Choosing Textured Surface or Smooth Surface Breast Implants
All breast implants marketed in the United States have a solid silicone envelope, essentially a precisely sized and shaped, stringently engineered, manufactured, and sterilized solid silicone “bag” completely filled with silicone gel or salt water (saline) and hermetically sealed so its consistency is soft, and so it naturally feels and moves like normal breast tissue. The surface of this flexible solid shell may be smooth or rough (textured). Smooth surface implants appear translucent and glossy, while textured surface implants have a rough surface and opaque, ground glass appearance. You will see, feel, and understand both of these implant surfaces during your consultation with Dr. Laverson. Textured and smooth surface implants both may be filled with silicone or with saline (salt water). Differences in behavior (implant-tissue interaction) between smooth and textured surface implants have been studied, and both are acceptable to use in most situations.
Because of their rough surface, tissue around textured implants grows into the interstices and micro-irregularities, gripping the implant surfaces and immobilizing them exactly where they’re placed during breast augmentation surgery. Implant placement is important to breast appearance. The center of a round implant must remain behind the center of the breast. Shaped implants must remain in anatomic orientation with the tapered edge at the top of your breast and the fullness at the bottom. Textured surfaces increase friction between the implant and its surroundings so the implant is more likely to remain in position, and less likely to rotate. Dr. Laverson believes textured surface breast implants are less likely than smooth implants to migrate to your sides (and thus more likely to remain toward your center) when placed beneath the pectoralis (chest) muscle. “Sub-pectoral” (beneath the pectoralis major muscle) breast implant placement means the implant is wedged between the pectoralis muscle covering its front surface and the implant base rests upon your curved ribs. Contraction of the muscle during use of the arms applies force to the front of the implant and on its inner aspect, tending to push it out toward the side and down. The capsule your body forms around a textured implant grows into the rough implant surface and like snow tires with deeper treads, the implant resists downward and outward displacement by dynamic muscular force. Smooth surface breast implants slide more easily and with their lower coefficient of friction may be more prone to migration when placed beneath the pectoralis major muscle.
Smooth surface implants may have an advantage when the implant position is subglandular (in front of the pectoralis major muscle). To produce a soft implant that assumes a natural shape, the implant shell is not filled to capacity during the manufacturing process. This allows the implant to shift its shape like the natural breast with changes in body position. Normal behavior of the implant is to wrinkle slightly at the top because of this underfill. In thin, lean women, women with large implants, and women with implants in subglandular position, these implant wrinkles may be transmitted to the skin, which produces a very artificial appearance, and discloses the presence of implants. This tendency is amplified when a textured surface implant is subglandular, because the textured surface grips the capsule, which is attached to overlying soft tissue and skin. Thus, when a superficially placed textured implant ripples, these ripples may be more visible on the skin surface than if the superficially placed implant is smooth, and non-adherent to the surrounding capsule.
Depending on your body type, your lifestyle, your preferences, and the size implant you select, Dr. Laverson may recommend smooth surface or textured surface implants. There is no cost difference.