Do Textured Breast Implants Mitigate Malposition? A Systematic Review and Meta-Analysis

The widespread utilization of silicone implants for cosmetic augmentation and breast reconstruction has encouraged many innovative design characteristics since inception in 1962. Despite a multitude of studies, there exists limited collective evidence supporting textured implants' efficacy in reducing implant malposition. In this study, the authors present a systematic review and meta-analysis to assess all available data regarding textured devices associated with outcomes of implant malposition. A literature search was performed covering PubMed/Medline, Scopus, and Web of Science databases. Cohort studies assessing textured vs nontextured implants were included in the final review. Primary outcome data included rates of implant malposition, and secondary outcomes included capsular contracture, rippling, and infection. Nine studies met inclusion criteria, including 2011 patients undergoing breast reconstruction and 1229 undergoing cosmetic augmentation. Malposition occurred in 5.2% of breasts in the textured cohort and 8.9% in the smooth cohort; however, pooled analysis demonstrated no statistically significant difference between groups. No significant differences were observed for capsular contracture, seroma, or rippling. A higher rate of infection was observed in the textured cohort, although this finding was not consistent across all analyses. No cases of breast implant-associated anaplastic large cell lymphoma were reported. Review of existing literature failed to identify statistical superiority in textured implants for reducing malposition. Interpretation is limited by retrospective design and heterogeneity among included studies. Level of Evidence: 3 (Therapeutic)  For image description, please refer to the figure legend and surrounding text.