Do textured implants settle the same way as smooth ones?

Part of what we call settling is just swelling going down, but smooth implants may settle a bit as the scar capsule forms and matures. Textured implants should not settle very much. Although the original purpose for texturing was to reduce capsular contracture, this is no longer considered the most important factor. Sientra's textured silicone gel implants have a higher percentage fill, which may mean slightly less tendency for rippling. This can be especially important for high profile implants in a thin patient.

Textured implants do not settle the same way that smooth implants settle.  You need to define your goals and communicate them to the plastic surgeon.

Textured implants are made to adhere to the surrounding tissues and therefore no settling would be expected. The appearance may change as the surrounding tissues change and the swelling subsides. With smooth implants, there may be some movement as tissues stretch, but this should only be minimal. Basically, even smooth implants are meant to stay where the surgeon places them.

The upside is textured implants tend to stay in place in patients who may tend to have skin or tissue laxity. I find them useful on certain breast lift patients. The down side is they cause visible rippling and wrinkling at a rate much higher than smooth implants, especially in thin individuals.  They also have a higher rupture rate and are probably only marginally helpful at preventing capsular contracture. 

Textured implants take some time to settle, just as smooth implants do.  Textured implants are mainly used to reduce the risk of skin contracture. Best, Dr. Karamanoukian