Smooth vs. Textured Breast Implants: Which One Should You Choose?
Introduction
When considering breast augmentation, one of the key decisions is choosing between smooth and textured breast implants. The implant surface type can significantly impact aesthetics, feel, longevity, and potential risks.
This guide explores the differences, benefits, and risks of smooth vs. textured breast implants, helping you make an informed choice based on your body type, lifestyle, and desired results.
What Are Smooth and Textured Breast Implants?
Smooth Breast Implants
✔ Feature a soft, seamless outer shell.
✔ Move freely within the breast pocket, mimicking natural breast movement.
✔ Often used in round implants for a softer, more natural feel.
Textured Breast Implants
✔ Have a rough, sandpaper-like surface that adheres to the surrounding tissue.
✔ Designed to stay in place, reducing the risk of implant rotation.
✔ Commonly used with teardrop (anatomical) implants to maintain their shape.
Smooth vs. Textured Breast Implants: Key Differences
| Feature | Smooth Implants | Textured Implants |
| Feel | Soft and natural | Firmer |
| Movement | Moves freely within the breast pocket | Stays in place, reducing shifting |
| Shape | Mostly round implants | Used for both round and teardrop implants |
| Capsular Contracture Risk | Slightly higher risk | Lower risk |
| Rippling Risk | Lower in silicone; higher in saline | More noticeable in thinner patients |
| BIA-ALCL Risk | No confirmed cases | Associated with certain textured implants |
When to Choose Smooth Breast Implants
- If You Want a Soft, Natural Feel
Smooth implants move freely within the breast tissue, mimicking natural breast movement. They feel softer to the touch, making them a preferred option for patients who prioritize natural texture.
- If You Prefer a Round Breast Shape
Since smooth implants are mostly available in round shapes, they provide consistent volume distribution and a fuller upper breast appearance.
- If You Want Lower Risk of Implant Rotation
Because they are round and can move without affecting breast shape, smooth implants eliminate concerns about implant rotation, which can cause distortion in teardrop implants.
- If You Have Thinner Breast Tissue
Patients with less natural breast tissue often experience less visible rippling with smooth implants, particularly silicone-filled options (Spear et al., 2019).
When to Choose Textured Breast Implants
- If You Are Getting Teardrop (Anatomical) Implants
Textured implants help keep teardrop-shaped implants in place, preventing them from rotating and maintaining a natural breast contour.
- If You Want Lower Capsular Contracture Risk
Studies suggest that textured implants reduce the risk of capsular contracture, a condition where scar tissue hardens around the implant (FDA, 2022).
- If You Have a High Risk of Implant Displacement
Textured implants adhere to surrounding tissue, making them ideal for patients with weaker breast tissue or those undergoing breast reconstruction.
Safety Concerns: Textured Implants and BIA-ALCL
The FDA and World Health Organization (WHO) have identified a link between certain types of textured implantsand Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)—a rare cancer of the immune system.
👉 Key Findings:
- BIA-ALCL is primarily associated with macro-textured implants.
- The risk is low but present, and some textured implants have been voluntarily recalled by manufacturers.
- Smooth implants have no confirmed cases of BIA-ALCL (FDA, 2022).
If considering textured implants, consult with a board-certified surgeon to discuss potential risks and safer alternatives.
Final Thoughts: Which Breast Implant Type is Right for You?
| Best Choice If You Want… | Recommended Implant Type |
| A soft, natural feel | Smooth implants |
| A fuller, round look | Smooth implants |
| A teardrop shape with minimal movement | Textured implants |
| Lower risk of capsular contracture | Textured implants |
| Minimal risk of BIA-ALCL | Smooth implants |
Ultimately, the best implant type depends on your desired aesthetic, body type, and medical history. Consulting a qualified plastic surgeon is crucial to finding the safest and most suitable option for your breast augmentation.
Frequently Asked Questions (FAQs)
Q: Are textured implants banned?
A: No, but some textured implants have been recalled due to their association with BIA-ALCL. Always discuss options with your surgeon.
Q: Do smooth implants feel more natural than textured implants?
A: Yes! Smooth implants move freely and feel softer, while textured implants feel slightly firmer due to their rough outer shell.
Q: Can smooth implants be used for teardrop shapes?
A: No, teardrop implants require texturing to maintain their anatomical position.
Q: Are textured implants still safe?
A: Most are safe, but macro-textured implants have been linked to BIA-ALCL. Discuss safety concerns with your doctor.
References
- Spear, S. et al. (2019). “Breast Implant Texturing and Capsular Contracture: A Comprehensive Review.” Plastic and Reconstructive Surgery Journal.
- U.S. Food and Drug Administration (FDA). (2022). “Breast Implant Safety and Associated Risks.”
- American Society of Plastic Surgeons (ASPS). (2021). “Trends in Breast Augmentation: Smooth vs. Textured Implants.”
- World Health Organization (WHO). (2020). “Breast Implant-Associated Anaplastic Large Cell Lymphoma: Risk Factors and Prevention.”
