Differences between textured and smooth breast implants on the same body
Allergan breast implants rose to prominence and experienced their strongest growth with BIOCELL textured-surface technology during the period from 2006 to 2018. By 2019, Allergan breast implants (the BIOCELL textured-surface line) were recalled worldwide at the request of the FDA due to their association with the risk of a rare type of lymphoma (BIA-ALCL).
“Adherent textured” breast implants believed to reduce capsular contracture
For more than 10 years (from 2006 to 2018), Allergan textured implants using BIOCELL textured-surface technology experienced strong growth and became the “king” of the global aesthetic market, including Vietnam. At that time, aesthetic surgeons strongly favored this type of implant because of its “adherent textured” property, meaning that the implant stayed where it was placed, helping fix the implant in position, preventing movement within the pocket or displacement during vigorous activity, creating a very stable breast shape, and was once believed to help reduce capsular contracture.
However, the medical evidence later changed this view. By July 2019, after multiple long-term clinical studies, the FDA (U.S. Food and Drug Administration) and international health organizations found that the macrotextured (rough) surface of Allergan BIOCELL implants was a leading factor associated with continuous irritation of immune cells around the breast implant pocket. This chronic inflammation can lead to a rare type of lymphoma called BIA-ALCL (Breast Implant-Associated Anaplastic Large Cell Lymphoma).
Because of this risk, on July 24, 2019, Allergan officially announced a worldwide recall of all BIOCELL textured implants and permanently discontinued the production of this implant line.
Currently, many patients in Vietnam as well as overseas Vietnamese who underwent breast augmentation during the peak period (2006–2018) still have these BIOCELL textured implants in their bodies and have not yet had them removed. In light of this situation, Dr Ho Cao Vu encourages patients who have previously received older-generation implants with macrotextured surfaces and high tissue adherence (such as Allergan/McGhan, Eurosilicone, Polytech…) to proactively visit reputable medical facilities for breast implant removal surgery to reduce the risk associated with cancer.
Differences between textured and smooth breast implants on the same body (case study)
This is an extremely rare and unique clinical case involving an overseas Vietnamese patient who underwent breast implant removal surgery. Ms. Lan Thanh said that she had undergone breast augmentation on November 9, 2011, and firmly believed that she had received matching smooth gel breast implants from the Mentor brand (according to the information recorded on the warranty card).
However, an unexpected truth was revealed directly in the operating room. When Dr Ho Cao Vu performed the dissection and removal of the old breast implants, the surgical team found that the patient had actually received two completely different types of implants from two different brands: a textured Allergan implant on the left side and a smooth Mentor gel implant on the right side.
This “mismatched pairing” over 14.5 years provided highly direct medical evidence of how the body reacts to each type of breast implant surface within the same individual:
Left pocket with the Allergan textured implant:
The pocket was very thick, with multiple folds, wrinkles, and an uneven, rough surface. The reason is that Allergan’s macro-textured surface technology stimulates body tissue to grow and adhere tightly to the implant shell, causing a prolonged chronic inflammatory response. The body responds by continuously increasing the production of collagen and connective tissue to “surround” this foreign body more tightly. As a result, the pocket becomes thicker and firmer (causing breast firmness, with implant folds clinically visible in multiple areas), and the implant shell had aged and turned yellow after 14 years.
Right pocket with the smooth Mentor implant:
In complete contrast to Allergan, the smooth Mentor implant has a completely smooth and glossy shell surface. After 14 years, the gentle and continuous friction of the smooth surface against the pocket wall acts like a natural “polishing” process. Because there is no adhesion and less inflammatory irritation, the pocket around the smooth implant usually remains soft and does not contract to form folds. The body forms only a very thin and smooth physiological pocket, while the gel and the Mentor breast implant shell inside still remain intact and have not deteriorated.
Smooth gel breast implants are not the cause of capsular contracture
Currently, many aesthetic consultants are advising patients to avoid soft, smooth gel breast implants for the reason that: “The softer the gel, the more likely it is to cause capsular contracture.” However, from a scientific perspective, this is actually a commercial tactic of switching concepts to direct patients toward more expensive implant lines, or it may result from a lack of updated modern medical knowledge.
Smooth implants only stimulate the body to form a very thin, soft, and smooth physiological fibrous capsule around the implant. The cause of capsular contracture does not come from the breast implant but from the surgeon’s dissection technique and, very rarely, from individual predisposition. With their rough surface, textured implants are the ones that continuously rub against the breast tissue, stimulating a prolonged chronic inflammatory response. After a long period of time (more than 10 years), this inflammatory response causes the fibrous capsule to thicken, become rigid, and contract, leading to the complication of capsular contracture.
The events of 2019 are the clearest evidence: while macrotextured implant lines (such as Allergan BIOCELL) were banned from circulation and recalled worldwide by the FDA and international health organizations because of the risk of inflammation causing thickening of the fibrous capsule and lymphoma (BIA-ALCL), in contrast, smooth gel implants from reputable manufacturers with more than 40 years of history have continued to meet the FDA’s highest medical safety certification standards and have remained approved for use for many decades.
Recommendation for removal of macrotextured breast implants
Based on clinical experience from nearly 2,000 breast implant removal surgeries involving various types of implants (including older-generation macrotextured implants, textured implants manufactured using the salt-loss technique, smooth implants, saline implants, and others), Dr Ho Cao Vu has observed a series of serious complications that developed silently inside the patients’ implant pockets. Particularly with textured breast implants, abnormalities occurring at a high frequency include pockets containing mucoid fluid, papilloma formation, inflamed and reddened lining tissue, persistent oozing bleeding within the pocket, double capsule, severe grade 3–4 capsular contracture, and even calcified fibrous capsules that become rock-hard. In view of these existing risks, Dr Ho Cao Vu recommends that patients who have received unsafe textured implant lines included in FDA warning lists proactively undergo early breast implant removal surgery to completely eliminate the risk of lymphoma (BIA-ALCL).
Painless breast implant removal
Many patients delay breast implant removal because they are afraid of pain, the need for a recovery period, or the side effects of antibiotics. Dr Ho Cao Vu stated that breast implant removal surgery using a new-generation ultrasonic surgical scalpel and laryngeal mask anesthesia helps patients regain consciousness quickly, without side effects from anesthesia such as nausea, vomiting, or severe fatigue. Patients can be discharged after 4 hours and do not need additional painkillers or antibiotics after surgery.
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Consultation information – Schedule an appointment with Dr. Ho Cao Vu:
Hotline: 0911 413 443
Personal Facebook: Dr. Ho Cao Vu
Clinic address: No. 2, Toan My 2 Residential Area, Phu My Hung Urban Area, Tan Phong, District 7, Ho Chi Minh City
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