Breast Implants: Smooth & Textured
by Tim Neavin, M.D.
Saline and silicone breast implants come in both textured and smooth flavors. Most women who already breast have implants sitting in their body probably don’t know if their implants are of the textured or smooth type. And most women that see me for breast augmentation don’t know there are different textures to these devices.
Textured breast implants have a rough feel to their surface. Smooth breast implants are just that, smooth. The different textures of the outer shell lend themselves to different behavior within the body. While most breast implants used in the United States are smooth, I do think there is a trend of using more breast implants of the textured variety, particularly from the brand Sientra. (Of note, there are currently 3 major breast implant companies providing breast implant choices to women: Allergan, Mentor, Sientra).
There may be an advantage of using textured devices for reduction of capsular contracture (hardening of the breast from implants). Some evidence does suggest this trend. However, there may also be a slightly increased risk of rippling (wrinkling) of the breast, particularly in very thin women who have very little breast tissue.
Textured breast implants incorporate into the tissues, unlike their smooth cousins. This could be of either benefit or detriment. When placed properly, textured implants less often fall to the side when lying down, which is a common complaint of thin women with larger breast implants.
However, they may also not fall and “mature” as nicely as the smooth devices. That is, breast implants generally stretch out the lower portion of the breast, giving large implants the ability to develop into naturally looking breasts. The prettiest breasts are shaped with 55% of the volume below the nipple.
Larger textured breast implants, because they incorporate into the tissue, may not “fall”, resulting in less volume below the nipple. The effect is superior breast fullness imparting a more unnatural look. While some women prefer this, most do not.
In summary, breast implants are smooth or textured. Textured implants have both advantages and disadvantages. The ideal candidate for a textured device is a woman who is not thin, who has had a prior capsular contracture, who has reasonably sized breasts, with no breast sagging.
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