Textured Breast Implants served a role. Is their time up?*

This 30 year old woman desired larger breasts She was very active in physical fitness and wished to avoid interference with her pectoralis muscle and possible animation deformity that is sometimes associated with sub muscular placement. She underwent sub glandular ( on top of the muscle) placement of 325 cc Mentor Siltex breast implants. The choice was based on studies showing that capsular contracture ( fibrosis and hardening of the tissue around breast implants) is higher in sub glandular placement. Textured implants were designed to overcome this problem and studies show that there was less chance of contracture in textured implants. Reducing risk of capsular contracture can also involve meticulous handling of the implants, expert surgical technique to reduce risk of bleeding and use of protective sleeves ( Keller funnel) to avoid any bacterial contamination of the implant upon insertion. Recent concern about ALCL which is a rare form of lymphoma that can effect woman with textured implants has caused plastic surgeons to reconsider these types of implants. Although the risk is extremely low- it is a possibility and despite some advantages of textured devices ( less contracture, allowing shaped implants, and less movement of the implant), the risks have to be carefully assessed and discussed. Siltex texturing is not associated with as high a chance of developing ALCL as more aggressively textured devices. Close monitoring by your plastic surgeon and is recommended.