Textured vs smooth - rippling

Thank you very much for weighing in on the subject. Ive explanted in the hope of accepting my cup A. I haven't. Reimplantation is ahead in 3-6 months' time. Do textured implants pose a greater threat of rippling than smooth implants? My first set was textured anatomical. I wasnt happy with the shape.Besides I had visible rippling though my implants were small ones ( just 335 g).

Doctor Answers 10

Textured vs Smooth Implants and Rippling

Thank you for your question.  The short answer is yes, textured implants do pose a higher risk of rippling.  However, smooth implants can also ripple.  The reason for this is lack of overlying soft tissue coverage, especially if placed above the muscle.  The textured nature of the implants tends to adhere to the overlying tissue more than the smooth implant and hence causes more rippling.   The best way to reduce rippling is to place the implants below the muscle. 

Best of luck

Orlando Plastic Surgeon
4.8 out of 5 stars 52 reviews


I am not a fan of textured implants in general but there are occasions that I will use  them.. Rippling mostly occurs because the soft tissue envelope is thin.   Placing implants under the muscle helps as does inserting an acellular dermal matrix.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Breast Implants and Rippling

Hi, and thanks for your question. This can be a difficult problem. Any type of implant can have rippling. Typically the rippling is a little less noticeable with a silicone implant. Textured implants tend to show more rippling because of the potential adherence between the implant shell and the tissue envelope. The main key for rippling is to have enough tissue coverage over the implant. By putting an implant underneath the muscle, you are basically maximizing the coverage over the implant. In some patients, however, even that is not enough to camouflage the rippling if she is very thin. The shaped anatomic implants are typically a more cohesive and thicker form of silicone that in general shows the rippling less than other types. So if you saw rippling with your textured anatomical implants it's pretty likely that you will see rippling no matter which implant that you go with. If yours was previously put in above the muscle, though, that does give you a chance that by going under the muscle instead you will have enough tissue coverage to minimize the rippling.
Good luck and take care,
Dr. Howell

Hampton Alexander Howell, MD
Winston Salem Plastic Surgeon
5.0 out of 5 stars 32 reviews

Breast Augmentation - Choosing I

Rippling will occur with all breast implants and is not noticeable if you have enough breast or muscle coverage of the implant. 

#PlasticSurgery #BreastImplants #BreastAug #Recovery #Choosingimplants #texturedimplants 

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews


On the whole, textured implants because of their thicker shell tend to have more visible wrinkling than their smooth counterparts. Certainly the amount of overlying breast tissue has something to do with it. The newer overfilled silicone gel implants especially with more cohesive gel like this Sientra 207 series tend to ripple less than their underfill counterparts. It's surprising that you had wrinkles with an anatomically shaped implant especially if it was in Allergan for 410 which in my experience hardly ever has a wrinkle because it's so stiff. I recommend you seek the counsel of a board-certified plastic surgeon in your area and discuss these options with your he or she.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 54 reviews

Rippling occurs in all implants

Thank you for your question.  It would be helpful to know where you had the rippling-in the cleavage area, outer part of the breast, etc.  That being said, all implants can ripple to some degree.  I assume you are using silcione; saline implants ripple more than silicone.  Typically round (non-anantomic) textured have more of a tendency to ripple compared to smooth round implants.  Anatomic implants, which are also textured, may ripple slightly less than textured round. Since you did not like the shape of the anatomic, I assume you prefer to use a round, non-shaped implant for your revision.  In this case, a textured round implant may have a tendency to ripple more than a smooth round implant.  I prefer texture because it can minimize tissue stretch and may have less capsular contracture.  If your rippling was in the cleavage area and you have the implant under the muscle, there is nothing else you can do to decrease the rippling except to use a smooth implant.  So you and your surgeon will have to weigh the pros and cons of texture in terms of less tissue stretch and possibly lower capsular contracture rates versus increased rippling.  If the implant was on top of the muscle and you had rippling in the cleavage area, putting the implant under the muscle may help camouflage the rippling.  The newer high fill implants may, and I stress may, have lower rippling rates.  Only smooth are available right now but Allergan may come out with a textured version soon.  These implants are filled to 93% instead of 85%, so theoretically the rippling might be less.  If your rippling was on the outside of the breast, this is a common place for rippling and you may have rippling here no matter what implant you choose.
Hope this helps.
Tracy Pfeifer, MD, MS

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
4.8 out of 5 stars 29 reviews


All implants will ripple to some extent.  It really depends on how much tissue you have covering them.  In very thin women, rippling can be a significant problem.  The textured shaped implants have a more cohesive gel that can result in less rippling.  Also some manufacturers overfill theirs so that rippling is less of a problem.  Nonetheless it can still happen.  Other options include the use of dermal allografts to cover the implant or fat grafting.  

John Michael Thomassen, MD
Fort Lauderdale Plastic Surgeon
4.9 out of 5 stars 52 reviews

Textured vs smooth breast implants - rippling

Thank you for your question.

Textured implants have a thicker wall than smooth implants and can be more palpable. Rippling is usually associated with Saline implants.

The key is getting tissue coverage of the implant. Hopefully your surgeon can place the implant under your muscle for better coverage.

Since you did not like your textured implants I would suggest that you strongly consider smooth round silicone gel implants. For more information please read below:

Smooth vs textured breast implants


Thanks for posting your question. I am happy to try and help you.

Having said that, the biggest issue will be the size of the implants and the quality of your skin. Breast feeding history also is important. As long as you want to maintain an athletic frame both smooth and textured will work. As for most natural, the smooth is the way to go. Textured implants ripple more especially on thin women. Since all shaped implants are textured, I do not recommend them on thin women. If they rotate out of position even a little bit it is very noticeable. Don't worry about the generation of the device that is not the ball you should be keeping your eye on. Select the surgeon with the experience and results that you like.

Best wishes,

Dr. Michael J. Brown
Northern Virginia Plastic Surgeon

Michael J. Brown, MD
Ashburn Plastic Surgeon
4.8 out of 5 stars 33 reviews

Implant visibility and palpability

Only 2 things control how much you see and feel implants. The device itself and the amount and quality of tissue hiding it. Saline is more visible and palpable than silicone. Silicone that has a higher fill ratio or is thicker gel has less rippling. The texture has little to do with rippling. If you were subglandular go submuscular. There are many variables that requires an in person exam. 

Evan Feldman, MD, FACS
Texas Plastic Surgeon
5.0 out of 5 stars 87 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.