I am torn between smooth or textured implants. I am an IRONMAN and marathoner who likes to swim/bike/run, at an elite level.

I am torn between smooth or textured implants. I am an IRONMAN and marathoner who likes to swim/bike/run fast, at an elite level. My doctor said he liked smooth because it would give me more movement but then decided textured would be the best fit so my implants would stay in place even will all of my physical activities. I am an A cup getting 350 CCs, to become a full C cup. From what I've read... smooth seems safer and textured isn't that much of a difference? HELP!

Doctor Answers 23


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For my elite athlete patients including triathlon and weight lifters I would recommend textured implants with maximum cohesivity (#SientraBreastImplants) if you have enough breast tissue for coverage. If not than smooth implants are recommended in my practice. I make sure to make the pocket size exactly to the dimentions of the implant to minimize movement.

Smooth vs texture

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What a great question.  I have been lecturing studying that question and lecturing about it over the last three years.  If you have adequate coverage then texture would be great as it provides stability to ur implants with less animation deformity w muscle movement.  If you are too thin for texture I would opt for a sientra style 107 as it is a smooth round  implant but with a more stable cohesive gel.  That would be an excellent option as well.  

M. Bradley Calobrace, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 43 reviews

Breast implant type

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I appreciate your question.
The most important question for you is going to be above or below the muscle given that you are an athlete.
They both have plusses and minuses. After that, the implant type may or may not make a difference depending on your body structure and what you want to achieve.

The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

best of luck!

Dr Schwartz

Smooth or textured implants.

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Surgeons have different feelings on this and also made tailor a particular implant choice to a particular patient. In general, implants with smooth envelopes seem to be a bit softer and more natural than the heavier thicker walled textured implants. In my experience, textured implants are more likely to be palpable than smooth.

You're overthinking it. Go smooth.

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You're choosing a reasonable size for your implant. It's not huge. Placement should be sub muscular and beyond that, it doesn't matter! Silicone implants may hold up better over time than saline because they don't "piston" when you run. Smooth implants have a lower rupture rate than textured when looking at Mentor, but that may not hold true with other companies. I prefer a smooth moderate plus implant by Sientra because it is slightly overfilled. It's believed that the "overfill" will add longevity to the implant. Good luck!

Robert S. Houser, DO
Columbus Plastic Surgeon
5.0 out of 5 stars 17 reviews

Type of implant

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smooth would be my choice. 350CC,s would make you a medium C starting from an A cup. textured are thicker and more easily felt. there is no real advantage to the textured from my point of view. if you are placing the implants under the muscle, you will be fine.


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Thank you for your question. As you can see from the answers here, there is no correct answer. I think that things like your intended outcome, your starting breast size and your bodily dimensions are important factors to take into account when choosing an implant. I don't agree that you need a textured implant to have it stay in place during your activities. A breast implant pocket should be very precise and match the dimensions of the implant closely. So, even if you has a smooth implant it's position should be relatively stable. Good luck. 


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No implant is perfect.  Smooth implants are generally preferred.  In athlete subglandular placement should be preferred, if possible.  However all above options are viable choices.  You will have to make the final choice and decision.  

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 24 reviews

Implant selection

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Every surgeon is different. I prefer using smooth implants because they tend to move more naturally. Best to discuss with your surgeon.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Smooth or Textured Breast Implant

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For me, there is no question. I always use textured implants because there is good evidence that they reduce the risk of capsular contracture, even if the implant is sub muscular. In you, with your athletic endeavors, I would NEVER consider placing the implant below the muscle. Therefore, the textured implant is even more important. Use of an adequate inferior mammary incision, protecting the implant from contact with the skin, covering the nipple and soaking the implant in an antibiotic solution is also important. By the way, you need to consider that, if you are competitive such that swimming times are important, breast augmentation will slow your times. (If you or your surgeon are interested, the Journal of Plastic and Reconstructive Surgery Vol 71:P255, 1983 by myself and N. Levine)

Robert T. Buchanan, MD
Highlands Plastic Surgeon

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.