As a board-certified plastic surgeon in Houston’s Texas Medical Center, Dr. Courtney specializes in breast augmentation and revision, combining advanced surgical training with a genuine commitment to patient care. His background in complex breast procedures—and his meticulous attention to detail—shape every step of the process, from consultation to recovery.
This guide was created to simplify the science behind implant shape, profile, and texture, helping you understand how each choice can influence your results and long-term satisfaction. Our goal is to give you the knowledge and confidence to make an informed, personalized decision when you meet with Dr. Courtney.
The Variables That Matter (And Why)
Shape: Round vs. Anatomical/“Teardrop”
- In head-to-head analyses, overall complication rates and aesthetic satisfaction are similar between round and shaped implants
- Shaped devices may show less rippling in some series, but this advantage often accompanies textured surfaces, which changes the risk profile (OUP Academic)
Profile: Low, Moderate, High, Extra-High
- “Profile” describes how much projection an implant provides for a given base width
- Higher profiles can produce more upper-pole fullness on a narrower chest
- They also concentrate volume, which can influence soft-tissue stretch, palpability, and the way rippling presents over time
- Long-term clinical data comparing profiles are limited; one multi-study analysis found no clear increase in adverse events with high/extra-high profiles compared with low/moderate, underscoring that fit to your anatomy is the key driver of outcomes
Texture (Surface): Smooth vs. Textured
- Textured implants were designed to lower capsular contracture and rotation in shaped devices
- Recent meta-analysis still suggests lower capsular contracture rates with textured vs smooth implants, particularly when placed subpectoral
- However, textured devices are also the primary exposure linked to breast implant–associated anaplastic large cell lymphoma (BIA-ALCL)—a rare but real cancer of the capsule
- Current U.S. guidance emphasizes informed consent and does not recommend prophylactic removal in asymptomatic patients, but the safety signal has shifted many practices toward smooth implants for cosmetic augmentation
Long-Term Outcomes
Shape: Round vs Anatomical
Comparative reviews indicate similar aesthetic satisfaction with round and shaped implants. While shaped implants (often textured) have less rippling, they may have higher infection rates in some cases. In contemporary cosmetic practice using smooth, round implants and careful pocket control, most patients achieve a natural look without the rotation risk associated with shaped devices.
No consistent difference attributable to shape alone; revisions are more often tied to factors such as tissue quality, pocket control, size selection, or capsular contracture. Large registry analyses (TOPS) highlight that surgical factors and indications drive complications more than the shape itself (Complications of Aesthetic and Reconstructive Breast Implant Capsulectomy: An Analysis of 7486 Patients Using Nationwide Outcomes Data).
Profile: Matching Projection to Your Chest
When profile matches base width and soft-tissue coverage, patients tend to report higher BREAST-Q satisfaction. Over-projected implants on a narrow soft-tissue envelope can accentuate palpability/rippling and accelerate soft-tissue stretch; under-projected devices can underwhelm results.
Long-term, multi-study data do not clearly demonstrate worse safety for higher profiles when chosen appropriately for the anatomy. Your chest width, tissue thickness, and goals for upper-pole fullness guide this choice in consultation.
Texture: Balancing Contracture Reduction Against Oncologic Risk
- Recent meta-analysis indicates textured surfaces are associated with lower capsular contracture rates than smooth in augmentation, and subpectoral placement lowers CC vs prepectoral.
- The FDA and professional societies recognize an association between textured implants and BIA-ALCL; although cases are rare, they are serious. The FDA also notes very rare reports of other lymphomas and squamous cell carcinoma arising in the capsule.
- Current recommendations emphasize patient education, vigilant follow-up, and avoiding routine removal in asymptomatic patients. Many aesthetic surgeons now prefer smooth implants to avoid this exposure.
To Sum it Up:
- Shape: Round vs. anatomical delivers similar overall satisfaction; the shaped option may ripple less but often involves added texture (considerations).
- Profile: Outcomes hinge on anatomy-matched projection, not “higher is better.” Evidence doesn’t show a blanket penalty for higher profiles when properly selected.
- Texture: Textured surfaces may lower the risk of capsular contracture, but are also associated with the primary exposure to BIA-ALCL; many patients opt for smooth implants for cosmetic augmentation today.
- Placement & follow-up: Subpectoral placement can reduce CC, and FDA-recommended imaging supports long-term safety for silicone implants.
The Best Results Begin with the Right Choices
The shape, profile, and texture you select aren’t just technical details; they determine how your results will look, feel, and evolve over time. Guided by Dr. Courtney’s artistry, advanced surgical training, and commitment to precision, each decision is rooted in science, safety, and your personal vision of beauty.
During your one-on-one consultation, Dr. Courtney will take detailed measurements of your chest, assess soft-tissue coverage, review before-and-after photos, and allow you to try on implant sizes to visualize your ideal look. He’ll also walk you through the FDA patient-decision checklist and long-term implant surveillance plan, ensuring you leave fully informed and confident in your choices.
If you’re considering breast augmentation or revision, we invite you to take the next step toward confidence that feels authentically your own. Schedule your private consultation with Dr. Courtney in Houston to design a look that enhances your natural proportions.
