Breast implants have a different lining depending on the way the manufacturer deals with the outer shell of the augment. Essentially the options are a smooth outer shell, or a rough (textured) shell. Smooth shell implants tend to behave quite similarly between different companies, however the textured implants are very different.
Smooth Implants
The commonest implants used around the world are smooth implants. Smooth implants are very slippery so they can be squeezed through some very small incisions. There is more size choice for smooth implants as they come in some flatter sizes than the rougher textures.
Smooth implants only come in a round shape as they are very mobile inside the breast. Being slippery, they rotate easily so would create bizarre shapes in anything but a round variety.
In my opinion the main downside of a smooth implant is it can descend below the breast line, or inframammary fold. This can cause problems such as ‘double bubble’ and ‘bottoming out’. The implant is so slippery, gravity can drag the implant down through the connective tissues of the lower breast. As the weight of the implant increases, so to does the risk of implant descent.
Another downside of the smooth implant is a slightly higher chance of capsular contracture. Imagine placing a cricket ball into a breast to get the idea of how this feels! It is due to a hard, painful scar forming around the implant. This risk is largely mitigated by placing the implant in a dual plane which is my preferred position.
When using a smooth implant I use extra long dissolving stitches to reinforce the lower breast. This creates that a nice strong internal support, like a hammock for the implant. I also tend to guide people to the textured implants if they are looking for larger breast augmentation.
Textured Implants
Textured implants have a rough feel to the shell of the implant. The thickness of the texture varies radically between different companies. The main benefit of the texture is it improves the ability of your breast tissues to grip the implant. The friction generated between implant and breast helps the implant stay in the position. Both round shapes and teardrop/anatomic shapes are available as they tend not to rotate any where near as much as a smooth implant. Also they have the lowest rate of capsular contraction, especially when used in a sub glandular position.
The big issue with textured implants is ALCL ( Anaplastic Large Cell Lymphoma). This is a very rare form of lymphoma which has a higher rate of occurrence as the thickness of the implant texture increases. Because of this the thickest types of textured implants have currently been withdrawn from the Australian market. Only the thinly textured, or micro textured varieties are now available. These are extremely safe with a quoted rate of ALCL of 1:60,000-80,000.
As you can see, there is a lot to discuss when it come to choosing your breast implants and its always best to take your time and really think about the issues which most concern you. Obviously always check your surgeons qualifications to discuss these ideas with you by referring to the medical board of Australia’s website and typing in their name. If doesn’t say they are a specialist in plastic surgery, then maybe get a second opinion!
Always feel free to contact us if you have any questions,
Sam
