Expert Doctor

Smooth vs. Textured Implants

Posted January 30, 2017

Munish Batra, MD

San Diego, CA

When it comes to smooth vs. textured implants, the more commonly used implants are smooth implants. Textured implants were introduced to try and minimize the risk of capsular contracture and they have been successful when they are placed over the muscle. But under the muscle, both smooth and textured implants give a person a similar capsular contracture rate. Textured implants are more expensive than smooth implants. That is why most surgeons use smooth implants over textured implants.


Textured implants come in different shapes because doctors tend to use textured implants more for breast cancer patients than breast augmentation patients. Breast cancer patients have no shape to their breast if they have had a mastectomy. Some of the textured implants come with a shape like a breast or more of a teardrop shape than the smooth implants which tend to be round.


In general, the best candidates for textured implants are cancer patients. Other ideal candidates for textured implants include patients who have already had issues with capsular contracture. Women who want to have breast augmentation for cosmetic reasons are better suited for smooth implants because smooth implants can be placed rather easily in women of various shapes and sizes.


When considering breast implants, a patient must also consider the incisions and scarring that go along with it. With smooth implants, the incision can be made in a variety of locations such as the areola, the armpit, and under the fold of the breast. Although making the incision around the areola can leave a woman with an invisible scar, there can be some added risks to this method.

A textured implant must be placed by making an incision in the inframammary fold which is the natural fold below the breast. With smooth implants, the incision is usually very small. With the textured implant, the incision is larger but can be hidden.


When comparing breast implants to a fat transfer procedure, the advantages of breast implants are irrefutable. The main advantage of implants is that they are more predictable in giving the desired volume than fat transfer. Once the implants are placed in the breasts, a patient can expect symmetric breasts that are more permanent and offers a lower risk of complications. With a fat transfer procedure, only a percentage of fat survives the procedure. This means that follow-up procedures are expected in order to get the desired size. In some instances, one breast retains more of the surviving fat than the other breast which leaves a patient with uneven breasts.

Breast implants give a woman immediate results while fat transfer patients must wait approximately 6 months to see the final results. A concern with fat transfer is calcification of transferred fat. This happens when the transferred fat does not get enough blood supply. During a mammogram, there are concerns that the calcification may be confused with cancer.


A patient can be limited to the type and size of breast implant due to her anatomy including her current breast size and body type. An implant should be in harmony with a patient's proportions and the doctor should advise a woman of limitations.


Both types of implants have a risk of rupture, leaking, and infection. With the textured implant, there is a higher risk of developing seroma which is a fluid buildup around the implant. Therefore, many patients will need a small drain put in when choosing a textured implant.  Textured implants may also have a higher rate of fold flaws and rupture.


There are some notable differences in recovery between the smooth implants and the textured implants. With the smooth implants, the recovery and downtime is significantly faster. Patients need to minimize their activities for the first week and then they can resume driving, grocery shopping, and other activities without pain. By three weeks, the patient is able to go to the gym and perform non-impact exercises. By six-eight weeks, a woman can run and do weight lifting.

However, patients with textured implants will need three weeks of minimal activities before they can begin to increase activities. This extensive recovery is usually due to a seroma buildup.


As time passes, both implant types do very well. Within ten years, approximately 30% of patients need a follow-up procedure. This can be due to capsular contracture, rupture, or drooping breasts. A woman who has had a pregnancy, gained weight, or lost weight may need a breast lift to remedy drooping breasts. If a patient is experiencing pain or a change in shape due to scarring or gel leakage, another procedure will need to be done in order to remove the scarring and replace the implant.   


Breast implants are the most common form of plastic surgery in America. However, it is important to make sure the surgeon who performs the procedure is board-certified. A board-certified surgeon who is skilled in performing implant procedures will normally produce the best results for patients.


Written by Cosmetic Town Editorial Team – SP

Based on an exclusive interview with Munish Batra, MD in San Diego, CA

Article Last Updated on January 30, 2017