Using Both Smooth AND Textured Silicone Implants in Same Augmentation? (photo)

I have an asymmetry issue.. one breast sits a good bit higher than the other. The plastic surgeon I visited said that he wanted to use a textured implant in one (the larger and lower one) to help it hold its shape. Then he wanted to put a smooth one in the other (smaller breast with almost no lower breast fold).. to allow that one to drop more and correct the asymmetry problem. Has anyone else used this technique? Do you recommend? Aren't they going to feel different? (Being placed sub-muscle).

Doctor Answers 8

Use of Both Smooth & Textured Silicone Implants in the Same Breast Augmentation

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 In general, it is not prudent to use asymmetric Smooth versus Textured implants in patients with asymmetries as they tend to feel and look different long term.

Dallas Plastic Surgeon

Asymmetrical Breasts

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Dear Brianna,


Using different textures for your implants may not be the solution to achieve commendable results.

What is important is to address the ptosis of your right breast by a lift.

Also, the type and size of the implants to be placed under the muscle is to be considered; silicone implants tend to give you a more natural look than the saline ones.

I encourage you to seek additional consultations with board certified surgeons of extensive experience.


Best of luck to you and thank you sharing your photograph.


Dr. Sajjadian

Breast asymmetry

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AS for your specific situation, it looks like one breast is fairly ptotic( saggy) and needs to be lifted. The implants chosen in my opinion should probably be the same type.  Textured implants tend not to move much and therefore don't "jiggle" like normal breasts.  In addition, they can cause more scalloping/ridging in my opinion.

Using Both Smooth AND Textured Silicone Implants in Same Augmentation?

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Thanks for this very interesting question and posting your photo. Before I address the use of different textured implants I must compliment your surgeon and all the posters in giving yiou some advise and guidance in solving the asymmetric breast issues you present. I feel we must first address the anatomic deformity posted. Your right breast is larger, slightly ptotic, has an inframammary crease in the more natural location. Vs the left breast is hypoplastic in volume, has high inframammary crease, deficient distance from areo;ar to fold. In my opinion you will need multiple operations. Whether using textures implant on the right worth a full lift matters is something I'm not sure of. So I will defer to your surgeon based upon his/her experience. With that starred I would use smooth round HP implants. but my first staff would be a right full lift and a release of left infra fold and fat grafting of the inferior quadrant. After a few months to allow healing, if the symmetry is improved than consider implants to attain additional volume and achieve netter symmetry with possible lifting revisions if needed. Finally after 6 months judge the result and tweak with any additional scar revision/lifting and additional fat grafting. That would be my plan based on the limited info and photo posted, not hashing examined you. Regards and Good Luck. 

Textured and smooth implants (submuscular) in same patient with breast asymmetry? Will it work?

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Without knowing the age and experience of your surgeon, I must first commend him or her on considering a thoughtful option to try to deal with your asymmetry.

But, I don't think it will work.

First of all, a submuscular textured implant does not move, and rather than "holding shape" what may happen is a higher risk of developing a Snoopy-dog or double bubble deformity. Secondly, a smooth implant on your non-droopy side will not create symmetry as it drops into position. That breast will remain cone-shaped and "perkier" than it's teardrop-shaped counterpart.

Your asymmetry is significant enough that implants alone (with any kind of implant surface) can not be expected to create symmetry. Implants add only volume to whatever breast shape is already present, and I try to tell my patients that during their consultations. Whatever breast shape a woman has before augmentation alone, she will have after surgery, just with larger breasts.

It certainly is reasonable to place implants alone as a first step, understanding that additional surgery may be needed to adjust implant position or perform some sort of modified lift on your droopy larger breast. But I would use smooth, round, silicone gel implants of different sizes, stay below the muscle, and accept improvement, not perfection. For a patient similar to you, click on the web reference link below. Best wishes! Dr. Tholen 

Using Both Smooth AND Textured Silicone Implants in Same Augmentation?

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The implants may indeed feel different in consistency and you may feel the edges or even wrinkles more in the textured implant depending on your tissue thickness in the lower portion of the breast where the implant is not covered by muscle.  Although your shoulders are "tipped" in the photo, it looks like when straightening your shoulders your one nipple is not far off the level of the other one, but of course the one crease is higher than the other and the distance from nipple to crease is much shorter on that side. The solution is to lower the higher crease to more closely match the other side and internally "release" the constricted lower pole of that breast to allow it to expand, using a "dual plane" technique, and using different sized implants.  I do not think it is necessary to use different types of implants in the two breasts.  I think that the placement of the two different implant types would not be a terribly predictable way of trying to improve this asymmetry.

Textured silicone implants

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The purpose of the texturing was initially to reduce capsular contracture. Next, the texture is present to hold the position of an implant, especially an anatomic implant to resist rotation. The degree of texturing and effectiveness can vary, and most of would not count on the texture to resist an implant drop. Our vote would be a similar implant on both sides, and be patient with relaxation of the fold on the smaller side. Better, not perfect.

Smooth and textured breast implants

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First, there are differences in the degree of texturing the implant manufacturers have on their products so not all "textured" implants are textured to the same degree.  The Mentor's for example, are very finely textured and the Allergan's are more course.

That being said, I respect that your surgeon is trying to do all possible for you because you have alot of asymmetry.  However, I honestly don't think that the plan is going to be as effective as it might sound.  Nevertheless, it wouldn't hurt to try especially if your doctor has used it to success before.

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.