Breast implants are available with a smooth, textured or micro-polyurethane foam-coated surface. Why is that?
The first breast implants were manufactured in the 1960s and had a smooth surface. A polyurethane foam covering was introduced in the 1970s to minimize the event of capsular contracture as well as implant dislocation and rotation. Textured implants were introduced in the late 1980s, to mimic the effect of the polyurethane layer.
What is capsular contracture?
As part of the body's natural reaction, a capsule of connective tissue is formed around any foreign body inserted into the tissue, including around breast implants. The undesired tightening of this capsule (capsular contracture or capsular fibrosis) can result in changes to the shape as well as to the position of the implant, and so to the shape of the breast. Additionally, the capsule can become very hard and cause pain. Capsular contracture is the most common complication of breast implant surgery and is classified using the Baker scale (see the section Risks and complications with breast implants).
Baker scale for capsular contracture
- Grade I - The breast is normally soft and appears natural
- Grade II - The breast is a little firm and appears natural
- Grade III - The breast is firm and appears abnormal
- Grade IV - The breast is hard, painful to the touch, and appears abnormal
A capsular contracture may never occur, or it may occur after weeks, months or years. It cannot be predicted if or when a capsular contracture will occur and, if it does, how pronounced it may be.
Capsular contracture rates, as well as rates of other complications such as rotation and dislocation, vary in relation to the implant surface: