The surface of breast implants come in two varieties: smooth and textured.
The smooth surface is the covering of the implant which is made of silicone. The inside of the implant contains silicone or can be filled at the time of surgery with saline (salt water).
The textured implant has a textured surface attached to the silicone shell of the implant. As the name implies this implant feel s “rough” to the touch.
The theory behind the textured surface is to minimize the risk of capsular contracture, and reduce the risk of rotation for anatomical implants.
What is capsular contracture? Any non-absorbable foreign body placed inside our body will form a “capsule” around it. Since the body cannot absorb this material, it “ignores” it buy forming a capsule (think of it as a very thin egg shell) around the foreign body. In some instances, this capsule becomes thick and starts to contract. This contracture will cause the breast shape to change and the implant will become tight and deform.
In the laboratory, a textured surface lowers the risk of capsular contracture. However, in the real world, this reduction is not as clear cut. If an implant is to be placed above the muscle (the pectoralis muscle is the muscle which lies underneath the breast tissue), there may be a higher risk of capsular contracture with a smooth surface implant. The risk of contracture is essentially the same if the implant is placed under the muscle. I always place the implant under the muscle, due to better protective covering, less implant palpability, and less interference with future mammography.
The two main issues with textured implant are the higher cost and the increased risk of rippling. Textured implants are more expensive to manufacture. Secondly, the breast and the surrounding tissue will become “stuck” to the textured surface. As the patient and the breast tissue moves, the stuck tissue will pull on the overlying skin, causing “ripples”. Trust me, this is not attractive!
Given the increased cost of the textured implants and the theoretical advantage of reducing capsular contracture, I do not feel their use is more beneficial than smooth surface implants.
Michael A. Jazayeri, M.D. is a board certified plastic surgeon. His office is centrally located in Orange County, in the city of Santa Ana. To schedule a complimentary consultation, please call (714) 834-0101.
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