I'm trying to decide between textured or smooth silicone implants. What are the latest reviews on each As of 2014?

I'm 5'5 140 pds 48 yrs old mom with two children. Deflated breast small C cup now. I've been advised that I should consider a lift but I could consider no lift as my sagging is not severe. ( my nipples donot point downward). I would like more volume at the top. Would like to be no larger than a D cup. I would like to not have lift as I donot want the scars. I play tennis 1x per week walk/run 3x per wee but not long distance.

Doctor Answers 12

Which Implants To Choose?

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Thank you for your question!  I personally like the smooth gel because the rippling effect is less than a textured implant.  It is hard to tell for sure which implant you will need without a physical examination, I reccomend you seek a board certified plastic surgeon. Best of luck!Dr Dhaval PatelDouble Board CertifiedPlastic SurgeonChicagoHoffman EstatesOak Brook

My personal preference is smooth implants

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I like smooth implants because they have less rippling, lower risk of seroma formation.  Texturing was created in hope of lowering capsular contracture rates but the evidence for that is inconclusive and especially when implants are sub muscular, the benefit is insignificant.  I place most of my implants under the muscle to there is no benefit to texture.

I'm trying to decide between textured or smooth silicone implants. What are the latest reviews on each As of 2014?

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As others have stated both implants when use properly can give a nice result.  The evidence that textured breast implants protect against capsular contraction is not uniform and certainly not definitive.

In essence it comes down to surgeons preference.

The most important thing is to find a very experienced board certified plastic surgeon to trust and have good rapport with and follow that surgeon's advice.

There are new textured shaped breast implants that are specifically made to increase breast projection in patients who are borderline needing a lift.

On the other hand textured implants have a thicker wall, can be more palpable, and tend not to move as freely as smooth walled implants.

Again find an excellent plastic surgeon and follow that doctors advise. For more information on textured and saline implants please read the following link:

Benefits of Textured implants

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Thanks for sharing your question.  Options for breast implants are now more extensive than ever.  I think this is a great benefit for patients that allows them to select truly specific implant relative to their body type.  In my practice I have incorporated the use of textured implants in many cases.  It is important to visit with a plastic surgeon that can help you understand which implants may best fit your needs during consultation.
Visit with a plastic surgeon that can make you feel comfortable about the process.
Best wishes

Steven Camp, MD

Choice of implants ( SMOOTH VS TEXTURED) will always be cotroversial

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Choice between smooth and textured is not across the board applicable to all kind of situation.  Both types have their own pros and cons.  Plastic surgeons have fluctuated from one side to the other over past 20 years.  You will not get meaningful answers by floating this questionnaire. 
Also need for a lift or no lift is only determined after personal exam by someone who knows art of plastic surgery.
Remember that your goal should not be breast implants. It should be BEAUTIFUL BREASTS.  Get a consultation with a plastic surgeon. 

Textured implants have the lowest risk in the most recent studies

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As a coauthor of one of the largest reports to date comparing highly cohesive gel implants over time, evidenced based research in our most prominent journal of Plastic and Reconstructive surgery supports the conclusion that textured Sientra implants round or shaped have the lowest risk of capsular contracture, deflation, and malrotation when compared to the other implants.  They currently have the most extensive warranty available for which we support wholeheartedly.

Trying to decide between textured or smooth silicone implants.

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I agree with the statements made by other doctors on this post. I don't find that there is as much of a shape difference using regular silicone smooth and textured implants. The more highly cohesive gel implants (commonly called gummy bear implants) may hold their shape better, but tend to be stiffer feeling and don't move as naturally as the normal silicone gel implants. 
I also agree that seeking consultation with a board certified plastic surgeon should be your next step. Picking a surgeon experienced in dealing with women shaped like you is much more important than worrying about the implant type.
Good luck

Smooth versus textured silicone implants is a very involved discussion

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For something that seems so straightforward, there are actually a number of points to consider here which make this a more complicated issue.  The important thing to note is that there is no one perfect implant that works for all people.  Each of the 3 manufacturers in the US has a different process to make its implants and apply its own kind of texturing, their gels and shells are all just a little different, and they are all made with slightly different dimensions and volumes.  Thus, you will need very sound advice from a surgeon who has knowledge and experience with all of the implants in order to make the best decision for you as an individual.  Generally speaking, I can tell you that my own preference is more toward that of my colleagues in Europe and Latin America where textured cohesive gel implants rule the day and the rates of capsular contracture and implant displacement are very low.  That being said, in cases in which a patient may need more than just a minimal lift, I find that textured implants don't always work as well, and therefore, for those cases I will still use smooth implants.  Again, which manufacturer's implants remains to be determined by the specific needs of the individual patient as there are still differences between them.  You have stated that you many not need a lift, and you would like to avoid one if at all possible.  This is something that only your doctor who has examined you thoroughly can advise you on.  Starting from that point, you can have a sound discussion of what kind of implants would work best for you to achieve your specific goals, but before you just decide that a particular type of implant is what you want, you need to have that evaluation.  So, to summarize and answer the lead-off point in your question, I personally would suggest that if at all possible you consider using textured implants in the year 2014, as there are now lots of data that show that these implants are associated with lower incidences of capsule contracture and implant displacement.  The implant companies are now comfortable enough with these studies that they are including capsule contracture in their warranty programs for textured implants.  Talk this over with your surgeon and try to find the implant that fills most of your specific needs and helps you achieve your goals.  Good luck.

Joseph L. Grzeskiewicz, MD
San Diego Plastic Surgeon

I'm trying to decide between textured or smooth silicone implants. What are the latest reviews on each As of 2014?

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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.

Currently, most plastic surgeons in the U.S. prefer smooth implants. You should discuss your concerns with your 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

Should Patient Choose Textured or Smooth Breast Implants?

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Textured implants are an excellent choice for some patients and smooths are an excellent choice for others. Many people would do equally well with both.

Because you have been advised to consider a lift, I would first choose a board-certified plastic surgeon with excellent before and after photos. He/she should be someone to trust because you'll need guidance.

Many people want, just as you do, conflicting results: more volume up top without having a lift, despite downward facing nipples. Perhaps a donut mastopexy (nipple lift) and breast augmentation would work. Or it might not. That's why you need a consultation with an excellent plastic surgeon!

Click on the link below to see a breast augmentation case with a nipple lift.

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.