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G. Patrick Maxwell, Michael Scheflan, Scott Spear, Maurizio B. Nava, Per Hedén, Response to “Clarification on Rotation Rates of Textured Breast Implants”, Aesthetic Surgery Journal, Volume 35, Issue 5, July 2015, Page NP124, https://doi.org/10.1093/asj/sjv031
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We appreciate the comments offered by Drs Wixtrom and Canady regarding our article, “Benefits and Limitations of Macrotextured Breast Implants and Consensus Recommendations for Optimizing Their Effectiveness.”1 Texturization of the surface of breast implants was originally developed in an effort to minimize capsular contracture. An additional benefit was to stabilize the position of the breast implant. While there are many factors that contribute to the stabilization of a breast implant—including patient selection, preoperative planning, operative technique, postoperative care, the surface area of the base dimension of the implant, the filler to shell ratio, and the character of the fill material—the focus of our article was on the texturization of the shell of the implant. Specifically, we attempted to document the differences in macrotextured surface technology (such as Biocell) and microtextured surface technology (such as Siltex). While I believe the content of our article stands on its own merit, I do appreciate the comments regarding the differences in a saline-filled textured implant versus a gel-filled (or, more specifically, a form-stable gel-filled) implant. Notwithstanding the above, it is important that readers are well aware of the findings of Danino et al2 regarding implant positional stabilization when comparing a Biocell (macro) textured surface saline implant with a Siltex (micro) textured saline implant. They documented that the macrotextured surface promotes an “adhesive effect” (within the pocket), while a microtextured surface does not. This adhesive property of a macrotexture allows for tissue adherence with the desired goal of “implant immobility with softness.” Such is not the case with microtextured surfaces. These findings are especially important with regard to the use of anatomically-shaped breast implants.
