What are the pros and cons of smooth versus textured and round versus shaped implants? (photo)

I'm 5'1, 23 year-old female, who weights 108 lbs, and I will be getting a Sientra "gummy bear" textured, high profile implant. I am an "A" cup, 34 A to be exact. Also, which would be best to achieve this look?

Doctor Answers 10

Sientra Breast Implants: Textured or Smooth Pros and Cons

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™ 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.

Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

Textured versus smooth breast implants

Thank you for your question. I agree with others you need a formal consultation with a plastic surgeon to answer this difficult question.

Generally speaking I only use textured breast implants what I am concerned about capsular contraction or correcting a capsular contraction. I generally feel that smooth walled implants feel more natural as the textured implants produces some degree of firmness and most people and it does not move as freely within the breast implant pocket.

What are the pros and cons of smooth versus textured and round versus shaped implants?

Way too much to discuss in this forum, you need to make an appointment for a surgical consultation. But my preference for the best results in most patients is smooth round implants with a moderate or moderate plus profile and with a dual plane technique.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

What are the pros and cons of smooth versus textured and round versus shaped implants?

This would be a very complicated answer and is best done as a formal consultation. In general, more Plastic Surgeons throughout the world currently use textured implants and more US surgeons use smooth. The shaped implants are newer to the US but very common throughout the world. All can have excellent results, but the size, shape, projection, and volume must be specifically tailored to your goals and your anatomy.

For more information, please go to my website at:

Garrett A. Wirth, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 12 reviews

Small round textured silicone best

At size 34 A each 100 cc’s of implant corresponds to 1 cup size change. From this, you can compute the volume required to achieve you desired goal. I always recommend small round textured silicone gel implants placed retro-pectoral since they look and feel more natural, are more stable, less likely to ripple or have complications needing revision. Textured implants are less likely to migrate and have fewer capsule contractures. Implant profile is irrelevant in the retro-pectoral position since the muscle compresses it and determines the projection.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 223 reviews

Textured versus Smooth implants

Thank you for your question.

In my opinion every women should have the knowledge of what implants to choose before the surgery. I believe that both implants give you the best results, but textured implants tend to cause a capsullar contraction more often. Smooth implants are my choice to place, they give you a more natural look and touch.

Jaime Campos Leon, MD
Mexico Plastic Surgeon
4.4 out of 5 stars 253 reviews

What are the pros and cons of smooth versus textured and round versus shaped implants? (photo)

Thank you for your question. Studies have shown that textured implants are associated with a lower incidence of capsular contracture. With regards to round versus shaped implants, I recommend that you make an appointment with a board certified plastic surgeon to discuss your breast augmentation options based on breast measurements and tissue dynamics.

Wesley T. Myers, MD
Conroe Plastic Surgeon
5.0 out of 5 stars 5 reviews

What are the pros and cons of smooth versus textured and round versus shaped implants?

To respond here about these differences would take a few pages. Best to trust your chosen PS to do the best for you..//

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Textured vs Smooth

Posting your pre-operative photo would be helpful. In addition, measurements of your chest and breast are necessary in order to make any semi-educated comment on the implant choice that would be best for you.

As far as the the pros and cons of smooth vs textured implants. This is a highly debated topic in the literature and unfortunately there is no clear answer. Obviously more details can be explained in an in person conversation then over this forum, there are many types of textured implants, however in general some will argue (likely those that use textured implants):

Textured: a little less capsular contracture, a little more seromas, and takes longer to "drop" or settle into the pocket.

Smooth: a little more capsular contracture, a little less seromas, and "drops" quicker postoperatively

As Dr. Wirth noted, most plastic surgeons worldwide use textured implants, while most in the US still use smooth implants, but textured implant usage in the US is rising. I use them because I would like the capsular contracture rate to be as low as possible.

Luis H. Macias, MD, FACS
Los Angeles Plastic Surgeon
4.9 out of 5 stars 60 reviews


I don't like the result you have chosen but a HP implant of significant volume should get you there

Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 62 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.