Rippling on New Silicon Implants? (photo)

Had saline implants for over 25 years, replaced them with Silicon 4 months ago under the muscle once again. I am 5'7 and weight 128 pounds, very thin build. I'm told due to my build and thin skin, the rippling that I am experiencing with these new implants I must live with or consider the gummy bear implants or add more skin which I will not do. Somehow I think if I were to go larger to perhaps 650 + cc versus the 500cc, I would eliminate the ripples as the implant feels loose inside. Thx

Doctor Answers (7)

Rippling with New Silicone Implants

+2

I am sorry that you are still having problems with wrinkling, but I do not think a larger implant is the answer. Most likely your new implants were placed in the original implant pocket. For patients who are very thin, this may often result in persistent wrinkling. The best solution is having the implants reposition behind the original pocket or adding a dermal matrix for additional coverage. You should discuss this with your surgeon or get another opinion from one with extensive experience in revisional breast surgery. Good luck.


Grand Rapids Plastic Surgeon
5.0 out of 5 stars 26 reviews

Rippling Effect Due to More To Soft Tissue Thinness and Laxity After Breast Implant Exchange

+2

By appearance and history it appears you have too much skin (soft tissue) for the existing size of your breast implants. The rippling you feel is more of your skin that is not adequately expanded over the implants rather than the rippling of the implants per se. Increasing the size of the implants may provide some improvement but is not the complete answer. A dermal matrix to provide better support and tissue thickness between the implants and the overlying soft tissue is likely also needed.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
5.0 out of 5 stars 27 reviews

Options for treatment of breast implant ripples

+2

First let me advise you to not go bigger, that will often make the type of ripples  shown in the picture (traction ripples) worse. You did not say if the implants are under the muscle, which often helps the upper part of the breast. High-profile implants may be more associated with traction ripples. Another thing to consider, somewhat paradoxically, is to add more support from below to hold the implant up. The best way to do this is with an acellular dermal matrix material such as Strattice. (ADM's can also be placed to add coverage over the upper part.)

Richard Baxter, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 23 reviews

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Fixing Rippling

+1
Your situation is unfortunately all too common: very large implants in a very thin woman.  Whenever the tissue is thinned and stretched, inevitably there will be some degree of rippling.

My bet is that your implants are not behind the muscle.  Though you may have been told that they are, my bet is that the left slipped in front of the muscle.  

If so, the implants should be put back behind the muscle and an ADM such as Strattice should be used to thicken the tissue and hold the muscle down.  If they are in front of the muscle, thickening your tissue with Strattice is also an option.

I've used gummy bear implants for over ten years.  They can help in this situation, but understand that fundamentally you have a problem in tissue thickness and the first priority in remedying it is therefore to thicken it.

The gummy bear implants do tend to ripple less. The Allergan Natrelle 410 is the most ripple resistant. However it has a teardrop shape.  If a teardrop implant rotates then it creates a deformity.  That is a rare problem when the tissue is tight, but may happen more often when the tissue is loose.  They also typically don't give the right shape in a breast such as yours.

I believe the best implant for patients in a situation such as yours is to use the Sientra Textured Round implants because they have a cohesive filler and the implant shell is maximally filled, thereby allowing for less rippling than many other implants.

Your problem is tricky.  Understand that there is no simple solution because there are a number of factors that are contributing to this problem.

There are also sections on gummy bear implants.


Steven Teitelbaum, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 28 reviews

Rippling on New Silicon Implants?

+1
I am sorry to hear about the problems you are having. Based on your description and photograph, you may be a good candidate for the use of acellular dermal matrix;  the use of this material ( placed between your skin and the underlying breast implant) may be helpful to treat rippling. In my practice, I have used this material for this purpose with good success.  I hope this, and the attached link are helpful to you as you learn more about revisionary breast surgery.  Best wishes. 

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 724 reviews

Rippling and silicone

+1

If you have rippling with silicone, then you probably could benefit from Strattice placement to camouflage the rippling.

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

Ripples with silicone implants

+1

Two assumptions I will make--these appear to be submuscular, and are without evidence of capsular contracture.If I am wrong, the likeliest contributing factor has been so identified.

 

The likeliest "cause" is the thinness of the cover of skin and muscle over the implant. Larger implants are not likely to solve this, and may add to the problem by making it present on both sides.

If this bothers you enough, adding soft tissue coverage with an acellular dermal matrix (Strattice) offers the likeliest chance of improvement.

Thank you for sharing your course and these photos. All the best. 

 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 31 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.