Best Breast Implant Type and Placement to Avoid Rippling?

I am currently looking at two doctors for breast augmentation, both of which are very good. I am 5'2" 93 lbs. One doctor is very adamant about me getting high profile silicone implants under the armpit because he was sure I would ripple with saline implants. The other doctor thinks I should do saline through the nipple.

Has anyone similar to my size and height had breast augmentation and can give me any advice? I know both doctors are fantastic but can't decide which procedure is best for my body type not to ripple. I am also olive skinned and am worried about noticeable scarring.

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12 Doctor Answers | Asked by ashtheprincess in Massachusetts

Doctor Answers (12)
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Rippling is only one variable

Patients have to remember a couple of things about breast augmentation. The first is that it is an imperfect operation with an imperfect device. That is, there is always going to be a risk or potential complication that we know about and need to discuss with the patient. One is the fact that all implants ripple. The other thing is that implants can not be totally compared to each other such that one is better than another. You can only discuss implants relative to individual... more

Robin T.W. Yuan, MD

4 reviews

Beverly Hills Plastic Surgeon

Many factors to consider with breast implants

There are many factors to consider with breast implants, including your anatomy, the thickness of your tissue, the current and desired size, etc. In my opinion, silicone under the muscle gives the best results in most cases. However, every surgery must be individualized for the patient. Good luck with your surgery.

Rippling and breast implants

All breast implants have irregularities when positioned. Most of the time they are invisible, obscured by the native breast tissue and subcutaneous fat. Saline implants, because their viscosity is very different from fat and breast tissue, are more likely to exhibit the irregular contour because of the significant transition in viscosity from breast to implant. Therefore, the more of the patient that can be placed over the implant, the better. In my opinion, saline implants are best... more

No one perfect solution

There is no way that anyone on here can give you an absolute answer without examining you. In general, silicone implants under the muscle will ripple the least. The smaller your breasts are to start, the more advantages silicone will offer you. Incision location is up to you and your doctor, but each has pro's and con's. I personally feel that the imframammary crease incision offers the best advantages for most patients, but not all. In the end, incision location should be an informed... more

Rippling and implants

Silicone under the muscle tends to ripple a bit less than saline. It is all about soft tissue coverage. Go with the doctor you feel most comfortable with. Pick the implant that you prefer.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

It's a lot more than just the type of implant

The type of implant matters a lot, but it is not the only thing that affects the problem of rippling. The first priority in avoiding rippling is to have a maximum amount of tissue coverage. A big implant under thin tissue will always have more rippling issues than a smaller implant under thicker tissues. For that reason, you should go behind the muscle. And you should avoid a large implant and a high profile implant, as I believe that to do so stretches and thins skin and permanently... more

Silicone is less likely to show rippling

You are a thin woman with minimal breast coverage. Your best bet will be a partially under the muscle augmentation. The scar choice will be up to you. Your areola may be too small to place a silicone implant through so your choice is under the breast or through the armpit and some surgeons don't place silicone through the axilla. Either way you look at it there will be a scar and there can be no guarantees as to how it will heal. Look at your surgeon's patient photos to help make the... more

Silicone breast implants, but probably not through the armpit.

Hi! Here are 2 facts that should help you: 1) Silicone breast implants are very safe, and they have a much, much lower risk of rippling than saline breast implants. I don't think I have ever seen rippling with high profile, smooth walled silicone implants, and I have a pretty big experience. 2) It's seldom a good idea to put in breast implants through the armpit, because there is a higher risk of bad shape (implants too high). If a breast augmentation patient is not happy, it is... more

Silicone would be your best choice

In most Plastic Surgeons' experience, silicone implants have a much lower tendency to ripple. I always advise a thin, small breasted woman to have silicone implants under the muscle. The incision site is of little consequence. The nipple scar usually heals the best and does not need to be any larger for silicone vs. saline. Sensation changes are the same for all incisions. The high profile vs. moderate profile is based upon your chest diameter and the ultimate final size of implant you are... more

Breast implants options

You bring up some very important issue on breast augmentation. For you, a lot will depend on how much breast tissue you have now. If you're an "A" cup, placing the implants under the muscle will give you a more natural look and prevent rippling. However, if you have some breast tissue and around a "B" cup you have the option of placing the implants under the breast tissue. This will be less painful and still provide you with a natural look. As far as the incisions... more

Silicone tend to ripple less than saline

In general, high profile silicone implants tend to have the least amount of rippling. However, you must be willing to accept the follow up that is recommended of patients with silicone implants as well as the additional costs. In general saline implants tend to ripple more and the the high profile saline project more (are more round) than the high profile silicone. Generally speaking the areola scar tends to be the thinnest due to the modified dermal layer in this area.

Otto Joseph Placik, MD

32 reviews

Chicago Plastic Surgeon

Breast Augmentation and Rippling?

Thank you for the question. For patients with your smaller frame I generally suggest sub muscular ( dual plane) breast augmentation with silicone gel breast implants. Palpability and rippling of breast implants may be related to several factors. These include the amount of soft tissue and breast tissue coverage over the breast implants, the position of the breast implants (submuscular versus sub glandular), the type of implants (saline versus silicone), and the degree of... more