I have Mentor Siltex silicone implants exchanged from Mentor smooth 23 years ago. No CC this time. Should I stay with textured?

Question

I have had no capsular contraction since but feel it is time to do an exchange. Should I stay with Siltex given my history of CC with the first set of smooth? I am a 69 year old female in excellent health. I’m afraid to go back to smooth if it would be increase my chances of getting CC. Does it really make a difference using either textured ir smooth implants as far as likelihood of contraction? My implants are on top of the muscle and I prefer them that way.

Daniel Barrett, MD · Answer

Dear Realreal98,
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

Connie Hiers, MD, FACS · Answer

If you have the new gel implants, (new gels were not available to most surgeons in the US until 2007) and if you are having no issues, then just have an ultrasound and/or mammogram to check your implants. If they are ruptured, replace them.  If not, keep them.  Since you have done well with Mentor Siltex, then you can have them again. I no longer use textured implants for augmentations because of the increased risks of late fluid forming in a pocket that tears away from the implant. Also, textured implants have a shorter lifespan than smooth.  I saw that in my own patients during 1992-2007 when saline implants only were being used.

Douglas Taranow, DO, FACOS · Answer

I would replace your implants with the same Siltex implants you now have.  Why test fate...you have no issues now, continue with the same.
Best wishes,
Dr. Taranow

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