Textured or smooth implant? (Photo)

Question

Wanting to go up a cup size or even less. I am a 32 C but want a little more fullness higher up. I was planning 175 cc - 200 cc, smooth, munder the muscle but the doctor I was planning to go with only does textured implants. I’ve read that textured might not feel as soft and will not move around as naturally as a Smooth implant. Since I have so much of my own tissue will this matter, or should I find someone else who will use a smooth silicone implant?

Joe Gryskiewicz, MD, FACS · Answer

Hello,
I would recommend to find a surgeon who uses smooth round implants. The textured aren't as safe. I've been in practice for over 33 years and I swear by Mentor Smooth Round implants. I would happily do a virtual consultation with you if you'd like. 
All the best, Dr. Joe

Ali Riza Öreroglu, MD · Answer

I prefer to select implants based on individual patient examinations and their preferences, but if you're seeking a slight increase in cup size and want a fuller look in the upper part, opting for smooth silicone implants could be beneficial. Despite the advantages of textured implants, smooth implants generally provide a softer and more natural feel, especially for those with ample natural breast tissue. You can also go for nano-textured implants.

Gianfranco Frojo, MD · Answer

I would not recommend textured implants for your case. Textured implants are ideal in patients with short nipple-to-breast fold distances or tuberous breast deformities (technically these are on the same spectrum). In addition, the capsular contracture rate is unreasonably high with the use of textured devices. I would recommend seeing a board-certified plastic surgeon with plastic surgery residency and aesthetic fellowship experience.

Daniel Barrett, MD · Answer

Dear alohakh123,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon' s experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Brian K. Reedy, MD · Answer

Thanks for your question! I would recommend a smooth-walled implant. Textured implants have had increasing issues related to BIA-ALCL so it is not my preference to use them. Good luck!

Gary M. Horndeski, MD · Answer

In your photograph, your breasts are low on the chest wall. More important than implants is a breast lift. The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers or small implants can be placed if additional volume is desired. I do not recommend textured implants.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  A large portion of my practice is dedicated to breast surgery and breast revision.  I have been in practice 28 years and have a considerable amount of experience in this.  Most surgeons prefer not to use textured implants.  I have done an informal study on all of the textured implants over the years that I have removed and over 50% are not incorporated.  In my opinion, there are very few benefits to textured implants and only negatives.  In your case, you definitely would need a lift.  I have seen too many times people with slightly sagging breasts and placing an implant thinking that that it will lift the breast.  All that does is increase the weight to an already sagging breast making them larger and more sagging.  You should be able to have an excellent result with an experienced plastic surgeon.  Best wishes to you.

Ronald J. Edelson, MD · Answer

Mist surgeons use smooth especially since there is increased risk of breast implant associated lymphoma with textured implants

Michele A. Shermak, MD · Answer

Hello! Thank you for your question.
There are many decisions made around how breast augmentation is performed. Typically textured implants are used because the surgeon thinks an anatomical shaped implant would serve his/her patient better. This means less upper pole fullness.
The issue is that the FDA essentially removed textured implants off the shelves because texturing has been associated with inflammation and potential lymphoma - a rare, but real concern.
It looks like you would do well with a smooth round implant.
I would recommend you seek consultation with a board certified plastic surgeon. You can find one at plasticsurgery.org.
Best of luck to you!

Textured or smooth implant? (Photo)

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