How Can You Distinguish Between Rippling and Rupture?

Breast Implant Rippling most often occurs when there is insufficient soft tissue coverage due to little overlying body fat and breast tissue. Implants placed beneath the muscle help to minimize this phenomena but the lower and outside breast (as pectoralis muscle is no longer present), towards the cleavage where the muscle thins out or on top of the breast where breast tissue is often lacking are the most common places to see rippling. It is often accentuated with certain positions (e.g. bending over,or leaning). Most of the time, rippling is felt along the outer side of the breast and the inner side of the breast next to the cleavage. Breast implant waviness (rippling) that is felt but not noticeable to the eye is very common and should not be a concern. However, when rippling is visible, patients are often self-conscious about their appearance.Factors that are associated with increased rippling include:Traditional Saline implants (IDEAL® Saline implants less likely)Textured implantsLarge implantsThin patients with low BMIImplants placed above the musclePrior history of ripplingFactors which are less likely to have rippling include:Heavier and larger breasted womenUsing a highly cohesive form-stabile silicone implants (gummy bear)Smooth implantsSmaller implantsSubmuscular placementOnce rippling occurs it is very difficult to correct. Rippling can be minimized by placing a biologic fabrics (e.g. AlloDerm®, Strattice™, SERI®), submuscular conversion if implants are above the muscle, fat transfer, use of adjacent tissue (muscle or fascia) if available, and in persistent cases implant removal and fat transfer. Seek the care of the best board certified plastic surgeon possible with experience in breast revision surgery.#rippling#breastaugmentation

For saline, a ruptured implant will result in deflation and within a couple of days the breast will lose considerable volume, you won't require medical expertise to realize that something is wrong.

With silicone implants, it is more difficult. If there is any question on the part of your plastic surgeon, an ultrasound is about 85% accurate in making the call for a ruptured implant, if not, then an MRI is quite useful.

Thank you for the question.

Rippling refers to the visible or palpable “waviness” of a breast implant.  This may be seen with any type of breast implant but is more common with saline  breast implants and more severe if an implant is deflating ( compared to a appropriately filled implant).

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 overfilling of saline filled implants. Generally, weight loss will extension weight any rippling/palpability  of the implants.  Deflation of the implants will also increase the rippling/palpability of the implants.

Correction of the rippling may involve further surgery including implant pocket exchange if possible ( sub glandular to submuscular), implant exchange if possible (saline to silicone), and/or the use of allograft to provide an additional layer of tissue between the implant and the patient's skin. Patient weight gain (if possible) may also be helpful.

Breast implant rupture (if saline)  may present with a changing breast size  or shape and increased breast implant rippling. It usually becomes very clear clinically when a saline breast implant is leaking. Sometimes however it may take a few weeks/months for the implant to leak completely. This leakage does not cause any harm to the patient's well-being.

On the other hand, detection of a silicone breast implant leak may not be possible clinically. An MRI study may be indicated.

Consultation with a well experienced board-certified plastic surgeon may be helpful.

Best wishes.