Smooth vs. Textured Breast Implants

What is the difference between textured and smooth implants? Do textured implants last longer? Is it true that smooth implants have a tendency to move to the sides after many years in the body? If so, how do you avoid that from happening? Do textured implants have more rippling? Do smooth implants feel more natural inside the body? I am so confused and I would like to make the best decision for me. Thank you!

Doctor Answers 8

Smooth vs. Textured Breast Implants

This is a very complicated topic with a lot of different opinions. Additionally, it depends on whether you are speaking about saline or silicone implants, whether you are wanting them above or under the chest muscle, and whether this is a first time augmentation or a reoperation for problems with previous implants. Textured saline implants wrinkle and ripple more and have a slightly higher leak rate than smooth saline. Textured and smooth silicone implants have an equal capsular contracture rate if placed under the muscle; the CC rate is higher for both if placed above the muscle with textured implants having a slightly lower rate than smooth. Textured implants don't always move as naturally as smooth implants with changes in body position and can wrinkling and waviness in thinner patients. They also can feel stiffer in many patients, especially the gummy bear type implants. Texturing came into vogue with the older style silicone implants because it lowered the capsular contracture rate significantly. Newer silicone implants have a much better manufacturing process and contain a semi-solid gel, not a liquid like the old ones. Newer silicone implants don't show much difference in CC rates between smooth and textured surfaces. Textured surface implants are now mainly used in stiffer shaped implants because the texturing helps to keep the implant from rotating when placed in the body. There is a ver rare form of lymphoma that has been identified in less than 0.1% of breast augmentation patients and has only been found in patients with textured implants up to this point in time.Saline implants seem to have more of a tendency to cause pocket stretching, possibly because they are less flexible and push more against the surrounding tissue when you are laying prone or force is applied to the implant. I see much less pocket stretching with silicone implants.Nationally, most doctors use smooth implants in both saline and silicone.

Nashville Plastic Surgeon
4.8 out of 5 stars 72 reviews

Smooth vs. Textured Breast Implants

Thank you for the question. The difference between these types of implants is the feel and surface characteristics of the outer surface of the implants. I do not think that there are any advantages of using textured implants and use the smooth round implants almost exclusively. 

Personally, I think that the surface coating of the present plans are probably the least important factor when it comes to a successful outcome achieved with breast augmentation surgery. Much more important, will be careful selection of your plastic surgeon and careful communication of your goals. 

 Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, and computer imaging) will be critical.    Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of know words such as “natural” or "C or D cup” etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.

3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.

I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

Smooth vs texture implants

Textured implants have a slightly rougher surface than smooth implants. It is designed this way to adhere to your tissues, so that they remain in place better. However, an accurately formed pocket will eliminate the risk of displacement, whether textured or smooth implants are used. An experienced board certified plastic surgeon would be able to achieve natural feeling and looking results with either type of implant. I suggest you listen to the advice of your surgeon, as they’ll be able to recommend which is better for you based on your unique body and goals.

Leila Kasrai, MD, FRCSC
Toronto Plastic Surgeon
5.0 out of 5 stars 66 reviews

Smooth vs textured

I prefer smooth implants for most patients because I think they move better than textured. I think rippling can happen with both implant types.  Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Smooth and textured

There are a wide variety of implants to suite a wide variety of women. Not all implants will work equally well in all women. I would suggest meeting with a board certified plastic surgeon and discussing all your concerns. During the consultation , you will be examined and measured. Your doctor can select the range of sizes that will best suite your frame and tissue. He/she can also discuss the differences of the implants and what will work best for you.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.6 out of 5 stars 13 reviews

Breast implants - smooth or textured?

Thank you for asking about your breast implants.
  • You are confused because it is a HUGE topic - but hope this helps.
  • Implant selections can be very confusing - and your surgeon's job is to help you choose.
  • Textured implants may be less likely to form capsular contractures and may attach more firmly to tissues, giving a little support to the implant. Anatomic implants are usually textured.
  • They are more expensive to make; they do not last longer.
  • Smooth implants stay in place, if the implant fits your chest. 
  • If the implant is too large, it will make space for itself by moving to the sides. 
  • Smooth implants feel more natural.
  • A very very rare cancer has been associated with textured implants - because it is so rare we don't know if the connection is real.
  • In North America, the most popular implant is the smooth round implant.
Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Smooth vs textured

Hello and thank you for your question.   You will find many different preferences among surgeons for the texture style of an implant.  I generally used smooth implants.  Texture can have less capsular contracture but tend to not feel as natural as smooth.  Far more important than the texture of the implant is the appropriate dissection of the implant by your surgeon.   The size, texture, shape, and profile of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 123 reviews

Smooth vs textured implants

Each surgeon has their preferences. I prefer smooth round implants. Textured implants were believed to reduce the incidence of capsular contracture, but do potentially cause more rippling. I find the textured "gummies" too firm. I would recommend you feel the implants at your surgeon of choice office and look at results of both implants to help you decide.

Rick Rosen, MD
Norwalk Plastic Surgeon
5.0 out of 5 stars 22 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.