What is the difference between textured and smooth implants?
Textured implants have a rough surface designed to reduce rotation and capsular contracture, while smooth implants have a polished surface and carry a documented association with a rare condition called BIA-ALCL.
Breast implants come in two main surface finishes: textured and smooth. A textured implant has a bumpy, sandpaper-like surface that encourages tissue integration and adherence to surrounding structures. A smooth implant has a polished, rounded surface that moves more freely within the tissue pocket.
The primary advantage of textured implants is reduced implant rotation. Because the rough surface creates friction and anchoring, the implant stays in place better if the patient moves or changes position. Textured implants also show lower rates of capsular contracture, a complication where scar tissue tightens around the implant and distorts its shape.
Smooth implants, by contrast, move more naturally with the breast tissue. However, they carry a documented association with breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), a rare immune condition. While the overall risk is very low, regulatory bodies including Health Canada and the FDA have studied this link closely. Most cases of BIA-ALCL have occurred with textured implants, not smooth ones, though the evidence has shifted the market and informed surgical choices.
Today, many surgeons in Ontario favor textured implants for the rotation and contracture benefits, while others use both types depending on patient anatomy and preference. Your surgeon can discuss which surface finish aligns with your goals and medical history. To find providers who can walk through these options, browse breast augmentation surgeons in the directory.