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by Dr. Gregory T. Lynam

Textured Implants

Textured implants have often been placed in patients
requiring a less mobile implant. Learn all about the benefits
and risks of this type of implant.

When were textured implants first used?

The first textured implant was produced in 1968 based on a design from plastic surgeon W. Pangman and was known as the “Natural Y” implant, so named because it consisted of three internal compartments which were meant to retain the shape of the upper aspect of the implant. It was essentially a regular, smooth-surfaced silicone implant with a polyurethane foam coating of 1.5–2 mm on its surface.

How are textured implants made?

In terms of textured surfaces, the Biocell surface results from a “salt-loss technique.” After the mandrel is coated in silicone and before the implant surface is cured, an additional step is introduced into the standard protocol. To produce a textured-surface implant, some manufacturers (Allergan, Inc.) introduce an additional step into the standard protocol, during which a silicone-coated mandrel is pushed into granular salt before being allowed to cure in the laminar flow oven. Once the surface has cured, this salt is then removed by washing the surface of the implant in water, but the implant surface remains pitted with randomly-arranged, cubed indentations.
https://academic.oup.com/asj/article/31/1/56/273842

Is it possible to identify a specific type of implant associated with a lower or higher risk of ALCL?

Studies have noted that to date, when the implant type has been identified, ALCL has been found more frequently in association with breast implants having a textured outer shell rather than a smooth outer shell. http://wayback.archive-it.org/7993/20171115053750/https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/ucm239996.htm

Does the surface texture of the breast implant shell–smooth versus textured–increase a woman’s risk of developing BIA-ALCL?

Data suggest that BIA-ALCL occurs more frequently in individuals with textured breast implants, though more work needs to be done to understand the risk factors for the disease.BIA-ALCL appears to develop more frequently in individuals with textured implants than in people with smooth-surfaced implants. Before getting breast implants, make sure to talk to your health care provider about the benefits and risks of both textured-surface and smooth-surfaced implants.

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