Textured vs. Smooth Implants: Which Option is Best for You?

When undertaking breast augmentation surgery, there are several key choices to consider. Two of the main decisions you'll need to make include the implant filling (saline vs. silicone) and the implant outer shell.

Understanding the difference - Textured vs. smooth breast implants

There are two implant shell options currently on the market - smooth and textured.

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Smooth Implants

Smooth implants are popular for breast augmentation — known for their natural feel and movement.

Let’s explore their characteristics in detail:

Texture

Smooth implants are made with a soft silicone shell that’s relatively thin compared to textured implants. This softness contributes to a more natural feel and allows for more flexibility in the implant’s shape.

Movement

Due to their slippery surface, smooth implants move freely within the tissue membrane. This movement mimics the natural breast tissue’s behavior — so you get a more realistic look and feel.

Placement

Surgeons place smooth implants above or below the chest muscle (submuscular or subglandular placement). The choice often depends on your anatomy and desired outcome.

Capsular contracture risk

Smooth implants were once thought to have a higher risk of capsular contracture. However, recent studies suggest the difference in risk between smooth and textured implants is minimal when a surgeon uses proper techniques - though the risk is always present. 

Appearance 

Standard round smooth implants create a rounder, fuller look in the upper pole of the breast. They can give a more dramatic cleavage effect, which some patients prefer.

Longevity

On average, smooth implants last 10 to 20 years before surgeons recommend replacement. But it may not be necessary if there are no complications and you’re still satisfied with their appearance when that time comes. Some women enjoy their implants for more than 20 years.

Cost

Generally, smooth implants are slightly less expensive than textured implants. But the cost difference is usually minimal and shouldn’t be the primary factor in choosing between the two.

Textured Implants

Some surgeons and patients prefer textured implants for several reasons. They’re the only option for teardrop implants, which provide a more natural breast shape.

Here’s a closer look at their characteristics:

Texture

Textured implants have a thicker, firmer shell with a rough surface similar to fine sandpaper. This texturing promotes tissue adherence and reduces implant movement. Patients and surgeons may choose textured implants over smooth ones for better stability and shape retention.

Movement

Unlike smooth implants, textured implants are designed to stay in place. The rough surface encourages surrounding tissue to grow into the texture, effectively anchoring the implant into position.

Placement

Textured implants are best placed beneath the chest muscle. The rough surface helps the implant adhere to the surrounding tissue — reducing the risk of displacement and potentially lowering the chance of capsular contracture.

Capsular contracture risk

Some studies suggest that textured implants have a slightly lower risk of capsular contracture, especially when placed under the chest muscles. But recent research indicates the difference in risk is minimal compared to smooth implants when you visit a skilled surgeon.

Appearance

Surgeons often use textured implants to create a more shaped or anatomical look. They’re the only option for teardrop-shaped implants, which give a more natural-looking breast slope for some patients.

Longevity

Like smooth implants, textured implants typically last 10 to 20 years. However, there have been concerns about the long-term safety of certain textured implant types, which you should discuss with your surgeon.

Cost

Textured implants may be about 30% more expensive than smooth implants. Surgeons may charge more using this implant type because the rougher surface can make it harder to insert into the breasts.

Which type of breast implant feels the most natural?

If your implant is placed correctly underneath the chest muscle and covered by adequate breast tissue, then it should be almost impossible to feel the difference between textured vs. smooth implants. With this in mind, many women and surgeons will opt for smooth implants to seek the most natural feel. 

Many believe smooth implants feel more natural due to their softer shell and ability to respond to gravity. When you stand, the implant will drop slightly to a more teardrop shape, and when laying they can flatten and shift to the sides, just as natural breast tissue would do.

 Alternatively, textured implants have a thicker, firmer wall and are more likely to have palpable folds and ripples that can be obvious if you have a petite frame with limited breast tissue. If you opt for a teardrop-shaped implant, the thicker, textured shell will not change shape when laying down, which can look and feel more unnatural.

Are breast implants safe?

Both smooth and textured breast implants are generally safe, but you should understand the risks associated with each type before getting either.

Smooth implants have a long history of safe use. Surgeons often choose smooth implants because they feel natural and move easily in the breast pocket.

In contrast, textured implants have been linked to a rare cancer called BIA-ALCL. But it’s incredibly rare — the FDA found that only 1 in 355 to 1 in 30,000 patients with textured implants might get it. There is only one case of BIA-ALCL in a woman with smooth implants. If you catch BIA-ALCL early, your surgeon can treat it by removing the implant and the tissue around it.

Health experts say you don’t need to remove your implants if you’re not having issues. But they want everyone with breast implants to know about BIA-ALCL. Talk to your surgeon if you notice any new swelling or pain in your breasts.

The key to safe breast implants, whether smooth or textured, is working with a highly trusted surgeon. They should understand your medical history and surgical goals. With the right doctor and proper care, both types of implants can be a safe choice for breast augmentation.

Risk of capsular contracture smooth vs. textured implants

Once the implant has been inserted into the breast, a capsule made of soft, fibrous scar tissue will begin to form to help keep the implant in place. This scar tissue can be unusually dense and hard for some women, tightening around the implant to cause chronic pain and a distorted breast shape. This condition is known as capsular contracture, and recent data shows that textured implants have a slightly lower incidence rate than smooth implants.

So which is better: Smooth or textured?

Both smooth and textured implants can give you great results, but they have different strengths. 

Smooth implants feel softer and move more like natural breasts. On the other hand, textured implants have a thicker shell and are less likely to move around in your breast. Some prefer textured implants for teardrop-shaped implants because they stay in place better.

Your body type, skin, and the look you want all play a part in choosing the right implant. What works best for your friend might not be the best for you. Talk to a board-certified plastic surgeon in your area — they can help you pick the right implant for your goals.

If you have any concerns or are considering breast augmentation surgery, be sure to book a consultation with Dr. Orloff at Burbank Plastic Surgery today.