Breast Implant Revision: Q&A

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I Had 4 Previous Revisions and then Finally a Lift. Now There Is Rippling, What Should I Do?

I still have a huge problem, I had major sagging before and bottoming out. My last surgeon (of 3) fixed the sagging with a full lift. Now I have rippling which I never had before, and the right implant is still off to the center a bit causing some issues. I shouldn't have rippling because I have my own breast tissue, even though the surgeon removed 50 cc's of my tissue during surgery. He is going to tighten the skin on the bottom but does not say it will fix this.

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14 Doctor Answers | Asked by Chelsea489 in West Palm Beach, FL

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Multiple revisions usually get farther and farther from perfect

Please read and re-read Dr. Aldea's note as it excellently describes the problem we see in many patients. I will add to that the fact that inherently, with each revision the patient's expectations invariably go UP and the reality of the potential result often can go DOWN because of scar tissue etc. This creates a growing EXPECTATION MISMATCH which is not resolved by continually changing surgeons thinking that someone will finally have the magic to give you a perfect... more

Rippling of Breast Implants?

Thank you for the question. 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... more

4 revisions

I agree with Dr Aldea. Each procedure bears its own risk. My mentor used to say that perfect is the enemy of good. Surgery is not the equivalent of changing hair color. It is serious business and sometimes saying no or that the implants or procedure a patient wants isn't what I would recommend isn't easy but it may be the right thing for all concerned. More surgery may produce ore or different problems and it is important to have a good reality check as to the risks and benefits of a... more

Rippling post mastopexy

This may be due to saline implants.Also the implant pocket can be revised so you can move the right implant to a more normal position.

Multiple revisions for breast surgery.

Thank you for your post and the photos. Rippling is simply the ability to see the implant through thin tissue. Even though a person may have breast tissue, after a lift, this tissue is tightened and this tightening will always thin the tissue to some degree. The underlying implant (and usually more common with saline implants) can then be visible. To correct this, the best options involve placing the implants under the muscle and/or adding a dermal matrix such as Strattice. This allow for... more

David Bogue, MD

6 reviews

Boca Raton Plastic Surgeon

www.drbogue.com

Solution for Implant Rippling

Visible rippling can happen when the implant is close to the skin and has little breast tissue coverage. This is seen more often with saline implants but can occur with silicone as well. If you have had several surgeries and the implants are still positioned incorrectly the best solution is to use a biocompatible material such as Alloderm or Strattice which cover and support the implants. The advantage of using one of these materials is that they can also be used to create new... more

Breast Revision and Rippling

Sorry to hear about your troubles. But, there are potential solutions. From what I can glean from your photos, to correct your right implant from moving too far off to the side (if that is what you mean by "off center"), your implant pocket on the right will need to be adjusted and made more narrow. To correct the rippling on the left, you need more thickness of your breast to camouflage the implant rippling; if your implants are saline, I would also switch to silicone to... more

Rippling following breast augmentation

Rippling can be seen with any type of implant. It is more common with saline implants, and textured implants Rippling occurs least commonly with smooth round moderate profile plus silicone gel implants Rippling is also related to the overlying tissues.The thinner the tissues the greater th chance of rippling The overlying tissues can be thickened with fat injectionsor dermal grafts.These grafts are either from human donors , animal sources or synthetic materials ... more

You need soft tissue coverage and fat grafting is an option

I am sorry that you had to go through multiple operations and still have problems with your implants. You do not have enough breast tissue to cover the implants. I would recommend fat grafting over the implant to provide more coverage. For patient with similar problems I have done fat grafting many times. You can refer to my web site for more information.

Kamran Khoobehi, MD

28 reviews

New Orleans Plastic Surgeon

Implants ripple after four breast revisions

Even with a silicone gel breast implant, it may be possible to see a small fold or ripple over a breast implant. The more breast tissue to cover the better, though breast implants and natural breasts all have imperfections and limitations. Your pictures show a result that is very good, and probably should be viewed as good enough. Best of luck, peterejohnsonmd

4 Previous Revisions and then Finally a Lift. Now There Is Rippling, What Should I Do?

Dear Chelsea489, I can feel the frustration in your question but I fear you do not completely understand what happened, how you arrived here and what your options may be. A simple surgical fact is that IDEALLY you should have only one procedure. With each operation, the amount of scarring increases, the extent of skin malleability and skin blood supply decrease and the likelihood of average to poor results and complications become higher. SO- HOW do we go... more

All breast implants ripple, the problem is can the ripples be seen or felt

While all implants ripple and saline ripples more, it is not a question of if the implants ripple but can the ripples be seen or felt though the breast. The idea that ripples can't be seen or felt if you have breast tissue is not exactly right. It depends on how much and how thick the breast tissue is over the implant. When patients of mine who have experienced ripples I have found that fat grafting the breast to thicken the soft tissue cover often will give excellent results and hide... more

Strattice is a good option for rippling after breast implant revision

With every re-operation the breast tissue changes and subsequent operations become even more challenging. Using Strattice to build an internal bra is a very useful option to support the implants especially after a lift and to add coverage to conceal rippling.

Revision surgery

Chelsea489, Hoping to offer you some help here. First of all, I feel for you that you are unsatisfied with your results after 3 prior procedures with other surgeons. There is some asymmetry in your result, which can occur in the hands of any good plastic surgeon. However, there MAY be some benefit to another revision, depending on whether your goals can be set realistically in terms of an outcome. Rippling can occur despite the fact that you have your own breast tissue. When a lift... more