Textured Vs Smooth Under Muscle - Does It Help with Gravity?

Read that textured may help with gravity, that is that the textured vs smooth may help the implant stay in place hence less need for a lift in the long run vs smooth. Is this correct. Recently changed my mind from textured to smooth based on that they feel more natural even when under and that they move more like a natural breast vs textured.This is from girls who have had both or have felt both on others. I read not much difference in CC when both undergoing hence opted for smooth but now ?

Doctor Answers 16

Textured versus smooth breast implants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The likelihood of implant and breast sagging over time is far more dependent upon the size/weight of the implant and the elasticity/tone of your skin. Although texturing can create a minor amount of "stickiness" with respect to the capsule, it will not prevent bottoming out or implant ptosis over an extended period of time. Advantages of implant texturing focus on capsular contracture rates. However, many surgeons and patients prefer smooth implants as they "move" with the breast more naturally, rather than the breast "moving" over the implant. If you are significantly concerned about sagging over time, one option that works well is the use of a dermal matrix (Strattice for elective cases). This allows for an "internal bra" which supports the implant and reduces the impact on the lower pole of the breast. It usually requires a submuscular placement and does add significant cost to the procedure. However, it also has a very low rate of capsular contracture. Definitely something to consider.

Boca Raton Plastic Surgeon
5.0 out of 5 stars 26 reviews

The purpose of breast implant texture in augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The answer concerning breast implant texture, vs. a smooth implant is simply capsule contracture. Smooth silicone implants were prone to capsule contracture and texture was added in an attempt to reduce the contracture rate. There were many types and patterns developed to 'confuse' the scar and reduce the tightness. The trade-off is more surface 'grab' which causes ripples or folding for some, and a reduction of the implant lifespan. Today most surgeons prefer a submuscular smooth implant. The texture will not reduce droop of the breast or reduce the need for a breast lift.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Breast implants and gravity

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It is difficult to prove such things but in my opinion and experience, the surface of the implant and even its volume has little or nothing to do with actual sagging of the breast in the future. I also think it's a myth that wearing a bra or not wearing one has anything to do with it. Breast implants are like pillows behind the breast and really don't influence what the breast above it does. There are situations where the capsule around the implant stretches and the implant sags down but this is different from breast ptosis. 

I agree that smooth-wall, round implants have the most advantages overall including, possibly, a lower deflation rate compared to textured surface silicone shell implants. 

I tell patients not to plan or count on breast sagging because of the implant but that they might for other reasons and if they do then a mastopexy can be done in the future with or without doing anything to the implant. 

Scott L. Replogle, MD
Boulder Plastic Surgeon

Textured versus smooth breast implants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It sounds as if you have a good appreciation of the issues involved. A textured implant may resist gravitational changes with time but this may present with beneficial as well as detrimental effects. Occasionally, the implants remain relatively fixed in place whereas the breast tissue may sag over the implant producing a double bubble appearance.  When placed under the muscle the risks for CC are difficult to measure when discussing smooth versus textured and generally don't support their use.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Textured vs. smooth

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

THere are subtle differences between the implants in terms of capsular contracture and rippling.  BUT neither would obviate the need for a lift in the future.  This truly is where art meets science.  Surgeons will generally use whichever they are more comfortable with.  Pocket placement must be precise with textured implants because they tend to adhere to their location and not "drop" into place like a smooth implant.

David A. Lickstein, MD
Palm Beach Gardens Plastic Surgeon
5.0 out of 5 stars 9 reviews

Smooth over Textured

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Textured implants came out in the late 1980's and early 90's to replace what were known as the Meme implants.  These implants had a polyurethane layer over the implant.  Although there were some problems with this implant they did have an extremely low capsular contracrture rate.  This is what texturing attempts to simulate.

I use only smooth implants when I use round implants.  I reserve using texture when I am using a shaped implant such as the new Gummy Bear or 410's.  I have always found that textured implant wrinkle much more and don't offer any advantage over smooth, especially in the submuscular position.

Smooth - Good choice, good luck

Textured Implants Do Not Slow Drooping

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Textured implants do not prevent or slow drooping of the breast, which occurs in front of the implant, with the laxity of the breast tissues and skin over time.

Smooth implants do feel more natural.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.7 out of 5 stars 46 reviews

Smooth implants- simple is better

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I was trained to use smooth implants in primary augmentation cases. I think they wrinkle less than smooth implants. We place all implants in the sub-muscular position, so any small reduction in capsular contracture observed with the use of textured implants is really negligible in this position. The new form stable implants that will come out someday are all textured. This will help prevent implant rotation, which can be a major issue when a form stable implant is used, because of their asymmetric shape and volume.

Smooth vs. textured breast implants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Theoretically what you are saying makes sense, that the textured are less prone to shift in position from gravity than the smooth. However, that has not been proven. There are other factors such as placement over vs. under the muscle, the actual implant weight etc. that also come into play. I would guess that if you put a very large implant in the breast it will shift downward over time regardless of the texturing. What's very large for a 5' tall individual is not so large for a 6' tall individual.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Smooth breast implants have been our choice for ten years

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

We prefer smooth, round breast implants. A  natural look and feel can be achieved with these implants. Recenly, we replaced textured implants with smooth ones in 2 patients and they were amazed at how much better the smooth ones felt.

Francisco Canales, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 35 reviews

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.