Recent media attention has transformed breast augmentation, a routine surgical procedure, into a highly controversial one. Capsular contracture is cited in both the lay press and scientific literature as the most frequent complication of breast augmentation. This retrospective study compares two similar groups of breast augmentation patients. The first group consists of 98 consecutive patients utilizing smooth-surface silicone implants, and the second group consists of 99 consecutive augmentations using textured-surface silicone implants. The operative technique and postoperative care were identical--with the surface differences being the only significant variable. Textured-surface silicone implants are shown statistically to reduce capsular contracture to 4 percent, compared with a 21 percent incidence with smooth-surface silicone implants.