Ten-year review of a prospective randomized controlled trial of textured versus smooth subglandular silicone gel breast implants

Although textured silicone breast implants have been shown to reduce the in cidence of capsular contracture, there is little evidence if this effect is maintained in the long term. It has been 10 years since the double-blind. randomized trial in which 53 patients received either Mentor smooth (26) or textured silicone gel implants (27). Of the 14 patients who were not known to have developed a contracture in the smooth group, 11 were reviewed. Thr ee had bilateral contractures. In the textured group, 18 of the 24 patients not known to have contractures were reviewed. None had developed contractu res. At 10 years, the incidence of capsular contracture was 65 percent of p atients with smooth implants (an increase of 6 percent on the 3-year result s) and 11 percent for the textured implant patients (no change on the 3-yea r results). A database containing the details of 1100 patients reinforces these results by examining the differences in contracture rates of textured, smooth, and polyurethane-coated implants. The effect of submuscular placement on reduc ing contracture rates regardless of texturing is discussed, as is the appar ent increase in capsular contracture in patients who smoke.