Textured coatings for implantable medical devices can be provided in metallic or polymer surface layers having surface texture factors down to nanometer and sub-nanometer levels. Implantable devices having such textured surfaces and methods of coating such devices comprises providing a substrate surface of an implantable device and forming a coating layer of the substrate surface by directing a mixture of atoms of a first type of material and a second type of material toward the substrate surface while simultaneously and collinearly bombarding the substrate surface with ions, wherein the first type of material is substantially resistant to a removal process and the second type of material is substantially susceptible to a removal process.