Smooth or Textured? Picking your Breast Implants in London

Having your choice of implants is an important part of the breast augmentation process. Gaining a more prominent breast contour that fits your natural body shape enables you to realise your aesthetic aspirations in the most striking way possible. Choosing the right implant, smooth or textured, is a key aspect of your treatment plan. Dr Ricardo Frati is only too happy to guide you in your decision-making process so that you are left with the most aesthetically pleasing, most natural-feeling implants possible.

Specialising in breast augmentation, body contouring, and other elective enhancement procedures for the body and face, Dr Frati offers first-class treatments at Britain’s premier private Harley Surgery. With two locations in London, and offices in Birmingham and Manchester, patients can choose their implants and undergo their breast augmentation procedure at the location closest to their residence. Call +44 20 3633 2619 or book your personal consultation with us online.

Before & After Photos

Before and After Photos

About Breast Augmentation

Breast augmentation enhances and refines the size and shape of the breasts. It remains one of the most popular cosmetic surgeries in the world, and has remained a firm favourite procedure with doctors and patients alike. Numerous studies have shown that breast augmentation surgery can enhance sexual attraction, self-esteem, and marital and social relationships significantly. One study even notes that breast augmentation surgery had the potential to improve women’s self-esteem and sexual satisfaction by 80%. (1)

Why Choose Breast Augmentation with Implants?

  • Enhance Appearance – If you are dissatisfied with the size or shape of your breasts, you can gain the look you want with implants. Implants can help to balance the overall body silhouette. Tailored to your specific aesthetic requests, Dr Frati can help you choose the best breast implant option for your needs.
  • Restore Breast Size – Age and weight-loss can reduce the amount of tissue in the breasts, and increase sagging. You may be happy that you have shed a few pounds in some areas, but you may be disappointed if your chest size is also reduced. Implants can restore lost breast volume, and even go a little bigger, should you require a larger size.
  • Recover from Breastfeeding – Breastfeeding can take its toll on breast tissue. Many women report that their breasts do not return to their original aesthetic, even after they have finished nursing. Implants can restore lost breast volume and address sagging skin, leaving you with a more youthful-looking, prominent chest.
  • Gain Symmetry – No natural breasts are symmetrical. However, in some cases, there is considerable asymmetry. One breast may be larger or sit lower on the chest due to an imbalance of fatty tissue. Dr Frati can more precisely align breast size with the addition of properly sized implants.
  • Improve Body Confidence – Many women struggle with self confidence in their figure, and larger breasts are often high on the priority list if we have the opportunity to change our appearance. With an expertly performed breast augmentation, you can achieve the body you desire at Harley Surgery!

So, what are the pros and cons of smooth and textured implants? Harley Surgery provides highly personalised aesthetic consultations in London, Manchester, and Birmingham. He will explain the benefits of each type of implant and help you make the right choices for your treatment. Find out more about Dr Frati’s premier breast procedures on our website.

Which Implant is Right for Me?

For many years, patients have been able to choose what their implants are made of, and what shape they are. There are silicone implants, saline implants, and various different projection levels. Patients can choose from round implants, or more natural-looking teardrop-shaped implants. But few patients realise that they can choose the texture of their implants, too!

Both smooth and textured implants are an excellent choice, but only one will be the right choice for you. Dr Frati will work with you to discuss your goals, so you can make an informed choice regarding the texture of your implant. 

Capsular Contracture and BIA-ALCL

Like all surgeries, breast augmentation carries with it certain risks. While the vast majority of implants pose no issues to patients, you should still have a clear picture before you opt for treatment. Two such conditions are capsular contracture and BIA-ALCL.

What is Capsular Contracture?

Capsular contracture can occur in some patients after breast augmentation surgery. It’s the most common complication that can arise after implants are placed. Although the precise trigger is unclear, an inflammatory response from the body can cause a fibrotic reaction around the implant. The body recognizes that the implants are foreign bodies and takes steps to protect itself. This means that the tissue around them can become hard capsules, which can make the breasts firm, misshapen and sore. (2) Patients can take steps to minimise the chance of capsular contracture by massaging the tissue. In some cases, patients choose a capsulectomy or capsulectomy with implant removal to mitigate the effects of capsular contracture.


An individual’s lifetime risk of developing BIA-ALCL is very low. Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare kind of T-cell lymphoma; a cancer of the immune system. At Harley Surgery, we believe that all patients should be aware of the risks, no matter how small they are. The American Society of Plastic Surgeons states that between 1 in 2,207 and 1 in 86,029 patients will develop the disease. (3) And , a recent 2021 study estimates that the overall risk of developing BIA-ALCL from all breast devices was as low as  one in 500,000.(4)

Smooth or Textured?

Smooth Implants

All breast implants have a silicone shell and either a silicone or saline filling. Smooth walled implants are devices without additional texturing of their outer surface. The outer shell is glossy and slippery to the touch. These implants are less opaque than textured ones.

Benefits of Smooth Implants:

  • Mimics natural breast movement
  • More natural appearance
  • Smoother and softer feel
  • Good for those with more breast tissue
  • Good for above-muscle placement

There are few disadvantages to smooth implants, but there are some considerations to know before your surgery. Smooth texture is only available for round implants, not anatomically-shaped ones. And, depending on their placement and the immune response of the patient, there is a slightly higher chance of capsular contracture occurring.

Textured Implants

Textured implants, when compared to smooth implants, look quite different when placed side by side. They are more opaque and have a rougher surface. Textured implants are available in shaped implants, the most common of which is the teardrop implant.

Benefits of Textured Implants

  • Breast tissue grips surface for less mobility
  • Reduced risk of scarring
  • Anatomically-shaped design available
  • Increased friction, less likelihood of rotation
  • Lower chance of capsular contracture

Over the years, breast implant studies have sought to explore the link between textured implants and BIA-ALCL. Current research shows that there is a slightly higher risk of BIA-ALCL for patients with textured implants. Scientists in the field stress the importance of patient education in cosmetic and reconstructive surgeries with textured implants, despite the low risk of developing the condition. (5)

Personal Consultation

Dr Frati will meet with you at one of our four locations to discuss your breast augmentation procedure. Simply give us some details of your medical history, let us know if you have any history of breast surgery, and let Dr Frati know the aesthetic you want to achieve. He will conduct a breast examination and note skin elasticity and asymmetry, if it is present. If you are a good candidate for breast augmentation surgery, he will discuss the types of implant available to you. Oce you have decided, he will draw up an individual treatment plan and schedule you for your procedure.

Cost of Breast Implants in London

The cost of your breast augmentation depends on the type of implants you select and the type of individual treatment plan drawn up for you by Dr Frati. For further details, and to book your personal consultation with us at Harley Surgery, call us at +44 20 3633 2619 or fill out an online form to request a personal consultation.

Find the Harley Surgery blog online for more information about the UK’s leading provider of cosmetic surgery and non-surgical treatments!


Are textured breast implants safe?

Although textured implants have been associated with conditions like BIA-ALCL, a type of non-Hodgkin’s lymphoma, these complications develop in a very small number of patients annually. With the low risk of adverse effects from textured breast implants, the consensus within the cosmetic surgeon community is that textured implants are safe for use with the vast majority of patients.

How do I know which type of breast implant to choose?

When choosing your breast implants, it’s important to take a number of factors into consideration. Your doctor will talk to you about the aesthetic you’re looking for, as well as paying close attention to your physical anatomy. Once they have performed an examination, and you have discussed your goals in full, you can work with your doctor to choose the right implant type for your needs.


  1. Shridharani, S. M., Bellamy, J. L., Mofid, M. M., & Singh, N. K. (2013). Breast Augmentation. Eplasty, 13, ic46. 
  2. Headon, H., Kasem, A., & Mokbel, K. (2015). Capsular Contracture after Breast Augmentation: An Update for Clinical Practice. Archives of Plastic Surgery, 42(5), 532. 
  3. Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). (n.d.). American Society of Plastic Surgeons.  
  4. Lynch, E. B., DeCoster, R. C., Vyas, K. S., Rinker, B. D., Yang, M., Vasconez, H. C., & Clemens, M. W. (2021). Current risk of breast implant-associated anaplastic large cell lymphoma: a systematic review of epidemiological studies. Annals of Breast Surgery, 5, 30–30. 
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