Breast Implant Update on Smooth vs. Textured Surface

A woman deciding between smooth and textured implants for her breast augmentation.

Fake News

You may have seen a news show lately proclaiming “Breast Implants Cause Breast Cancer!” This is a shocking sound bite and one to catch your attention for sure. But remember, TV news is now in the entertainment industry, and shock is what they want so that you do not change the channel.

The “fake news” might keep you on the same channel for a few minutes longer, but even when the bit on implants is aired, it is a truncated story without all the facts. I hope you did not fall prey to this bit of news exaggeration.

News You Can Use

You deserve the real story about the risks and whether breast augmentation revision surgery is necessary. So here is what I tell my Columbus-area patients:

The tiny bit of truth that was twisted to become the shocking headline is this: There is a very rare type of lymphoma of the breast implant capsule that is associated with textured breast implants. It is not a straight cause-and-effect type of result. In other words, having textured implants is just one factor in the association. Many women with these type of implants do not have lymphoma. But there is something about the textured implant that, in very rare circumstances, leads to a lymphoproliferative condition in the capsule. It is so rare that it is hard to study and hard to categorize, but there are some general themes that have emerged.

What should you do?

This lymphoma is so rare that most patients with textured breast implants do not need to worry. The thing to be aware of is that if you have strange swelling or other unusual symptom in your breast, you should seek a consultation (ideally, with the plastic surgeon who placed the implants) to learn more.

Individualized Treatment

Every patient and every case is different, so it is difficult to even make recommendations. But in some of the reports, the patient who has had textured implants (usually, for quite some time) starts experiencing pain or swelling. This can be a fluid collection around the implant, which should be tested for the lymphoma. In these rare cases, the patients should be advised that the implant capsule and the implant inside should be removed and tested for the lymphoma ALCL. The removal procedure is called a total capsulectomy. This operation can be quite straight forward, or it can be very challenging due to the adherence of the capsule to other anatomical structures.

Why does the textured implant do this?

We do not know for sure the answer to this question yet. The main theory right now is that the texture can cause a low-grade type of ongoing inflammatory reaction in the capsule that over many years causes it to develop into a lymphoma. Many ongoing studies are looking into these questions, and a national implant registry is collecting this data in conjunction with the FDA.


When this type of news headline is splashed across the TV and magazines, it is important to keep in mind the bigger picture, remembering that this is exceptionally rare. But if you do have textured implants, you should be aware of this development. And if your implants have been in place for longer than 10 years, it probably is a good time to see your plastic surgeon to discuss your options.

Patient Well-Being

For many women, breast implants have enhanced their confidence and body image, so this news is an unexpected consequence of a wonderful experience. You can read about some of the very real and personal reasons patients choose to get breast implants in this earlier blog post.

For every doctor, the ultimate goal is the patient’s well-being; and for every plastic surgeon who does breast augmentation, it is the same. So, patients should seek the advice of their surgeon. The doctor-patient relationship is the heart of all shared medical decision-making, and it will guide each plastic surgeon and breast implant patient to the best outcome for each situation.

If you’re worried about your implants or you’re considering a breast augmentation revision and you’re in the Columbus, Ohio, area, you can request a consultation online or call my office at (614) 569-2649.

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