Are textured implants safe? I've read they have a higher risk of cancer. My doctor suggested Sientra Textured. Advice?

I'm doing my research prior to my breast augmentation. I'm reading that the textured implant may have higher risk of cancer. My doctor suggested sientra textured. Should I suggest the smooth?

Doctor Answers 5


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The media loves scaring patients about extremely rare risks because it brings in ratings.  It's also a major disservice to patients, and can scare people into making choices that are not based on statistics.

Sientra / Silimed's True Texture has been used in upwards of 800,000 patients and they have had a total of 4 ALCL cases so far.  That puts the risk of ALCL at approximately 1 in 200,000 with their textured implants.  Compare that to a 1 in 17,000 annual risk of dying in a car accident, and a 1 in 8 lifetime risk for a woman to get breast cancer, and it puts things in perspective.  On top of that, of those incredibly rare patients that get ALCL, 98% are cured simply with implant removal and capsulectomy (scar tissue removal).  So the odds of getting ALCL and needing chemo, radiation or some other major treatment becomes less than 1 in a million.  Your odds of reoperation due to capsular contracture or malposition because of smooth implants is astronomically higher than your risk of ALCL.

I still use mostly textured anatomical implants because I feel that they usually have the most pros and the least cons for my patients.  It is important to be aware of ALCL, but if your surgeon thinks textured implants are best for you, I would not let the minuscule odds of getting a highly curable problem dissuade you from using the best overall implant.  Hopefully, the statistics I quoted will help you understand the true relative risks.  I'm sure your surgeon would be happy to discuss things further if you have additional concerns.  Best of luck!

Santa Monica Plastic Surgeon
5.0 out of 5 stars 58 reviews

Textured vs smooth

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As you have eloquently heard from previous answers ALCL is the cancer you are talking about and the risks are very low.   The benefit of texture is a lower CC rate (particularly above the muscle) and stability of implant position.   The disadvantages are rippling, palpability and ALCL risks.   I use both smooth and textured and choose based on the specifics of the case and patient preference.  If you are a worrier and know this will concern you after the implants have been placed, I would recommend smooth.   One less thing to worry about. 

York Jay Yates, MD
Salt Lake City Plastic Surgeon
4.9 out of 5 stars 189 reviews

ALCL is a rare type of lymphoma associated with breast implants

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Anaplastic large cell lymphoma is a rare type of lymphoma that has now been associated with breast implants. About 300 patients have been identified by the FDA as possibly having breast implants and ALCL. This is a tiny percentage of all implant patients (about 10 million women worldwide are estimated to have breast implants according to the Plastic Surgery Educational Foundation), but patients and doctors should follow this issue closely. 

ALCL appears to be more associated with textured breast implants, but this does not preclude their use in appropriate patients, based on the rarity of the disease. 

Stay informed. You are doing the right thing by educating yourself about a procedure prior to deciding if it is right for you. 

The FDA's website provides information about ALCL ( 

Steven Goldman, MD
Cleveland Plastic Surgeon
5.0 out of 5 stars 168 reviews

Are Textured Sientra Implants Safe?

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There is a very small risk of the rare tumor ALCL present with prior breast implant placement. There is extensive literature present on the internet and the scientific studies are in process.

Looking down this thread, there are risk numbers provided for this problem in Sientra Textured implants.  If the prior doctor's post is correct, 4 cases in 800,000 patients is a very small incidence. In perspective, 1 in 8 women will develop breast cancer in their lifetime. This is a dramatically higher risk and has not been associated with the breast implants.

You might go back to your plastic surgeon and discuss the advantages of textured vs. smooth implants for your surgery.

Best Regards,

Douglas J. Raskin, MD
Colorado Springs Plastic Surgeon
4.9 out of 5 stars 69 reviews

What you need to know about textured implants

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Textured breast implants are not associated with a higher risk of breast cancer. What they are linked to in very rare instances is a condition called ALCL, which is a cancer-like condition that can form in the scar capsule. It is curable by removal of the capsule. If you are having round implants, then smooth is probably a good choice, but shaped implants need to be textured. 

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 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.