Textured silicone breast implant use in primary augmentation: core data update and review.

Evolution of silicone breast implant design has focused primarily on advances in implant fill, surface texture, and shape. Fifth-generation, shaped, form-stable, silicone breast implants from all three major implant manufacturers are now approved for use by the U.S. Food and Drug Administration in the United States. As part of this approval, the U.S. Food and Drug Administration mandated Core Study follow-up of silicone implants for 10 years after premarket approval. An updated and comprehensive collection of Core data from all three manufacturers is presented in this review. In addition, cause and rates of capsular contracture, seroma, rippling, and malposition are discussed. New concepts such as tissue friction coefficient are discussed that may influence outcome after primary breast augmentation. The theoretical advantages and disadvantages of the various textured surfaces ranging from microtexturing to macrotexturing are presented in relation to breast tissue incorporation.