I have saline mentor implants filled to 375cc. Within the last year I have gotten alot of rippling. It almost fills like they have deflated some and are not that full. Is this normal. My doctor says its because I lost weight. I need answers please
Doctor Answers (10)
Rippling of breast implants
Thank you for the question.
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.
Having discussed these issues, PREVENTION of rippling/probability is of critical importance.
Much of the final “look” achieved after breast augmentation surgery depends on several factors:
1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the preoperative breast appearance the more likely the breast augmentation “look” and "feel" will be optimal.
2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing long-term well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone) or model (low/moderate/high profile) of implant. Make sure you're working with a well experienced board-certified plastic surgeon.
3. The type of implant used may determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have. If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants. If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result. On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference. Patients may need an MRI to diagnose a silicone gel rupture. Saline implants are also less expensive than the silicone gel implants. Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants. On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational. As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.
4. The size and model of breast implant used may make a significant difference in the final outcome, including the presence of rippling/palpability of the implants.
I hope this helps.
How to avoid rippling with breast augmentation
Several factors are critical in limiting the risk of rippling with breast augmentation: implant type, pocket location, implant size, and preoperative anatomy. Thin patients with a paucity of breast tissue are at an increased risk for rippling. Placing the implant under the chest muscle gives more coverage and support to the implant. Rippling can be worsened with capsular contracture which occurs 50% less frequently with submusclar augmentation. Limiting the size of the implant can help because if the implant puts too much pressure on the breast paranchyma (tissue) then it can cause the breast to atrophy or shrink, giving even less coverage to the implant which worsens rippling. Finally, silicone implants ripple less than properly filled saline implants.
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Causes Of Implant Rippling
Weight loss is one possible explanation for visible rippling after augmentation. Rippling is also more commonly seen with saline implants and implants over the muscle. Therefore the best chance of preventing rippling is to have silicone implants placed under the muscle.
Rippling with saline breast implants
If you have rippling with saline breast implants you may consider converting to silicone implants which have a lower incidence of rippling. Your skin may have become thinned out or you didn't have alot of breast tissue before surgery.Also, breast implants placed subglandularly (in front of the muscle) are more prone to rippling. In severe cases, patients sometimes need a synthetic skin substitute sewn into the pocket around the implants to minimize rippling. Consult with a board certified plastic surgeon for a complete evaluation.
Rippling with saline breast implants can be due to a number of things.
Rippling with saline implants is particularly bothersome in thin women with little breast tissue of their own, especially if their surgeons used an over-the-muscle position. Even with below-muscle placement of the implants, as swelling resolves, skin and muscle stretch, and weight is lost, rippling is more common.
Rippling is even more common when surgeons under-fill the implants. Some surgeons erroneously believe that 300cc implants should be filled to 300cc, and some even think that the implant manufacturers will not honor the implant warranties if they "over-fill" and leaks occur (or they use this as an excuse to not over-fill). Manufacturers not only honor the warranty regardless of fill volume, but are aware of and understand (from many studies that have demonstrated this) that proper "over-filling" (about 10% but variable depending on implant size, type, and manufacturer) actually DECREASES leak and deflation rates. That being said, even "perfect" overfill cannot eliminate ripples in all patients, especially the slim women with little breast tissue coverage.
Deflation can also occur, and is more common in underfilled implants (the ripples crease and fold with every breath and motion, and eventually wear out and develop a pinhole leak) and in textured-surface implants (because of the tiny high and low spots present on the surface of the textured implants that can weaken and fail with repeated flex and stretch). (Also shown to be true in numerous studies). This is unlikely in both implants at the same time, so your surgeon is probably accurate in his assessment.
Aside from these concerns, and knowing that the present-generation of cohesive silicone gel breast implants cannot leak and deflate, feel softer and more natural than saline implants, and do NOT require periodic MRI scan to "look" for deflation (they CAN"T leak or deflate), silicone gel implants almost always improve the degree of rippling, and in many cases eliminate it altogether. They also feel better and more natural! This is why 98-99% of my patients now choose silicone gel implants, and many of my former saline implant patients and all of my nurses who have had saline implants have switched to silicone.
For more information about silicone breast implants, read my article (on the About tab on my Profile page on this site) titled: "Are Silicone Breast Implants Safe?" and also click on the link below. Best wishes!
Rippling is normal for saline implants
Your surgeon is right about the rippling. All saline implants have rippling and it may be less visible or palpable because of the thickness of the breast tissue. If you have lost weight you will notice more rippling. If saline implant deflate, they go flat in few days. You have option of going with silicone gel implants or fat grafting to make the rippling less noticeable.
Rippling of breast implants
If you lose weight and especially if the saline implants are above the muscle, you will develop rippling. You can either gain a few pounds or you can switch to gel, under the muscle and greatly improve it. Rarely, a patch or Strattice or Alloderm will thicken the coverage but be sure to be gel under the muscle before anything else.
Rippling pretty common with saline implants
To have wrinkling or rippling of your breasts after saline implants is rather common. If it seriously bothers you, or cause you pain or discomfort, I would recommend that you consider switching to silicone implants. There is less rippling associated with silicone implants. You might also want to go a little larger than your present size of saline implants.
Here are a few answers
The implants are not extremely large but you didn't comment on how large you are and how long you have had the implants. Large implants in a small breast can cause thinning of the overlying breast and skin over time. This is especially true if you are otherwise a small person. If you have lost weight, is could also result in thinning of the tissues covering your implant and make it more noticeable. If the implant feels like it has lost tone as well, it could be leaking. Time will tell. Changing to a gel implant can help to decrease the amount of rippling that you feel. Sometimes with excessive weight loss, a breast lift is also needed. Hope this helps.