Textured or smooth, is there a difference when sub-muscular?

Hi,IHaveGotVeryLittleFat,VLittleSkin,VLittleBrstTissue on my chest, but, I want to achieve full, as natural as possible looking breasts. I wanted to go for smooth implant as they are soft in feel, I care about that, and I've read that textured implant's borders are quite visible, but IsItTheCaseEvenIf you go sub-muscular? IWantMyBreastsToBeQuiteCloseTogetherCreatingA cleavage, I don'twant to have this effect whenEachBreastGoesReallyFarOutsideTheChestFrame, I'd hate that. So, smooth or textured?

Answers (8)

Breast augmentation

Is my opinion the implants placed under the muscle tend to have a softer and more natural look because the muscle drapes gently over the top of the implant. When implants are placed above the muscle, particularly in the very thin patient the result can look like a coconut stuck to the chest. There is also clear evidence that capsular contracture rates and infection are lower when implants are placed under the muscle and that mammography is better. For my athletic patients, which is about 99% of my practice, when they go to the gym and bench press or weight lift the implants will look less natural for that moment in time because the pectoral muscle pushes on the implants. But for the 97% of their lives, not bench pressing or weight lifting a submuscular implant I believe he is a much more natural appearance. While a woman with a fuller breast can sometimes hide a subglandular implant pretty well, a subglandular implant can burn bridges for patients who might want a breast lift in the future. A subglandular implant separates the breast tissue from the muscle. If the patient wants a lift in the future the blood supply to the nipple and the areola is more in jeopardy. Best wishes.
Antoine A. Hallak, MD, FACS

San Diego Plastic Surgeon
5 reviews

Implant options

In my experience textured implants, because of the manufacturing process, create a slightly thicker shell which has the potential to cause more rippling and visible, palpable problems with the implant.  This is especially true with saline implants. Shaped implants generally require a textured surface to promote "sticking" or adherence of the implant to your own tissue to prevent rotation of the device. If a shaped device rotates inside your body the result is unpredictable. The studies indicate there is little difference in capsular contracture between smooth and textured implants as long as they are under the muscle. Hope this answers your question. Most plastic surgeons in the US use smooth round silicone gel filled implants placed under the muscle. Dean Vistnes.

Sub muscular vs Sub Glandular placement

A: Sub muscular vs Sub Glandular placement
Submuscular placement may be more uncomfortable the first few days following surgery. The possible benefits of submuscular placement are that it may result in less palpable implants, less capsular contracture, and it will make it easier to image the breast with mammography. The appearance may be more “natural” for patients who are very thin. Subglandular placement may make your surgery andrecovery shorter and you may have less discomfort. This placement may provide a slight “lift”. Subglandular placement may result in more palpable implants, more capsular contracture and more difficult imaging of the breast with mammography. This placement is often recommended for those patients with sagging, but do not want a breast lift (mastopexy) and for tubular breast deformity
Larry S. Nichter, MD, MS, FACS
Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
183 reviews

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If you want smooth breast implants have smooth breast implants

Thank you for your question.  Smooth breast implants are used far more commonly in the United States than are textured breast implants.  There is no reason for you not to have smooth breast implants placed beneath your chest muscle, they should work fine.  You're correct that textured implants can be firmer, and are more difficult to place during surgery.  Always respect your own feelings and have what you want.

Textured or smooth, is there a difference when submuscular?

   In general, textured implants can be more palpable and visible.  Smooth implants under the muscle are a more common choice.

Kenneth Hughes, MD

Los Angeles, CA
Kenneth B. Hughes, MD
Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
552 reviews

Smooth or textured

I would recommend choosing a surgeon you trust and go with their guidance. There are a lot of opinions about the differences between smooth and textured implants. I can present data from the literature to argue for any opinion.

 Many of the problems that are seen I believe are due to many different choices made in the placement of the implants such as pocket, size, type of implant, etc. As one surgeon has mentioned most US surgeons place smooth implants under the muscle yet we still see the problems that this technique is supposed to minimize. I realize my answer may not help guide you at all but I would recommend that you interview different surgeons and express your expectation for your result. Then let the surgeons guide you in what they feel will give you the best result in their hands. Then choose the one you have the most faith and trust in. 
David M. Kahn, MD
Palo Alto Plastic Surgeon

Smooth vs. Textured Implants?

I prefer smooth implants over textured. Smooth implants have a thinner shell, are softer in feeling, and are less likely to rupture. Overall, there is a lower complication rate with smooth implants compared to textured implants

Smooth or textured?

This depends on the saline or silicone and which manufacturer of the implants.  Some textured saline implants have a thicker shell that may make the implant more palpable.  One silicone implant company warranties their textured silicone implants against capsular contracture for two years when the implants are placed under the muscle.  This decision is best made in consultation with your American Board of Plastic Surgery certified surgeon.
Todd C. Case, MD
Tucson Plastic Surgeon

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.

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