Hello, and thanks for the question. Textured implants are designed to promote some degree of adhesion between the implant and the tissues. Although they do drop and "settle" into the pocket after placement, they may not move as much as a smooth implant. This doesn't mean that they won't end up looking as good as a smooth implant, it just means that the pocket and implant placement need to be a little more precise for a textured implant. Indeed, some textured implants, such as the teardrop shaped, highly cohesive gel implants ("gummy bears") don't settle or drop much at all. My primary reason for using textured implants include the use of the "gummy bears" in patients with really thin tissues, as this implant is less likely to cause "rippling" (seeing folds on the implant through the skin), and capsular contracture (hardening of the scar tissue around the implant). Another reason to use textured implants would be in placement above the muscle (submammary placement), as it has been shown that textured implants reduce capsular contracture in the submammary position. If the implant is being placed in a submuscular position (beneath the muscle) I typically use a smooth implant, as the capsular contracture rates are similar to textured when beneath the muscle. Smooth implants are also a little softer, and are a little more reliable as far as settling nicely into the pocket and filling out the lower aspect of the breast.Hope this helps!