 26 reviews

Textured implants verses smooth implants

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Actually is very know that the textured implants are the best option to prevent a condition that the plastic surgeons know as capsular contracture. I dont use smooth implants.

Dr. Marte

Manuel Marte, MD
Dominican Republic Plastic Surgeon

Textured or smooth breast implants

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Excellent question. These are both good choices.
  • The pocket is the same for smooth and textured implants.
  • Manufacturers texture their implants in various ways.
Apparently the method of texturing makes a difference.
  • For instance, there is a very very rare kind of lymphoma associated with one kind of textured implants, but this is so rare it is hard to know if the association is real.
  • Textured implants may be more likely to cause infection but are less likely to lead to capsular contracture (implant hardening) compared to smooth implants.
  • Sientra textured implants, to my knowledge, have never been associated with the rare lymphoma.
  • For implants over the muscle, a Sientra textured implant seems reasonable if avoiding capsular contracture is high on your list. Best wishes.

Textured vs smooth implants

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In most cases I prefer smooth implants because I think that the implants move more naturally, and second the texture tend to "stick" to the tissues more and look a bit rigid.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 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.