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Breast Implant Safety: What You Need to Know About Shell Surface Type

Blog Post March 26, 2021 post.reading-time

While there are several subcategories of surface types, let’s broadly consider textured vs. smooth surfaces for simplicity.

Motiva SmoothSilk®

With the CONTINUING NEWS COVERAGE of breast implant-related events, many of us – especially those with breast implants of our own – may be left feeling concerned about the potential risks of having or receiving such devices, and even confused by the often highly technical terms being used in media coverage.

Education is a large, and often overlooked, part of the equation that allows breast reconstruction and augmentation patients to make the safest and most fulfilling choices for themselves.

As Diana Zuckerman, president of the National Center for Health Research in the US, has SAID to the media, “When women decide to get breast implants for reconstruction after mastectomy or for breast augmentation, they should not be putting their lives at risk…”

We couldn’t agree more. As part of our mandate towards improving women’s health, we’d like to assure women that with the right type of breast implant, it is still very possible to maintain a safe, high quality of life thereafter.

An important factor that can affect long-term health after breast reconstruction or augmentation is the chosen implant’s surface or shell type. While there are several subcategories of surface types, let’s broadly consider textured vs. smooth surfaces for simplicity.

Traditional smooth implants generally better mimic the natural breast since they can move about freely in their pockets after breast augmentation. They can also lead to more implant displacement over time.

There’s a reason we refer to such surfaces as “traditional”: since the 1960s, manufacturers of such implants HAVEN’T DELIVERED SIGNIFICANT INNOVATION when it comes to their surface (or other implant-related) technology.

As their name suggests, textured implants have a rougher surface – one that’s sometimes compared to sandpaper. Historically, surgeons have chosen to use this implant surface type due to the “Velcro effect” it achieves by adhering to surrounding tissue more easily, thereby reducing implant sliding or rotation.

But textured implants (especially those that are rougher or “macrotextured”) come with significant safety-related drawbacks. For one, that same Velcro effect can LEAD to wrinkling or traction rippling (i.e. when an implant strains surrounding tissue, making overlying skin look visibly rippled), which in turn can contribute to implant rupture.

Since textured shells have more surface areas with nooks and crannies, bacteria can more easily adhere to their surfaces as well, leading to increased risk of chronic inflammatory conditions such as late seromas, double capsules, and even an uncommon form of cancer known as breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). In fact, textured implants are almost exclusively associated with BIA-ALCL since there have been no reported ‘pure’ cases with smooth implants (without a prior history of a textured device).

The good news is that women no longer need to compromise and settle for either implant type if they wish to receive a breast augmentation or reconstruction.

Motiva Implants® offer patients the world’s most comprehensive portfolio of advanced smooth breast implants.

By “comprehensive”, we mean that the product family offers a wide range of implants that come in various projections, volumes, shapes, and gel types (for either more “youthful” or “natural” look, feel, and movement) to customize and create the best possible implant match for every patient’s body. This product line includes an anatomically shaped smooth implant, which is novel as historically, anatomical implants have only been available with textured surfaces.

And by “advanced smooth”, we’re referring to the Motiva SmoothSilk®/SilkSurface®, one that has been classified as smooth per the ISO-14607:2018 international standard (the same category as traditional smooth implants) but is more advanced than traditional smooth implants in the following ways: Traditional smooth implants come with reduced risk of chronic inflammatory conditions (such as BIA-ALCL) but increased risk of capsular contracture (an often-painful medical complication in which a large, fibrous capsule forms around the implant and compresses it), while SmoothSilk®/SilkSurface® comes with minimal risk of both.

In fact, SmoothSilk®/SilkSurface® has yielded an EXTREMELY LOW OVERALL COMPLICATION RATE of less than 1% till date. Its uniform, controlled nanosurface is elastic enough that it can be inserted through smaller incisions, which in turn promotes a healthier, smoother post-op recovery process.

“Motiva Implants® go in comfortably through a smaller incision, and we know they cause less inflammation in the body around the actual implant, which again probably confers benefits in avoiding the long-term implant complications,” SAYS DR. TERRENCE SCAMP, a prominent plastic surgeon in Australia who has worked with a wide range of implant types.

Motiva Implants® have other UNIQUE SAFETY FEATURES, and its manufacturer Establishment Labs is committed to continuing its mission to further safety in breast surgery for the long run. Motiva Implants® remain available in 70+ countries and Establishment Labs has not received any warnings or regulatory actions from health authorities. Read more about our position on breast implant safety HERE.

Use the MOTIVAIMAGINE CENTER® LOCATOR to find an experienced plastic surgeon in your area that can help you learn more about Motiva Implants® and assess which implant type would best suit you.

*Motiva Implants® are not available for sale in US and Canada.


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