Breast Implant Revision: Q&A
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Will Rippling on the Inner Side of the Muscle Disappear?
2nd BO after 7 months due to implant flipping. The PS told me he would try a dual plane procedure to cover the implant. I asked if rippling could be visible and he said that the top part is covered by muscle. Now after 7 days I have rippling on the inner part of the the L-breast and if feels as if the implant would only be covered by a very sheet of skin. Further pics and info on Realself JCSM.
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10 Doctor Answers |
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JCSM
in Shanghai, China
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Rippling on inner part of breast after breast implant
You indicated that you had a dual plane breast implant surgery. This means that the top of breast impant is covered by muscle and skin, and the lower part is only covered by skin. This technique works well because it allows the breast implant to settle into a natural position. It is my preferred surgical approach. The inner aspect of the implant is only covered by skin and this is why yo are seeing visible rippling. I do not think this will get better...in fact it may get worse as time goes...
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Breast Implant Rippling
Thank you for the question and pictures.
Your situation may be improved with the use of allograft to cover the most visible/exposed areas of the breasts involved with rippling/palpability of the implants.
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...
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Will Rippling on the Inner Side of the Muscle Disappear
The visible ripple suggests that at that point the implant is probably only covered by the skin/breast tissue. In slim patients it can be challenging to provide enough cover over the implant and sometimes choice of the implant helps. It is unlikely for a visible implant to disappear on its own - you can try some fat graft to disguise it.
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Implant rippling
Big implants in lean patients is always challenging. My approach is to use smooth gel implants under the muscle the first time around and do some fat grafting is rippling occurs medially. If the rippling is better with a little support from underneath, adding a sheet to Strattice may also help.
Lisa Lynn Sowder, M.D.
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How to fix rippling
Although there is no guarantee, the chances of having visible rippling of breast implants can be reduced by:
Using silicone gel implants instead of saline implants
Adding soft breast tissue coverage over the implant with fat transfer
Adding soft tissue coverage by lining the implant pocket with a biocompatible material such as Strattice
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Breast Implant Rippling
It is unclear to me whether you have saline implants or silicone gel implants. If the tissue is thin enough, you can see rippling with even gel implants, but always less than with saline. Textured surface implants ripple more than smooth implants. If you have anything other than smooth silicone gel implants, you could consider replacing them with smooth gel implants which at least would show less rippling than other implants. It is also unclear to me whether you were...
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Fat grafting is a great way to increase the soft tissue coverage of the breast implant and hid rippling
When there is not enough soft tissue coverage of the breast implants you will see and or feel ripple. All implants ripple but saline implants ripple much more. If you have saline implants you could have them replace with gel. If you have gel and there still is rippling, fat grafting of the breast make a much nicer breast and will hid the ripples if enough thickness is added.
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Breast implant ripple toward the inside of the breast
Though your surgeon may have intended to place your implants into a submusular position during your revision, the ripple on the inside of the breast usually indicates that the implant is still located under the gland only and is able to show through the thinner cover. If the implants stay soft and the shape is attractive it is best to let things be.
Best of luck,
peterejohnsonmd
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Fat grafting will help
The problem is that the soft tissue is thin and does not provide enough coverage for the implant. I would recommend fat grafting to increase soft tissue layers . This can be done under local anesthesia and without touching the implants. You can check my web site for examples.
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Rippling
In the dual plane approach the lower portion of the breast is in the subglandular/subcutaneous position. As there is less covering, the implant will be more visible and palpable if the tissue is thin. My current approach would be to allow all tissues to heal, and if rippling is still an issue consider using Strattice to line the pocket and thicken the tissue.
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