Why Do Textured Saline Implants Have a Shorter Lifespan Than Smooth Implants?

I have smooth saline implants, after major weightloss, i have a lot of loose skin. My doc put in 595cc in one, 600cc in the other. Within one month postsurgery, left one is soft, but ripply on the underside, right developed CC IV. Doc wants to replace both with textured, larger size, overfill both to keep from wrinkling and CC. I've read textured do not last as long as smooth, how much less do textured generally last than smooth, and why is that?

Doctor Answers 5

Why Do Textured Saline Implants Have a Shorter Lifespan Than Smooth Implants

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Great question. The exact reason is unknown, However we do know that the number one cause for implant failure is called crease fold failure. It is thought that textured implants tend to have a greater tendency for folds to persist once they are formed.

Textured Saline Implants DO last less than Smooth Saline breast Implants

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Regarding: "I've read textured do not last as long as smooth, how much less do textured generally last than smooth, and why is that?".

All breast implants ripple. Silicone gel breast implants ripple less than Smooth saline implants which in turn ripple less than textured saline implants. The reason for the increased rippling of textured implants is related to their fixed, velcro like immobility in the breast pocket where they attach to the surrounding breast/muscle tissue so that any gravity on the implant , such as leaning forward, translates to a down pulling of the implant accentuating these folds. (That is why putting textured saline implants over the muscle / under the breast in thin breasted women is a bad idea).

While a smooth saline implant rotates in the pocket, the textured implants are fixed. This means that the folding happens in the exact same spots leading to faster shell fatigue and leaking.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Textured vs Smooth Surface implants

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Textured breast implants were developed about 15 years ago with the intention to reduce the chance of capsular  contracture. The thinking was that the textured surface would produce a micro-inflammatory reaction and that would prevent or lessen capsular contactrure.

This was never proven to be true. Textured implants have not proven to offer any advantage in the prevention or lessening capsular contracture. Therefore most US plastic surgeons have aborted their use.

Textured implants are used more frequently in Europe. European surgeons favor them because they think they reduce capsular contracture. Once again there is no scientific evidence for that. I must note that European plastic surgeons tend to place the breast implants over the muscle instead of under. In these case where the implants are placed over the muscle the textured implants might be advantageous in reducing capsular contracture.

A Swedish professor of plastic surgery published 3 years ago the best study on this issue. He performed a series of breast augmentations all by himself. So all patients had the same surgeon and the same technique. Each patient got a textured implant on one breast and a smooth surface implant on the other breast. His results showed that there was no difference in the rate of capsular contracture between textured and smooth surface implants. This is the best study ever on this topic.

This is the evidence pertaining to your question. Textured implants may last as long as the smooth surface implants.

The key decision i you must make is if you wish to have another set of breast implants. Since you developed capsular contracture you have a very good chance of developing capsular contracture again. The cause of capsular contracture is not  known. However it is a biologic response  of the body to the implants. If   you get new implants of any kind and any  type  you must know that you may get capsular contractrure again.

Consider the option of removing the implants and having a mastopexy.

Discuss all your options with your doctor.

Textured implants and lifespan

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Interesting thought that textured may not last as long as smooth walled, but this has not been verified in the literature, although anecdotally I do find that textured seem to rupture  more often.

Textured saline implants have a shorter lifespan

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In total agreement with Dr. Aldea's explanation. Easy concept to understand if something is fixed (textured implants) and can not rotate in position than the wrinkling cause the outer coating or shell of the implant to "fatigue" or rupture in micro cracks at first. While smooth non fixing implant surfaces rotate so there is much less shell fatigue. 

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.