Risk of capsular contracture with smooth round implants in the subglandular position

Apologies for my endless questions...! I have decided on smooth round implants as I am very concerned about breasts feeling real and moving naturally. Subfascial seems to offer benefits of natural movement and no animation deformity. In terms of risk of contracture, is it too risky to have smooth implants in the subfascial position?

Doctor Answers 4

Capsular Contracture

There is no evidence that subfascial implants have a lower contraction rate than other forms of implant placement. I am yet to be convinced that they confer a greater cosmetic advantage over either sub muscular or sub glandular. I think that it is technically more difficult to achieve a protective covering for the implant than a sub muscular approach. I believe that it is not mainstream surgery yet and like all relatively new techniques it takes some time before the medical literature and the surgical community can confirm its real worth.

Capsular Contracture with Subglandular

Yes   risky 

30 - 50% risk of encapsulation 

would use textured if you have enough soft tissue 

Best Regards 
DR Shamoun 

John Milam Shamoun, MD FACS
Newport Beach Plastic Surgeon
5.0 out of 5 stars 21 reviews


Capsular contracture rate is slightly higher in front of the muscle compared to behind the muscle. Having said that, the difference in rates is not huge. Although textured implants may reduce contracture, I do not like the results, and they have been associated with Acellular Large Cell Lymphoma(ALCL). Google it.  I never use textured implants.
Good luck

Not recommended

Breast augmentation with implants on top of the muscle should be done with textured breast implants.  Use them.  You will love your results.
Best Wishes,
Nana Mizuguchi, MD

Nana N. Mizuguchi, MD, FACS
Louisville Plastic Surgeon
4.6 out of 5 stars 45 reviews

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