Are Textured Implants Under Muscle Hard?

Texturing is a process which supposedly lowers the incidence of capsular contracture. However, this is not consistent. It promote growth of the capsule into around the textured surface which creates the impression of a thicker capsule as well a relatively immobile one. Furthermore not all textureing is the same

Textured breast implants have been shown to have less scaring around them and are utilized when shaped into a cohesive gel that is anatomic or tear drop. The textured shell allows for tissue adherence and keeps the anatomic implant in one position, which is not necessary for a round implant, especially when placed under the muscle. They have been shown to have more rippling which is related to the thicker scar around the implant. This would be nullified when placed under the muscle. In the US, textured anatomic silicone implants are not available, but outside of the US they are. Is there an advantage? That is difficult to say, because breast augmentation should have little margin for error, and an anatomic implant and a textured implant can add that extra variable which can throw the final result off. You will be happy with a smooth round breast implant placed in the subpectoral pocket. 

Yes, the feel of a textured implant is different.  If you are placing them under the muscle there is no real indication to use a textured implant.  The feel of a scar around a smooth implant is a little bit thinner.  The incidence of contracture under the muscle is the same for a textured and a smooth implant.  The data is very inconclusive so a smooth implant under your muscle is indicated.

Best Wishes

To achieve the softest feel of an implant, I recommend a smooth silicone gel implant. The texturing is of little importance unless the implant is shaped or anatomical.

I recommend that if you are seeking the most natural, softest, least likely to ripple implant, then go with the smooth wall, silicone gel implant placed under the muscle.

150 cc implants seem ver small.  You may also want to consider a low profile implant.

 

sek

I use smooth round implants and can get a very natural looking and feeling result.  Textured implants were developed to reduce capsular contracture (bad scar tissue forming around the implant) but when placed under the muscle, the rate of capsular contracture is very low regardless.  If you want a very natural feel - silicone is the best choice for you.

I am not a big fan of textured implants because I feel that they do not move as freely as smooth implants.  Choosing the right size for you would have to be determined by physical exam.

Women with little natural breast tissue may especially benefit from placing implants under the muscle.  Smooth silicone gel implants may also provide the most natural feel.  Hardness that may develop is most likely secondary to scar tissue developing around the implant, a capsule contracture and not related to the textured surface of the implant.

Regarding: "Are Textured Implants Under Muscle Hard?
I am 38, Asian, 160cm, 48kg, 32A cup, breast fed twice. Not only the look, I want the feel to be as real as possible. I don't aim to have the image of a woman with big breasts. I liked this doctor for his reputation and experiences and he who recommended textured implants (150cc) under muscle, but another clinic had better/softer implants (textured but much smoother). Would the feel/movement be different depending on implants?"

The choice of implant can definitely influence the look and feel of the breast. Personally, I think gel implants placed under the muscle would give you a better result. I do NOT like textured implants but cannot comments on the implants used in Japan as they may be different than the ones available in the US. The texturing adheres to the tissues creating more rippling and results in quicker deflation than the smooth implants. In the US it is rare for us to use 150cc implants. The average bring in the 300's or so. I would therefore defer to your surgeons. I would re-think the texturing and softness issues - they are important considerations.

 

Dr. Peter Aldea

"Hardness" that develops after breast augmentation is usually the result of capsular contraction. Different surgeons will have different preferences based on experience but I seldom use textured implant any longer for augmentation. The texture was developed as an attempt to reduce capsular contracture. Much is still not understood about capsular contracture however. Polyurethane implants were available in the 80's and had a demonstrable decrease in capsular contraction rates. These were removed from the market because of health concerns. The manufactures of silicone implants developed proprietary texture coatings to try to replicate the benefits of polyurethane. There were some studies that did seem to show benefit to the texture with silicone gel implants but there was much less data on saline filled implants. The texture does add to the wall stiffness in my opinion and folds or ripples may be more apparent. Again, this is based on individual preference and experience of the surgeon. I feel silicone gel implants give a more natural feel because of the cohesiveness of the gel which cannot be replicated by saline. Where you place the implant relative to the gland and muscle really is a choice that needs to be made at the time of consultation based on the individual anatomy and what you are trying to accomplish