Sientra: Textured vs. Smooth?

Question

Aside from the obvious, what is the difference between textured and smooth implants? There doesn't seem to be a visual difference. Is it just about the feel of the implant and what that person prefers?

Larry S. Nichter, MD, MS, FACS · Answer

Of interest is that about 90% of the world outside the United States prefers textured breast implants, where as almost the reverse is true in the USA. I think this trend will change as textured implants such as Sientra's use more highly cohesive silicone gel so that there is less likelihood of rippling. The big advantage is that  a primary augmentation patient will qualify for a free replacement implant if she requires revision surgery to correct a significant capsular contracture within the first two years after implantation. Perhaps most importantly from a patients perspective is that breast implant "massage" is not needed with textured implants, and they don't drift to the side when you lie down.Sientra’s TRUE Texture&trade; implants were found to carry a significantly reduced risk of capsular contracture compared to its smooth implants, according to a study published  in Plastic and Reconstructive Surgery. The analysis looked at more than five thousand implants over a five-year follow up process, providing a very robust set of data as a foundation for this finding. It is with this statistical confidence in the resilience of their textured implants against capsular contracture that Sientra introduces the C3 Program.As with the implants themselves, Sientra’s C3 Program is only available through plastic surgeons certified by the American Board of Plastic Surgery. This is done to improve patient confidence even further — it ensures that surgical procedures using Sientra implants are only done by the most qualified doctors.

Robert Cohen, MD · Answer

Every implant has its own set of pros and cons and there is
no perfect implant. However, generally I tend to use mostly textured anatomical
implants because I feel these have the most advantages and the least
disadvantages. Advantages are texturing over smooth implants including more
stable position to the implant, which is less likely to shift over time, lower
risk of capsular contracture and the elimination of the need to do breast
massage every day after surgery. The shell of textured implants can be slightly
thicker and are slightly more palpable through the skin in thinner patients.
However, when using a formed stable anatomical implant such as Sientra’s
classic anatomical implant, the implant still has a very soft and natural feel
and can create an excellent shape in thinner patients. Smooth round implants
will feel slightly softer and have a thinner shell, however they are more
likely to shift out of position over time because they are not adherent to the
tissues and do not have a coefficient of friction that prevents them from
sliding around in the pocket.

John L. Burns Jr., MD · Answer

Implant texturing is hypothesized the reduce the rates of capsular contracture in subglandular augmentation.  The textured surface impedes the body's ability to form scar tissue around the implant.  Sientra provides a capsular contracture warrenty for 2 years for their textured implants in cases of primary augmentation.

Joe Gryskiewicz, MD, FACS · Answer

Hi,Textured Sientra implants in the largest published study showed less capsular contractures.  They may migrate less, also.  Sientra uses a proprietary process to texture their implants.   Because of this Sientra is the only implant
company who has a warrantee (C3)if you develop a capsule after receiving their
textured implants.  They have a special process which makes the  texture. 
This implant shell is unavailable elsewhere.  Sientra only sells to BC plastic surgeons (by
ABPS - The American Board of Plastic Surgery) who are members of
ASAPS (The American Society for Aesthetic Plastic Surgery) and or a member of
ASPS (The American Society of Plastic Surgeons). All the best,  "Dr. Joe"

Elisa A. Burgess, MD · Answer

In particular, the shaped implants should be textured to help prevent rotation.  The Sientra shaped implants are textured and the goal is for them to adhere to the tissue.   Other names for shaped implants are anatomic, teardrop, form stable, cohesive, or gummy bear.  These are all catch phrases for this classification of implant.  Mentor and Allergan also make this classification of implant and they are also textured. Most people make their selection of silicone implant based on how the gel feels and not how the shell or textured part feels.  You can't really feel the textured shell once it is inside you.  Your plastic surgeon will probably have all of these types of implants available so that you can feel them side by side.  I find that many of my patients like the feel of the Sientra gel.  Good luck!

Peter J. Capizzi, MD · Answer

As a Sientra implant user, the textured implants in their portfolio are the most advanced textured process available with the finest results in our plastic surgery literature.  The Mentor textured process is an imprinting process resulting in a more shallow textured surface.  The Allergan process is one that results in deep pores and is the most aggressive as they state.  The Sientra product is Tru-texturing and is a proprietary process that results in a soft feel, stable surface that adheres to the soft tissue and results in the lowest capsular contracture rate on the implant market today.

Christopher S. Verbin, MD · Answer

Textured breast implants have shown less capsular contraction, and can provide a better over-all and softer breast. They can be placed above and below the muscle.  Round textured implants integrate better into the body. However, in a patient with a very thin chest wall, some visible rippling effects can occur, so if a round implant is preferred, a smooth round implant would give better results.Shaped implants are textured, and do not have the tendency to ripple like the textured round.  Shaped (tear drop, anatomical) implants are my preference and is what I use for the majority of breast implant patients due to the advantages of a lesser chance of capsular contraction, better shape, and less issues or dangers of rupture and gel migration. There has been no reported case of Sientra shaped implant rotation.

Farbod Esmailian, MD · Answer

This has become a popular topic once again with the emergence of Sientra.  Sientra has made a big push with the textured implants.  Texturing implants has been around for a long time now.  The idea for its use came about with the rise of capsular contracture and subglandular breast augmentation.  Some data has shown a decrease of capsular contracture with textured implants when they are placed in SUBGLANDULAR position.  However, there really has not been any good studies that have a decrease in capsular contracture with textured implants when they are placed in a subpectoral (behind the muscle) plane.In fact the use of textured implants does  have some unwanted effects.  There has been some cases of anaplastic lymphoma reports secondary to texturing of the implants.  There is also the issue of increased seroma, double capsule, and traction rippling with textured implants.  Also, with certain textured implants tend to have a higher ruptured rate.The link below has some more information regarding breast implants.Hope it helps.

Troy A. Pittman, MD, FACS · Answer

Thank you for your question.  There is not an obvious visual difference between textured and smooth implants.  The biggest difference between the two is the feel of the implant.  Textured implants tend to move a little less than smooth implants.  I've had patients complain that the textured implants feel a little artificial.  It is somewhat easier to create cleavage with a bra when smooth implants are placed.However, using textured implants to prevent migration of the implant may be beneficial in cases of a chest wall deformity (pigeon cheated individuals) or in cases where there is a risk of bottoming out.Textured implants have a lower rate of capsular contracture as well.Hope this helps.  Best of luck.

Michael Law, MD · Answer

For shaped implants both Sientra and Mentor  have 5th generation gel.  Each company has different styles and shapes for different body types and desired outcomes.  All shaped implants are textured to avoid rotation.  Sientra uses a proprietary method of texturing called True Texture that has a proven track record internationally over the past 20+ years.  In the FDA clinical trials Sientra had zero rotations, and 4.9% rupture rate.   Mentor uses a stamping method for texturing that has uniform shallow groves in the implant called Siltex.   In the FDA trials Mentor had a 3.4 % rotation rate, and rupture rate of 10.6% .

Sientra: Textured vs. Smooth?

Answers (15)

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