Does implant surface type affect contracture risk?
Texturing was developed partly to disrupt the way capsules tighten, and some studies found lower contracture rates in certain placements — but the picture depends on where the implant sits, and texture carries its own separate discussions.
Smooth or textured is one of the oldest forks in implant design, and contracture sits at the center of the debate. The idea behind texturing is mechanical: a rough surface lets tissue grow into irregular contact, interrupting the uniform, shrinking scar shell that defines contracture.
What the comparisons actually show
The clearest signal in the literature concerns placement above the muscle, where several comparisons found less contracture with textured surfaces; under the muscle, the difference largely fades, which is one reason smooth implants placed submuscularly remain a standard combination. The texture story later grew more complicated when heavily textured devices were linked to BIA-ALCL and some were withdrawn from markets — so today the surface choice weighs contracture data against considerations that have nothing to do with contracture.
How much surface type matters for you depends on the planned pocket, your tissue, and which devices are available in your market — inputs that differ for every patient. Bring the smooth-versus-textured question to a consultation with a board-certified specialist and ask how it interacts with your placement plan, rather than treating either surface as the safer answer in the abstract.
MediIndex articles are for general information only and are not medical advice, diagnosis, or advertising. Outcomes vary by individual — consult a board-certified specialist for personal decisions.