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Implants Placed Submuscular Yet Can See Rippling on the Outer and Bottom Sides, Even in Cleavage, Options?

asked 8 months ago by Tarang
Latest answer by Joe Gryskiewicz, MD
Question viewed 286 times
Tags: rippling, submuscular

I have 275cc cohesive gel silicone Mentor implants placed submuscular 2.5 months ago. I have very noticeable rippling on the outer and bottom sides, and also in the upper cleavage area where the implants are supposed to be covered by the muscle. I can even see faint rippling in the upper cleavage area even when I stand upright. Is there anything I can do to increase the thickness of chest muscles to better cover the implants? Or do I have to accept this? I am 5ft3 and 95 pounds.

17 answers to Implants Placed Submuscular Yet Can See Rippling on the Outer and Bottom Sides, Even in Cleavage, Options?

Rippling after breast augmentation

Rippling should be significantly reduced by placing implants under the muscle. I personally would not complicate matters by fat injections, which can have their own consequences. It's rare to see rippling on the lateral aspect of the breast unless you are bending over at the waist. This is inherent in performing an augment on a very thin individual. I would not advise you to gain weight as there is no certainty that this would increase breast size. Some physicians have had success with... more

Robert L. Kraft, MD
New York Plastic Surgeon

Rippling common on very thin patients with breast implants

Dear Tarang, The only thing that will work is to gain a few pounds. I would highly discourage trying to work your pecs as this might actually push the implants out of place and give you more problems. I've seen this many times on patients that are workout instructors. Best of luck, Dr. H

Gary M. Horndeski, MD
Houston Plastic Surgeon

Implants

In fact, to some degree most implants are going to have ripples or wrinkles of their shell. The degree to which you feel or see the ripples depends on a number of factors (submuscular, thin body tissues, etc.) While submuscular is below the muscle this is not total. The implant will extend out from beneath the muscle on the outer and bottom area. Many women will feel the ripples, less will see them. To some degree it may be difficult to hide this. I hope... more

Ronald H. Stefani Jr, MD
Chicago Plastic Surgeon

Rippling with silicone implants

Silicone implants can show rippling, although less than saline ones. In thin individuals with little body fat, the visibility of the ripples is greater. Feeling or seeing ripples in the lower aspect of the breast and on the side are common as there is no muscle to cover it there. If there are visible ripples up in the cleavage area, it might be that the muscle has torn off of its attachments to the breast bone and has moved up above the implant and the muscle is likely not covering the... more

Julio Garcia, MD
Las Vegas Plastic Surgeon

Rippling after augmentation

Rippling after augmentation may be related to the thinness of your skin but it's certainly a possibility that mild contractures exist. If the implants are textured gel implants and not smooth I have seen more rippling in those patients and on occasion have reoperated on the patient and switched to a smooth gel implant. It's probably not an issue with the muscle not being big enough as patients with smooth gel implants above the muscle often look very nice. more

Steven E. Ozeran, MD
Moscow Plastic Surgeon

Rippling after breast implant surgery

Based on your height and weight, you are very petite and 275 cc implants may have been a little large for you even though they are small by most standards. I suspect that you are very thin, so it is not surprising that you have some rippling. If you are adequately recovered from surgery, you may want to get a trainer and start working out your chest muscles to try and increase their thickness and cover up your implants better. Another possibility is insertion of acellular dermal... more

James McMahan, MD
Columbus Plastic Surgeon

Ripples with silicone gel breast implants

The truth is that all implants, both silicone and saline may ripple in individuals with very thin cover. First, you should make sure that your implants are indeed under the muscle. Also, with cohesive implants, if pushed through too small a breast incision, 'fractures' in the cohesive gel may form and distort the implant shape with ripples in the covering. So four things to consider; submuscular, smooth undamaged implant, perhaps higher implant profile, an allograft, in that... more

