Weighing the risks with textured implants?

I have experienced only 6 capsular contractures out of over 15,000 breasts with smooth saline implants.
In my experience, less than 4% rupture rate as well, smaller incision, and cheaper. Hope this information helps. Good luck. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Most physicians in the United States use smooth round implants which are not associated with ALCL. While the risk is very low with textured implants, most prefer smooth.

I am taking out all textured implants in patients who consult with me who have had them previously placed from other surgeons. I do not place textured implants, nor do I recommend them because of their association with ALCL. I would recommend smooth round silicone implants placed sub muscularly.
Good luck on your implant journey.

It's understandable that you're feeling overwhelmed with the decision-making process. Here's a breakdown of the pros and cons you mentioned:

**Textured Implants:**
Pros:
- Lower risk of developing capsular contracture.
- The risk of BIA-ALCL is relatively low (1 in 1 million), but higher compared to smooth implants.

Cons:
- There is a low chance of developing BIA-ALCL (1 in 1 million).
- The textured surface may pose a risk, albeit rare, for other complications.

**Smooth Implants:**
Pros:
- No reported cases of BIA-ALCL associated with smooth implants.
- Traditionally, they have a higher chance of being recommended for a natural feel.

Cons:
- Higher risk of capsular contracture compared to textured implants.

Ultimately, the decision should be made based on your individual preferences, body type, and the guidance of experienced surgeons. It's important to have an open and detailed discussion with your doctors about your concerns, including the specific risks and benefits tailored to your situation. Additionally, consider seeking a second opinion if you're still uncertain. Your peace of mind and confidence in your decision are crucial.


Best of luck !

Textured and smooth are both good implants. The smooth do have a little higher risk of capsule formation. The textured do have a higher breakage rate, risk of later seroma or fluid collection, and the still rare risk of that breast capsule lymphoma. Plus, the shaped textured implants might shift and not shift back. Hope this helps.

I personally see very little advantage with using textured implants and most of the plastic surgeons that I know who have a very busy breast augmentation practices use smooth implants.
Reduction in capsular contraction is really not all that great, with textured implants, and with a correlation of BIA-ALCL the use of the textured implants seems inappropriate.
Plastic surgery standards vary from country to country. If your providers have good, standing history with textured implants and feel comfortable using those then I suggest you go with your providers recommendation.
I do generally encourage people to have multiple consultations before selecting a provider and scheduling surgery.
The following are some general guidelines for patients to find the best provider for their needs.
To find the best provider, I suggest patient schedule multiple in person consultations with experienced plastic surgeons in their community. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patients who have similar body or facial characteristics to your own. An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. An experienced provider should in fact have hundreds or preferably thousands of before and after pictures to choose from for commonly performed procedures.
Being shown a handful of preselected images, representing the best results of a provider’s career is insufficient to get a clear understanding of what average results will look like in the hands of each provider.
There is no correct number of consultations needed to find the best provider. The more consultations you scheduled the more likely you are to find the best provider for your needs.
Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures. It’s not a bad idea to bring pictures of your own body/face to use as reference when reviewing before and after pictures.
The biggest mistake patients make is scheduling only one consultation without properly vetting or comparing providers before scheduling surgery.
Best,
Mats Hagstrom, MD