What You Need to Know About Textured Breast Implants

Dr. Robert Schwartz
October 11, 2022

You might have heard about textured breast implants in the news recently. Allergan, a major manufacturer of textured implants, has voluntarily recalled its Biocell textured implants and tissue expanders due to concerns about a rare cancer known as BIA-ALCL (breast implant-associated anaplastic large cell lymphoma). While this recall has resulted in some women getting their textured implants removed, it’s important to remember that the risk of developing BIA-ALCL is still very low. In this blog post, we’ll dispel some of the myths surrounding textured breast implants and help you make an informed decision about whether or not they’re right for you.

What are Textured Breast Implants?

Textured breast implants are made with a rough surface that helps them adhere to the surrounding tissue. This can help prevent the implants from shifting out of place over time. They come in round and teardrop shapes and are made from either saline (sterile salt water) or silicone gel.

Benefits of Textured Breast Implants

There are several benefits associated with textured breast implants, including a lower risk of capsular contracture (hardening of the tissue around the implant). Because they adhere to your body’s natural tissue, textured implants are more securely supported in your chest than smooth ones. This makes them less likely to bottom out - that is, stretch the skin on the underside of your breasts. Because the implants drop out of the upper part of your chest, bottoming out makes your breasts look less perky. Textured implants are one tool your surgeon can use to prevent this problem. Some studies have even found that textured implants may be less likely to cause sagging over time.

Risks of Textured Breast Implants

All surgical procedures carry some risk, and textured breast implants are no exception. In addition to the general risks associated with any surgery, textured breast implants may be linked to a very rare cancer known as BIA-ALCL. As mentioned earlier, Allergan has recalled its Biocell texture implants due to concerns about this cancer. The FDA estimates that for every 3 million women with breast implants, nine will develop BIA-ALCL. However, it's important to remember that this is still a very rare cancer, and the vast majority of women with textured implants will never experience any problems. To put this in perspective: to date, there are still under 1,000 cases of BIA-ALCL worldwide ever. The total number of breast implants placed since their invention in the 1960s is unknown but is likely well past one hundred million.

Our Recommendation

Unless you are at high risk of bottoming out, we recommend using smooth-shelled implants. This applies to most patients who don't need the tighter grip of textured breast implants to prevent breast stretching.

If you are a woman who is more likely to bottom out, we will discuss the pros and cons of texturing with you. We can help you decide if lowering the chance of bottoming is worth the very low (but non-zero) risk of BIA-ALCL.

So who is at higher risk of bottoming out?  We've identified two factors shared by women who tend to bottom. They’re simple and you can easily check them on yourself.

  1. Nipple Angle - Women whose nipples angle upward (and are located higher on the breasts) are more prone to bottoming out. The risk is lower in women whose nipples project straight forward or angle downward.
  2. Lower Breast Length - Measure the distance from the fold underneath your breast to your nipple. You’ll probably need help since it requires three hands. If this length is more than two and a half inches, you’re more likely to bottom out. Your risk is low if it’s less than 2 inches. From 2 to 2.5 inches, the risk varies and depends on other factors.


If you’re considering getting breast implants, you may have heard about textured implants and wondered if they’re right for you. While there are some benefits associated with textured breast implants, there are also some risks that you should be aware of before making a decision. We hope this blog post has helped

Whether you're looking for breast augmentation or breast implant revision, Dr. Schwartz can help you!

Check out our article about breast implants and what happens if they aren't replaced.

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