Swanson Center Blog

Breast Implants: Why Smooth is the Better Choice

Gwendolyn Godfrey - Monday, May 22, 2017

Some women may choose silicone gel implants while others choose saline implants (which are filled with salt water). The advantage of silicone gel implants is a more natural consistency, more like breast tissue. Saline implants feel more like a water balloon. At least that is how the implants feel when you hold them in your hands. Of course, once a breast implant is in your body, there is a layer of breast tissue and usually muscle (when the implant is inserted under the muscle) covering the implant, reducing any difference in how they feel. There is a difference in breast implant prices. Silicone gel is more expensive.

Then there is the shape of the breast implant to consider. Should it be round or shaped like a teardrop? Shaped implants are often called anatomical or form-stable. They tend to be a little firmer than round implants to help keep a teardrop shape. Shaped implants are textured, meaning they have a rough surface. They are designed this way so that the implant sticks to the tissues and resists movement. If a shaped implant moves, it may rotate, producing an unnatural breast shape. Rotation is not an issue for round implants. It does not matter is a round implant rotates, the breast will still look the same. Round implants are usually smooth because there is no need for them to adhere to the tissues.

We used to think that a textured surface helped prevent a complication called a capsular contracture. The body always forms a layer of scar tissue around a breast implant. Sometimes this layer contracts down on the implant and makes it feel hard, which we don't want. Texturing was thought to prevent this problem. However, it is not clear that texturing really works to prevent capsular contracture, especially when the implant is placed under the muscle.

Now there is something new to consider. Over the last decade, a number of women have developed a serious health concern, called anaplastic large cell lymphoma associated with breast implants, or BIA-ALCL.

Although this tumor is treatable and the prognosis is typically excellent, deaths have occurred - a total of 9 to date. We don't really know why, but this serious problem has been linked to textured implants. Fortunately, there is no evidence that a textured, shaped implant is superior to a smooth, round implant. So there is no need for texturing. I have not used textured implants since the 1990s. I prefer implants not to be too firm. Ideally they should move a little and jiggle like natural breasts.

Today it is difficult to justify using textured implants, given what we know about the extra problems associated with them, which include late seromas (fluid collections occurring >1 year after surgery) and BIA-ALCL.

Breast implant prices in Kansa City are comparable to those found in the Midwestern region of the United States. Of course, breast implant prices should not be your deciding factor. More important considerations include the type of implant you choose and your surgeon. To reduce the risk of complications, women are best advised to choose smooth, round implants. Breast implant prices are also less for these implants. Surveys show that patient satisfaction after breast augmentation is unsurpassed among cosmetic surgery procedures. 

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