Rippling and Uncomfortable Breast After Augmentation

Breast Implant Rippling most often occurs when there is insufficient soft tissue coverage due to little overlying body fat and breast tissue. Implants placed beneath the muscle help to minimize this phenomena but the lower and outside breast (as pectoralis muscle is no longer present), towards the cleavage where the muscle thins out or on top of the breast where breast tissue is often lacking are the most common places to see rippling. It is often accentuated with certain positions (e.g. bending over,or leaning). Most of the time, rippling is felt along the outer side of the breast and the inner side of the breast next to the cleavage. Breast implant waviness (rippling) that is felt but not noticeable to the eye is very common and should not be a concern. However, when rippling is visible, patients are often self-conscious about their appearance.Factors that are associated with increased rippling include:Traditional Saline implants (IDEAL® Saline implants less likely)Textured implantsLarge implantsThin patients with low BMIImplants placed above the musclePrior history of ripplingFactors which are less likely to have rippling include:Heavier and larger breasted womenUsing a highly cohesive form-stabile silicone implants (gummy bear)Smooth implantsSmaller implantsSubmuscular placementOnce rippling occurs it is very difficult to correct. Rippling can be minimized by placing a biologic fabrics (e.g. AlloDerm®, Strattice™, SERI®), submuscular conversion if implants are above the muscle, fat transfer, use of adjacent tissue (muscle or fascia) if available, and in persistent cases implant removal and fat transfer. Seek the care of the best board certified plastic surgeon possible with experience in breast revision surgery.#rippling#breastaugmentation

Experiencing rippling and discomfort in your breasts after augmentation surgery can be concerning. Here are some potential reasons for these symptoms:
1. Implant Type: Rippling can occur more prominently with saline implants compared to silicone implants, especially if you have thin breast tissue or a small amount of breast tissue to cover the implant.
2. Implant Placement: If the implant is placed above the muscle (subglandular), it may be more prone to rippling compared to implants placed below the muscle (submuscular), as the muscle provides additional coverage.
3. Weight Loss: Significant weight loss after breast augmentation can cause the skin and breast tissue to become thinner, potentially making rippling more noticeable.
4. Capsular Contracture: This is a complication where the scar tissue around the implant tightens and squeezes the implant, causing discomfort and sometimes distortion of the breast shape.
5. Implant Size: Choosing an implant size that is too large for your natural breast tissue can increase the risk of rippling and discomfort.
6. Poor Surgical Technique: In some cases, rippling and discomfort may result from surgical errors or inadequate surgical technique.
7. Underfilling or Overfilling of Saline Implants: If saline implants are underfilled or overfilled, it can affect the appearance and feel of the breasts.
If you're experiencing these symptoms, it's important to consult with your plastic surgeon. They can evaluate your condition and recommend appropriate treatment options, which may include:
• Revision surgery to change implant size or placement.
• Treatment for capsular contracture, if present.
• Switching from saline to silicone implants.
• Fat grafting to improve breast contour and cover rippling.
• Other interventions tailored to your specific situation.
Always communicate openly with your plastic surgeon about any concerns or changes you notice in your breasts after augmentation surgery. They are there to help address your concerns and ensure the best possible outcome.

Thank you for your question and for sharing your concerns with us. Rippling can be seen when the surface of an implant shadows through the tissue, often found where the breast tissue coverage is thin. Some implant styles are more prone such as an overfilled saline implant. Others are less prone such as a shaped silicone implant. So one approach is to change an implant to one that is less prone to rippling.I would return to your surgeon who can examine you and help to diagnose the discomfort that you are feeling.  It is hard to know whether this will resolve or remain.  If you are early in your recovery, it is more likely that some of the discomfort could be due to the healing process.