Can Rippling of a Silcone Implant Correct Itself Without Surgery?

I'm 3 months post op after a breast lift revision (Capsulectomy) that affected my right breast. I have subglandular placement of smooth round silicone implants 375cc L, 397cc R. I am happy with the revision but may have been a little overzealous with aggressive messages right after the surgery. Now I have rippling on the interior (cleavage area) of the right breast, and I can also feel the side of the implant over my skin. Can this rippling correct itself or does it warrant further surgery?

Doctor Answers (9)

Rippling after surgery

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It is possible that the ripples may improve on their own without surgery.  If not, you should discuss your options with your surgeon.  Placing the implants under the muscle or adding acellular dermal matrix may help to to improve the result.


Los Angeles Plastic Surgeon
5.0 out of 5 stars 19 reviews

Rippling in Silicone Implants: What to Do

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                  Several factors are associated with the development of rippling following breast augmentation surgery. These include sub-glandular implant placement, saline implants and inadequate soft tissue coverage.

                  In the majority of cases rippling doesn’t improve with conservative management or the passage of time. Even with surgery this problem can be difficult to correct.

                  In many cases, the only option is surgical intervention. Surgical management varies from patient to patient and depends on the cause of the rippling.

                  When patients have sub-glandular implant placement, rippling can be improved by moving the implant to a sub-muscular position. When saline implants have been used, rippling can be improved by switching to silicone implants. Finally, when the problem is related to inadequate soft tissue coverage, added support can be provided by using supplemental materials like alloderm and strattice.

                  Without pictures or a physical examination it’s virtually impossible to make a specific recommendation in this situation. Your history suggests that moving your implant to a sub-muscular position would be an appropriate first step.

                  Consultation with your surgeon is appropriate as well. Your surgeon should be able to make an appropriate recommendation to address this problem. 

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 74 reviews

Rippling of Breast Implants?

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Unfortunately, it is not possible to give you good advice without direct examination.

Generally speaking, 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 of the implants will also increase the rippling/palpability of the implants.

Correction of the rippling may involve further surgery including implant pocket exchange if possible ( sub glandular to submuscular), implant exchange if possible (saline to silicone), and/or the use of allograft to provide an additional layer of tissue between the implant and the patient's skin. Patient weight gain (if possible) may also be helpful.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 710 reviews

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Silicone ripples in breast augmentation

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I would be less concerned with the palpability of an implant rather than the visibility of the wrinkles or ripples. Discuss your concerns with your plastic surgeon. From your description, it is difficult to make any recommendations. Massage generally helps rather than makes it worse.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 44 reviews

Breast revision for rippling

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The only way you can mask the ripples above the muscle is to gain weight and cover the implants with thicker tissue.  Otherwise you need to go under the muscle or use Strattice to cover the implants.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 48 reviews

Reason for Breast Implant Rippling

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Regarding: "Can Rippling of a Silcone Implant Correct Itself Without Surgery?
I'm 3 months post op after a breast lift revision (Capsulectomy) that affected my right breast. I have subglandular placement of smooth round silicone implants 375cc L, 397cc R. I am happy with the revision but may have been a little overzealous with aggressive messages right after the surgery. Now I have rippling on the interior (cleavage area) of the right breast, and I can also feel the side of the implant over my skin. Can this rippling correct itself or does it warrant further surgery
?"

Breast massaging does not cause rippling. All breast implants ripple and saline filled breast implants ripple more than silicone filled breast implants. (Textured shell and anatomic shaped implants ripple more than smooth and round implants. As such textured silicone gel implants will ripple more than smooth round implants).

When breast implants are placed under the breast (subglandular) the ONLY thing that keeps them from being felt (ripples and all) is the thickness of the cover (in this case only breast tissue. Since the cover is least along the inferior and side periphery where the implants slump in the pockets, that is where they will be felt. The reason why you are feeling it more is that your capsulectomy operation removed scar AND some breast tissue THINNING the cover over the implant bringing the skin surface closer to the ripples.

The solution? Implant placement under MORE COVER (under the muscle) and, if needed, additional cover and support along the bottom (Alloderm or Strattice).

But the rippling will not go away in an intact implant. IF the implant deflates, the ripples will smooth away.

You may wish to discuss revision with your surgeon.

Good Luck.

Dr. Peter Aldea

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

Rippling after revision breast augmentation will not go away.

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Hi.

1)  If this bothers you, I am afraid you need more surgery.

2)  Need to go under the muscle.

3)  Higher profile implants do not ripple.  If you have moderate profile, go to moderate plus.

4)  Alloderm can help.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

Rippling and correction

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Rippling will not correct itself. It is often due to the thin soft tissue coverage over the implants. Sometimes with weight gain this gets better. 

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

Rippling will not correct itself

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The rippling is common for all kind of implants but more in saline implants. The reason for the palpable implant is due to the thinning of the breast tissue which will get worse as time passes. I use fat grafting to cover the implant and provide more coverage for the implants. Bigger implants are the worst solution.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
5.0 out of 5 stars 54 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.