There are advantages and disadvantages to using each type of implant for both the surgeon and the patient. Let’s address the concerns of the patient and then discuss the benefits of one type over another in terms of technical pluses and minuses.
A lot of information on the differences in outcomes between using textured or smooth implants for breast augmentation comes from anecdotal reporting or confounded studies and is thus as useful as preference or hearsay. With that in mind here are the supposed advantages of one over another with respect to different characteristics that affect breast enlargement.
Textured breast implants have a rough surface. The thinking behind this is that if the texture is irregular, cells that form a scar will not as be organized on such a surface, which would result in a softer, more pliable breast capsule, and diminish contracture rates. This disparity in breast capsule formation has never been conclusively demonstrated in studies. Because the textured breast implant does not have a regular surface, it is thicker, but at the same time thought to be weaker, because of its surface flaws. A well-known consequence of using the textured breast implant is its more tenacious adherence to the breast capsule that is laid down around it. This may be an advantage in a woman who has had a teardrop or anatomical implant placed at the time of breast augmentation to hold position. The reason that is important is that the shaped breast implant is not symmetric and must sit in the subglandular or submuscular pocket just so. In a thinner woman, or a woman with minimal native breast tissue, a breast implant that has adhered to the capsule and is not free to move around, will pull on the adjacent breast skin and cause breast surface irregularities. It will also be more palpable, and it may need to be placed through a larger incision owing to its lack of pliability when compared to a smooth breast implant. Textured breast implants may also carry a higher risk of breast implant rupture because any traction or pushing on the breast would also shear the breast implants by virtue of their close association with the breast pocket capsule. Finally, it may be more difficult to remove textured breast implants, again because of their adherence to the breast capsule.
