Prominent ripples on sides of breasts 9 weeks post-op. Was told to gain weight and they'll go away. (photos)

Do any other experts agree?. I'm a mom of three I am 5'7 &132. I don't buy this . I showed my dr what I wanted & she said "perfect , that's exactly what I was thinking.". I wanted high boobs. I have been told my ribs were uneven & that's why 1breast go's one way. she told me she could do another surgery & do 650 on one side & 700 on the other. Why are we talking about another surgery at 9wks. Post op My PS has done both my Ba's. Really dissapointed with her answer's.


Doctor Answers (12)

BBA

+3
Can you post a pre-op photo please?  WIthout those, it's difficult to post any useful commentary other than to tell you that with such large implants (especially over the muscle) this is typical.  If you want such large implants, then you must expect some rippling.  Your PS should have explained this to you.


Toronto Plastic Surgeon
5.0 out of 5 stars 28 reviews

Dissatisfaction after Large Breast Augmentation

+3
Hello,

Your disappointment with your doctor should not be regarding her execution of your surgery or the results of your surgery; your results are about as good as could be expected, and in my mind very much anticipated. You should be disappointed that your doctor did not expressly warn you that a very large tissue expander (your new breast implants) will thin out and stretch your breast tissue envelope in an unpredictable manner, and that you would likely get rippling, with almost complete certainty.

Not to make you feel worse, but you are only 9 weeks out and you have not seen all the potential side effects of these large implants: drop out, loss of upper pole fullness, and more severe rippling and thinning of your tissues. Don't assume just because others have gotten the same size implants that they will work for you.

The growth of the internet as a source of medical information for lay people combined with the growth in the number of doctors performing breast augmentation has led to a change in the dynamics of the doctor-patient relationship during a consultation for breast augmentation.  It is no longer about the doctor making the sole determination of what is best for the patient. It has become all about what the patient wants and believes she's entitled to.  Very few surgeons are willing to say 'no'; she will just go next door and have it done by the another surgeon.  This is unfortunate because the patient no longer has her doctor as her advocate.

I am truly sorry you are having problems, and I hope they don't get worse. You could try to keep your current size and perhaps have a revision surgery to insert ADM's like Alloderm or Strattice in an effort to minimize rippling and further stretching. Unfortunately they are very expensive, and there is no guarantee of complete resolution of ripping. Alternatively, you may consider fat grafting your breasts to increase the thickness of your breast tissue envelope around your implants. Finally, you may want to throw in the towel and go smaller.  Whichever you choose, I hope that you find happiness with your result some day soon.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 28 reviews

Prominent ripples on sides of breasts 9 weeks post-op. Was told to gain weight and they'll go away.

+2
You need to post before photos so we can compare results!!!! Otherwise very hard to respond to your concerns... 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 61 reviews

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Prominent ripples on sides of breasts 9 weeks post-op. Was told to gain weight and they'll go away.

+2
You are finding out all the reasons we tell patients on this site to be careful what they wish for when they want dramatically overisized breasts. The biger you go the more you accentuate the problems.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 13 reviews

Ripples

+2
I can't say that I concur with the advice to gain weight. Although it might work, I would wager that you would need to gain 50 to 75 pounds before developing enough of a fat pad to conceal the folds in the implant.

Before photos would have helped, but I assume these are very large implants placed in rather small breasts, and the risk of visible ripples is much higher compared with, say, a women with moderate size breasts and moderate sized implants.  If the 650 and 700 cc implants are larger than you already have, there is little chance this will make the ripples less noticeable. 
 
I would recommend a second opinion before undergoing another procedure. All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 31 reviews

Rippling in breast implants

+2
Large implants become visible because they exceed the diameter of the breasts.  They also cause the skin to thin, compounding the problem.  While it may be true that if you gain weight you would have more breast tissue, it is also true that if you had smaller implants, you would have less of a problem.

I spend a great deal of time in my practice talking patients out of large breast implants because of the problems large implants cause.  Patients are often eager to have very large implants, but are disappointed when they get rapid drooping, extensive rippling, thinning of the skin and require constant redo surgeries.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
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Causes of rippling in breast implants

+2
You obviously went pretty big and do not have much breast tissue to cover any flaws in the implants.  When the patient goes 3-4 cup sizes above their natural breast size such as an A to a D cup the natural breast tissue stretch and thin a lot.  Going above the muscle will tend to ripple more than below the muscle because you have less tissue covering the upper pole.  All implants have some degree of rippling some more than others.  There are vertical rippling and side rippling.  The Allergan brand smooth implants tends to have more vertically rippling because they have less implant fill.  That is how much silicone is filled for the implant shell size.  The Mentor MP+ have the most implant fill which helps to reduce vertical rippling but it has some moderate amount of side rippling.  All textured implants have some degree of side rippling.  So the bigger you go the more chance you will have less tissue covering any flaws in the implant.  The solution is either go smaller in the first place or end up trying to fat graft areas of the breast that display rippling.  Sometimes if a patient develops a mild breast capsule this thickens the breast tissue and rippling becomes less of an issue.  Hope that helps.  Dr. Chu

Benjamin Chu, MD, FACS
Honolulu Plastic Surgeon
5.0 out of 5 stars 34 reviews

Ripples after Breast Augmentation

+2
Thank you for your inquiry on breast augmentation post op advice.

It is hard to say exactly what is going on with your breast without an examination.  Since you are having serious concerns and not pleased with your plastic surgeon's response it is always good to get a second opinion.   You should find a Board Certified plastic surgeon in your area.  You can go to the American Society of Plastic Surgeons website to find a Board Certified plastic surgeon in your area.

Best Wishes.

EM


Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Rippling and Nipple position

+2
Thank you for your pictures.  A preop picture would be very helpful to see your nipple/areola position prior to augmentation.  I assume that there was a slight asymmetry prior that is now magnified with the increase in breast size.  I do not see how increasing the size of the implants at a second surgery is going to improve anything.  The rippling may improve if these are saline implants and they are switched to silicone and/or if they are above the muscle they are switched to below the muscle.

Earl Stephenson, Jr., MD, DDS
Atlanta Plastic Surgeon
5.0 out of 5 stars 8 reviews

Rippling Seen on Sides of Breast Post-op After BA with Large Implants.

+1
More information would be needed. Pre-op photos and exam would give information about skin thickness and pre-op breast size. Current size of implants shown is not known, but they seem to be in the 600+ range. Are the implants saline or gel?
As a generalization, if large implants are placed they will stretch the skin and if the implant is not held tightly by the skin envelope, ripples both palpable and/or visible will occur. If the skin envelope is thin to begin with, then with the usual saline or gel implants, some visibility or palpability of the implant shell is inevitable. Re-augmenting with large implants does not help because the skin gets further stretched, thinner and less able to hold the implant in a round shape. Rippling will recur.
 Although large implants per se, are not bad, they do not give a result that is smooth and without ripples or palpability of the shell, unless there is a lot of fat and breast tissue coverage, like a B+ to begin with.
  This is hard to correct after it occurs. Current approaches include smaller implants, reinforcement of the lower breast internally with acellular dermal matrix or Seri biosynthetic mesh.  If the problem is anticipated, the patient could be given the option of a form-stable or gummy bear implant which holds its shape better. However, once the pocket is made with round implants it is too big for the form-stable implants which needs a pocket that fits hand in glove for the implants.

Robert M. Lowen, MD
Mountain View Plastic Surgeon
5.0 out of 5 stars 25 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.