Weighing the risks with textured implants?

Question

I am an overthinker. That said, can you help me weigh the pros and cons? Two different European board cert drs have recommended textured implants to me. Text Imp have a lower % of developing capsular contracture. On the minus there is a low chance of developing BIA-ALCL. 1 in 1 mil vs 1 in 100 mil of women without implants. Smooth imp have a higher chance of capsular contracture and no cases of BIA-ALCL- yet the cancer is from a type of caps contra from my understanding. In Holland doctors still use text imp because of the low risk of capsular contracture. It's a lot to think about. Help.

Ted Eisenberg, DO, FACOS, FAACS · Answer

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

John L. Burns Jr., MD · Answer

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.

Warren Schutte, MD · Answer

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.

Randal Haworth, MD, FACS · Answer

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 !

Connie Hiers, MD, FACS · Answer

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.

Weighing the risks with textured implants?

Answers (5)