Peter E. Johnson, MD
Chicago Plastic Surgeon

www.peterejohnsonmd.com

Too thin for implants without ripples

The problem you are having is that you tissues are too thin to hide the inherent ripples even in a gel implant. The best way to deal with this is to gain 5-10 pounds. All other solutions such as fat grafting, dermal matrix materials etc involve more surgery and more cost.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Breast implant rippling

It does not sound like your implants are submuscular. You are quite thin so the edges of the implant will be visible as rippling if the soft tissue coverage is inadequate as would be the case if the implants were above the muscle or on the outer lower edges where there is never muscle coverage of the implant edges. If there is any doubt about the implant position you need to be examined by another surgeon and possibly get ultrasound verification of the implant position. If they are not under... more

Aaron Stone, MD
Los Angeles Plastic Surgeon

Rippling and palpability of breast implants

Thank you for the question. If you are sure that the implants have been placed under the muscle and you still have significant rippling present them there are only 3 possible options. First, you can try to gain some weight in order to increase coverage over the breast implants. The second option would be to use acellular dermal matrix (allograft) to provide coverage over the areas of severe rippling. And a third ( and less desirable) option would... more

Tom J. Pousti, MD
San Diego Plastic Surgeon

www.poustiplasticsurgery.com

Breast Augmentation

All implants have wrinkling. If you visit your surgeon's office to try on sample implants, whether saline or silicone, they all wrinkle when you hold them in your hand. Wrinkling is less obvious with silicone implants. So you can at least feel good that you chose silicone. Your tissue is evidently thin enough, even though part of your implants are under your chest muscles, to allow the wrinkling to be visible. Wrinkling may be part and parcel of having the implant, especially... more

Joe Gryskiewicz, MD
Minneapolis Plastic Surgeon

Implants Placed Submuscular Yet Can See Rippling on the Outer and Bottom Sides, Even in Cleavage, Options?

Because you have a low body fat count the muscle and tissue can only hide some of the "ripples". Best to try and gain weight or a fat graft , if you have any fat to the areas could help.

Darryl J. Blinski, MD
Miami Plastic Surgeon

Rippling with silicone implants

I would make sure your implants are placed submuscularly - if not, that would be a solution. Another reason you may have rippling is that the weight of the implant is weighing down your natural breast tissue - often Alloderm or other dermal matrix can be used to create an internal bra to hold the implant weight on the chest wall. Good luck!

Bivik Rajnikant Shah, MD
Columbus Plastic Surgeon

Ripples with submuscular gel breast implants

Weight gain is the most cost effective solution. Fat grafting has some advantages but I doubt you have enough donor site fat for coverage. Adding dermal substitutes to try to thicken your soft tissue envelope and downsizing your implant volume may improve your ripples but I doubt completely correct your issues. Wish I had better news

Craig Harrison, MD
Tyler Plastic Surgeon

What can be done for rippling following breast augmentation using silicone implants?

Rippling can occur following breast augmentation, especially in thin individuals. It is less likely to occur if placed submuscularly. I would double check to make sure that , indeed, the implants were place below the muscle. The operative report would reveal that information.If the placement is indeed submuscular then I would suggest 2 options. One is to transplant fat in the areas of rippling but this has to be done very carefully so as not to penetrate the implant. You may also... more

George Lefkovits, MD
New York Plastic Surgeon

Rippling after breast implants can usually be corrected with Alloderm, different implants, and fat injections.

Hi. 1) There are at least three possibilities, and we have made progress since the video was done. First, you probably have so called moderate profile implants. These are really low profile underfilled implants which are prone to rippling in thin women. We have seen this often. You need moderate PLUS profile or high profile implants. 2) Alloderm has been a big plus for thin women because it essentially gives you another layer of tissue to... more

George J. Beraka, MD
Manhattan Plastic Surgeon

Rippling after silicone gel implants

Are you sure your implants were placed in a submuscular position? I would make sure of that first. Given your weight, you are at risk for rippling. One other option not mentioned already would be fat grafting to provide more cover over the implants. Essentially, your fat from another part of your body would be carefully injected in the areas where you have rippling. This has to be done by someone who is experienced so that the implants aren't damaged. Good... more