Textured versus Smooth Implants for Breast Augmentation

Boston plastic surgeon Dr. Brooke Seckel discusses the difference between textured and smooth breast implants for breast augmentation

If you have decided that you want to have breast augmentation in Boston there are many decisions that you will have to make with the advice and help of your board certified plastic surgeon. In addition to deciding on implant size, location of incision, and implant under or over the muscle, you will also have to decide between smooth breast implants and textured breast implants.


What is the difference between textured and smooth breast Implants used in breast augmentation?

Breast implants consist of an outer silicone rubber shell which surrounds and contains either silicone gel or saline. Smooth breast implants have an outer silicone rubber shell which is very smooth, shiny and slippery. Smooth implants do not attach to the surrounding body tissue and are usually freely moveable within a tissue membrane or sack that forms around the implant and is called a capsule.

Textured breast implants have an outer silicone rubber shell with a rough, pebbly, irregular surface almost like soft rubber sand paper. Textured implants attach to the tissue capsule around them and are less likely to move.

Textured and smooth breast implants used for breast augmentation

Textured Breast Implant on left smooth implant on right

Why are textured and smooth breast implants available for breast augmentation?

One problem that can occur after breast augmentation is when the tissue capsule or membrane surrounding the breast implant becomes very tight. This condition is called capsular contracture and causes the breast to feel hard.

In the 1980’s textured breast implants were developed with a rough surface like sandpaper because research suggested that breast implants with a rough surface were less likely to cause capsular contracture.

Before and after breast augmentation with smooth round 350cc breast implant

Before and after breast augmentation with smooth round 350cc breast implant


Textured Breast Implants versus Smooth Breast Implants and the rate of Capsular Contracture after Breast Augmentation.

A research study published in the 1993 Journal Plastic and Reconstructive Surgery found that there were significantly fewer capsular contractures in patients receiving textured breast implants compared to those who received smooth implants. Another controlled study in the 1996 Journal of Plastic and Reconstructive Surgery had similar findings. However a prospective study published in the 1997 Journal of Plastic and Reconstructive Surgery found no difference in the rate of capsular contraction between textured and smooth implants.

As a result of the conflicting studies many plastic surgeons do not believe there is strong proof that textured implants reliably reduce the rate of capsular contracture.

Can you feel the difference between textured breast implants and smooth breast implants?

When textured or smooth breast implants are placed beneath the chest muscle in a patient with adequate breast tissue overlying the muscle it can be impossible to feel the difference between the two.

However textured breast implants have a thicker wall than smooth implants and thus can feel firmer. In addition textured implants are more likely to have palpable folds and ripples. Thus in very thin people with little breast tissue, if the textured implant is placed on top of the muscle it is more likely to be felt than a smooth implant.

Can you see the difference between textured breast implants and smooth breast implants?

Under ideal circumstances with implant beneath the muscle and adequate breast tissue over the muscle you cannot see a difference between a textured and a smooth breast implant after breast augmentation. However the risk of visible folds and ripples is greater with textured implants than with smooth implants. This is particularly true in thin patients with little breast tissue and more so if the textured implant is placed on top of the muscle under the breast.

Before and after breast augmentation with 350cc textured round breast implant

Before and after breast augmentation with 350cc textured round breast implant

When are Smooth Breast Implants Used?

Smooth walled silicone and saline breast implants are the most common choice of breast augmentation patients and plastic surgeons today. The new cohesive silicone gel smooth walled breast implants approved by the FDA in 2006 are much improved over the smooth walled implants in use prior to the 1980s. Today when possible breast implants are placed beneath the chest muscle which provides better coverage, less chance of visibility, and less risk of capsular contraction. The combination of an improved smooth-walled implant and modern plastic surgical techniques have reduced the chance of capsular contraction to well below 10% and with the best techniques as low as 2%.


When are Textured Breast Implants Used?

Many plastic surgeons have a preference for textured round breast implants and continue to use them routinely. In addition the new anatomic shaped or teardrop shaped breast implants are only made with a textured shell. The textured implant shell is firmer and stiffer and thus holds its shape better than a smooth implant. Therefore if you choose to have a shaped breast implant you will have to have a textured breast implant.

Textured breast implants are also often used to replace implants after removal of a capsular contraction. This is done in an attempt to prevent the recurrence of the capsular contraction.

Textured tear drop shaped breast implant for breast augmentation

Tear drop shaped textured breast implant

How Do You Decide?

Your decision to choose textured or smooth breast implants can only be made during your consultation with a plastic surgeon who is certified by the American Board of Plastic Surgery and very experienced in breast augmentation. Your plastic surgeon will explain the differences and help you decide. Most likely if you are having standard round breast implants you will choose a smooth breast implant. However if you chose a tear drop shaped breast implant you will have a textured breast implant. If your surgeon is one who prefers round textured implants be certain that the implant will be placed beneath the chest muscle and not under the breast on top of the muscle if at all possible.

Schedule Your Consultation Today

Dr. Brooke Seckel is a board certified plastic surgeon with years of experience performing breast surgery for women throughout Boston. If you are interested in learning more about this procedure, or other procedures such as stretch marks removal, double chin treatment and buccal fat pad removal (cheek reduction) contact Dr. Seckel today at 617-455-2859.