Textured versus smooth implants
Your question can provoke controversy amongst plastic surgeons. There is no "best" implant. I use smooth and textured (round) implants for various aspects of my practice. Rippling is related to multiple factors, including the thickness of the tissues over the implant I do want to note that the incidence of breast implant associated cancer (ALCL) is significantly higher in textured implants, although generally uncommon. Either way, you can't go wrong with your choice.
Smooth versus textured implants
That's a very good question. It's interesting, that in the rest of the world except the United States a textured and mostly shaped implants are the preference. It's only in the United States, that there is a high use of round smooth silicone gel implants. The advantage of texturing is that it does promote some frictional resistance to migration and with some of the textured surfaces actually allow for integration of the scar tissue to the implant disallowing any movement at all. This may be preferential in cases where the implant is shaped such that it would not rotate. Some of the manufacturers shells are thicker when textured as the textured surface is laminated on to a smooth walled implant. This makes an implant shell that is more unyielding and therefore stiffer. It's also more likely to wrinkle and to break. In today's mostly sub muscular implant placements there's a very small, if any, advantage to less capsular contracture with textured implants over their smooth walled counterparts. If you have a lot of overlying breast tissue and an increased risk of capsular contracture like smoking, that would make sense to use a textured implant because it's unlikely through that much breast tissue that you could feel the difference between that and smooth. On the other hand, if you're very thin, and want the softest, less wrinkled appearance,than a smooth walled device may be preferable. Like I said before, all shaped implants are textured to prevent rotation. Here, there is no wrong answer and most surgeons will have their own opinion on what works best in your hands. Good luck with your decision and surgery.
Thank you for your question. Textured implants have benefits and it is not just branding. They help with avoidance of migration, rotation and capsular contracture. They do however have a higher chance of rippling depending on how much breast tissue you have.
Textured or smooth implants
Textured implants have been used for many years in Europe and are more readily available now in the US. Some studies (you can check the different implant manufacturers---they publish their own studies) have shown that the rate of capsular contracture for textured implants is less than with smooth implants. However, the rate of contracture has decreased with every generation of implants, and it continues to be very low. Many times the choice of using textured or smooth implants is based on the surgeon's preference and own experience. I use both types of implants depending on what I feel will give the best result for the patient. I wish you luck in your upcoming surgery.
Smooth vs. Textured Breast Implants
The decision between smooth and textured breast implants ultimately comes down to what the board certified plastic surgeon thinks is best for your body. Both smooth and textured implants have subtle advantages that may help the final appearance of your augmentation, but without an examination there is no way to tell if one type would be significantly better in your case. The shell of textured implants is slightly firmer, but the main reason that they would tend to feel less natural is because they are intended to promote the adherence of the fibrous capsule that forms around the implant in the body to the surface of the implant. The result of this adherence is that the implants tend to stay in an aesthetically ideal position over years, avoiding unfavorable movement or spreading that can be seen with smooth implants, but sacrificing the more natural feel. Either way, great results can be attained using both types of implant.
I am reading that textured implants are harder, less natural feeling, more likely to deflate and ripple?!
Very good question. Textured implants have the same feel as smooth once they are in place. When we used textured saline implants, they definitely had more prominent rippling because the shells were a little thicker, and they do statistically have a slightly higher leak rate. They were popular because of the lower capsular contracture rate. The capsular contracture rate now is so low that their slight advantage is of no consequence. Most surgeons prefer smooth implants for most patients because they have a little movement in the pocket, thus mimicking natural tissue. The textured implants have no movement and so have little indication now except in patients that do a lot of upper body building and may cause implant displacement or the teardrop shaped implants because we do not want them to rotate. If you want smooth implants there are lots of very excellent surgeons that can help you.