Will Rippling Be Fixed with Larger Implants?

I had bad rippling, had a lift and implant exchange, went just 15cc's smaller so same size pretty much. Now still have minor rippling, doc says going to a larger implant may fix this issue - they are silicone, forget the brand but he said the best ones to prevent rippling already, new brand. They are over the muscle... would going under help? he says no cause the rippling is at the bottom of the breast more than the top. Thanks!

Doctor Answers (12)

Rippling

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To help improve rippling we have many options, changing the implant to below the muscle, switching to a form stable textured device, fat grafting on top of the implant, as well as covering with a skin substitute


New York Plastic Surgeon
5.0 out of 5 stars 37 reviews

Breast Implant Rippling

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A larger implant will cause more risk for rippling. Procedures which can help rippling are moving the implant below the muscle, grafting a material inside the breast (dermal matrix), changing the implant to a "form stable" implant, and sometimes fat grafting.It would help to discuss and evaluate your options in person.

Michael Horn, MD
Chicago Plastic Surgeon
4.5 out of 5 stars 24 reviews

Management of breast implant rippling: better coverage, better implant

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Going with a bigger implant is not the answer.  Most implant have rippling and it's just a matter of how much coverage you have to cover up the implant imperfections.  Going under the muscle makes things better (muscle is an extra layer on top of the implant thus making ripples less visible).  Using a smooth implant is better (because a textured implant sticks to the overlying tissues and is more likely to show rippling.  A fuller fill (whether saline or silicone) means less rippling.  For saline implants surgeons often overfill them to minimize rippling.  Now both Mentor and Allergan have silicone implants that are filled fuller than previous silicone implants thus minimizing rippling.  And finally, tear drop implants (anatomic/form stable implants) have the most cohesive type of silicone which maintains it's shape the best and thus ripples the least.  However, in my experience, tear drop implants are often 'too natural' for most breast augmentation patients as they lack upper pole fullness.  I no longer recommend these implants for cosmetic purposes.

Without examining you, as a general statement I'll say Mentor Cohesive II and Allergan Inspira True Form 2 silicone implants, placed under the muscle, are you best bet to fight rippling.

Martin Jugenburg, MD, FRCSC
Toronto Cosmetic Surgery Institute

Martin Jugenburg, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 143 reviews

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Larger implants aggravate rippling

+1

as you can see from the answers provided here.  Your best chance at diminishing rippling is using a form stable gel implant and if you want to minimize rippling in the upper pole, consider going under the muscle. Fat grafting can be considered to diminish or camouflage your rippling as an alternative.  Regardless, you should get a second opinion if your doctor is telling you to go bigger!

Curtis Wong, MD
Redding Plastic Surgeon
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Larger implants can ripple even more

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Unfortunaately a larger implant will produce even more thinning of the breast tissue and ripple even more. The least ripple is the gummy bear or form stable implant. You trade stiffness for smoothness but is something to consider.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 28 reviews

Rippling CANNOT be Fixed with Larger Breast Implants

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I'm sorry to hear of your situation. Before you make another very costly and potentially unrepairable mistake you should have a better understanding of the interaction of breast implants with the breast.

First, here are a few implant FACTS:
- ALL breast implants RIPPLE
- Saline filled implants ripple MORE than Silicone filled implants
- Underfilled Saline implants ripple MORE than fully filled saline implants
- Textured surface implants implants ripple MORE than smooth surface implants (This makes textured saline implants (especially underfilled ones) the worst rippling implants out there)

- There is NO WAY to smooth implant ripples EXCEPT to cover them with as MUCH breast and muscle tissue as possible. The more breast tissue you have the better cover and less palpable and visible the ripples would be. If you do not have a lot of breast tissue, you should have silicone filled implants and they should be placed UNDER the muscle. Sometimes, we also need to place additional shetts of biological tissue such as Strattice (VERY expensive) both to support the implant and to add cover to hide the ripples.

Putting a breast implant (much less a larger one) OVER the muscle (where it will have LESS cover) in a woman who ALREADY has ripples makes NO SENSE in my opinion.

Please consider your next step very carefully.

Peter A Aldea, MD
Mem,phis, TN

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 60 reviews

Larger implants will cause more thinning and more rippling later

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All implants have rippling but more in saline implants.  Patients with thin skin and minimal breast tissue to cover the implants, have more noticeable rippling. I use far grafting to increase soft tissue coverage of the implants.  Going under muscle will help the upper pole rippling but not the side ripplings. 

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.5 out of 5 stars 56 reviews

Rippling of implants

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Rippling may be treated by over filling a saline implant.  Placing them under the muscle especially in the upper pole may help. Also strattice may help.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Rippling implants

+1

Smooth silicone implants are the best choice when dealing with rippling but also putting implants under the muscle is important.  Particularly with a patient who has needed a lift with a history of rippling, this is the placement I would recommend.

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 11 reviews

Rippling with Breast Implants

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In the average patient, rippling is greatly reduced with Silicone implants.  Smooth silicone implants are usually the best option to prevent rippling.  In your case, I would consider having the implants placed under the muscle.  Of course, I would wait until you are healed from the last surgery.  You may need reinforcement at the bottom of the breast with a acellular dermal matrix (ADM) to eliminate rippling.  Consult with your Plastic Surgeon to discuss the options that are available to you.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 25 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.