Many methods have been developed to reduce the risk of contraction and hardening of the capsule surrounding breast implants after breast enlargement or reconstruction. One of the most successful is the use of implants with a rough or textured surface.
It was found that a new technology, the ion-beam thruster, could alter the surface of implant materials so that the development of a tight, organized capsule of collagen was reduced. The collagen around textured implants has been found to be less organized and less dense than around smooth wall implants. This has led to a decrease in the number of clinically significant hard capsule. In other words more breasts are soft after augmentation with textured implants than with smooth implants.
Studies have been performed using gel and saline implants and they show that hard capsule is 4-20 x more common if smooth implants are used. Some doctors feel that in the submuscular pocket this may not be a problem and so use smooth implants in this location.
When a textured implant is used, wrinkling of the implant may be more noticeable. It is sometimes a difficult decision to try and reduce the risk of wrinkling or hardening.
For breast augmentation it is common for smooth implants to be used under the muscle and textured implants above the muscle. If smooth implants are used under the muscle the pectoral muscle will massage it and in theory reduce hardening.