Choosing the right type of breast implant is one of the most important decisions before augmentation surgery. Among the available options, the surface texture of the implant — textured or smooth — directly influences the aesthetic result, long-term safety, and the way the body integrates the implant over time.

What Distinguishes a Textured Implant from a Smooth One?

The fundamental difference lies in the exterior surface of the implant. Smooth implants have a completely polished surface, allowing them to move freely within the pocket formed during surgery. Textured implants have a rougher surface — in varying degrees, from macro to nano-textured — designed to encourage tissue adherence and reduce implant displacement.

Advantages and Considerations of Each Type

Smooth implants offer a softer, more natural feel, a lower risk of capsular contracture in subglandular placement, and are the preferred option for round implants in the submuscular plane. However, they have a greater tendency to shift position over time. Textured implants, on the other hand, offer reduced rotation — particularly important for anatomical implants — and greater positional stability, though they have been associated with a very low risk of BIA-ALCL (breast implant-associated anaplastic large cell lymphoma), especially in their macro-textured form.

The choice between smooth and textured is not universal — it depends on the patient’s anatomy, the implant type, and the placement plane.

The Current European Standard: Micro and Nano-Textured

In Europe, the trend has shifted toward micro and nano-textured surfaces, which retain the tissue adherence advantages while presenting a significantly more favourable safety profile compared to macro-textured implants. This is the category that accounts for the majority of high-quality breast surgeries currently performed in Spain and Madrid.

A Personalized Decision

There is no universal answer. The right choice depends on the implant type (round or anatomical), the placement plane, the patient’s individual anatomy, and the desired result. In consultation with Dr. Vricella, this decision is always made after an individualized diagnosis — with full transparency and no pressure.

  • Round implant in submuscular plane: typically smooth.
  • Anatomical implant: always textured to prevent rotation.
  • Subglandular placement: textured may be indicated for greater stability.