Smooth round silicone gel implants in retropectoral augmentation mammaplasty: any aesthetic outcome can be achieved without texturization.

Background: Due to risks of texturization, the use of textured breast implants has been diminishing worldwide and is expected to continue to decline. The crisis with textured devices raises the need to revisit the use of smooth round silicone gel (SRSG) implants and to discuss the results that can be achieved with this alternative. The article aims to exclusively analyze SRSG devices: the changes associated with implant profile and degrees of filling, how these changes correlate to certain aesthetic outcomes, and the predictability and stability of these results over time. Methods: The experimental component of this study investigated the effect of gravity on various profiles of SRSG implants when their position was changed. The study's clinical component was a retrospective analysis of primary retropectoral breast augmentation patients with a minimum 1-year follow-up after the procedure. Results: In the experimental setting upon changing position, the anatomic conformation in higher profile devices was more visible compared with their lower profile counterparts. Clinical results of 92 augmented breasts (46 patients) with various types of SRSG implants revealed a full scope of aesthetic outcomes. Desired results were achieved even in challenging scenarios. Breast shape and upper pole contour were predictable with reliable and stable control over time. The overall complication rate was comparable to other breast implant studies. Conclusions: With proper device selection and good surgical technique, any aesthetic outcome can be achieved in retropectoral placement while keeping also prioritizing patient safety. Moderate and moderate plus profile underfilled implants are recommended when anatomical results are intended. Level of evidence: Level IV, Therapeutic. [ABSTRACT FROM AUTHOR]