I had saline implants placed under the muscle 6 years ago. I have only noticed rippling in the last year. I have always been very thin, 5'9 and 120 pounds and realize that the rippling is due to limited breast tissue. My question though is is the rippling permanent? Would changing to a silicone implant alleviate the issue? I am very unhappy with the shape, size and asymmetry, along with the rippling, so am leaning towards having them redone but was told the rippling could be permanent.
Is Rippling with Saline Implants Permanent?
Doctor Answers 12
Replacing saline breast implants with silicone gel breast implants under the muscle may reduce visible rippling
Thank you for your question. As a general rule silicon gel implants do tend to cause less rippling than do saline implants.. Placing the new implants beneath the muscle and is necessary covering them with acellular dermal matrix may solve your problem.
Correction of implant rippling
There are several factors that cause implant rippling
1 Saline implants ripple more than silicone gel implants( Moderate profile plus have the least tendency to ripple)
2 Textured implants ripple more than smooth implants
3 Rippling is more common when the overlying tissues are thin
4 Rippling is more common in the sub glandular than the sub muscular position,however surgeons often release the muscle leaving the lower half of the implant covered with skin only, this will predispose to rippling
I therefore use smooth round moderate profile plus silicone gel implants placed beneath the fascia
I reinforce thin tissue with mesh if necessary,and inject fat to thicken the skin
Rippling of breast after implants
It is not just the fact you don't have much breast tissue, but the fact that it seems that you have very little fatty subcutaneous tissue. Put another way; your body fat is very low. Because of this you have very little tissue over the implalnt. This would definitely be helped by switching the implant to silicone and changing the position of the implant; either under the muscle and/or under another layer of capsule tissue. Consult a board certified plastic surgeon
Note that no wrinkling cannot be guaranteed.
Talmage Raine MD FACS
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Silicone-Filled Implants Ripple Less than Saline-filled Implants
As a rule, silicone gel filled implants have less rippling than saline-filled implants. In very thin women who have less breast tissue, rippling may be visible with both types of implants and a third option are the "form-stable" silicone gel implants. Since these implants are designed to hold a "teardrop" shape, they tend to have the least amount of rippling but typically are a bit firmer than the round silicone gel implants.
If the rippling persists after changing to a different implant style or implant projection, other strategies including use of fat grafting, or use of a material known as acelular dermal matricies (Alloderm, Strattice) may be an option.
Rippling with implants
Rippling occurs because the tissues are very thin. Gaining weight can cause it to appear less, strattice or pocket repositioning may help.
Implant rippling can be permanent
If your tissue has thinned, even after submuscular augmentation, detectable ripples can be permanent. Weight gain can help, and sometimes fat grafting can help if practical. Facts are that a silcone implant (except the gummy bear) might have a visible ripple as well so take your time before you decide on a switch.
If you have thin skin and you went with a pretty big size implant you will have rippling. Even though your body is still making scar tissue so the rippling should get better with time.
Fat grafting to the breast can help you to cover the rippling
All saline implants have rippling. Patients will small amount of soft tissue will have more obvious rippling. you can have revision with silicone gel implants. I offer fat grafting over the implants if there is thin tissue over the implant in combination with implant exchange to gel implants.
All implants ripple and saline implants ripple more than silicone gel filled implants
Since all implants ripple and saline filled implants ripple a lot more than silicone gel filled implants, the question becomes can you feel or see the ripples. Placing the implants under the muscle decreases the chance of feeling or seeing the ripples but as in your case it doesn't prevent them. Replacing your implants with gel filled implants will help but not necessarily prevent rippling. It all depends on the amount of soft tissue over the implants. If exchanging the saline implants with gel filled implants doesn't completely do the job of hiding the ripples then you could consider having fat grafting to the soft tissue to hid the ripples. This will give you bigger and nicer breast and works very well. The limit here is do you have enough fat to graft.
Changing from saline to silicone does improve the rippling problem
If rippling is a concern, then changing to one of the newer silicone implants that have a higher fill (than the older silicone type), or choosing a shaped silicone implant (they have the least amount of rippling if any) may be your choice.
Martin Jugenburg, MD, FRCSC
Toronto Cosmetic Surgery Institute