Will 450 Cc of Breast Implant Cause Rippling?

I heard getting 450 cc or over will cause rippling, is this true? I'm an A cup and want a C or small D cup.

Doctor Answers 16

Size does not matter

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 Size really does not matter in this case.  The most important issue is how much of your own tissue you have covering the implant.  Good luck.

It's a matter of breast implant viscosity

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Viscosity is the resistance a material has to change in form.

Rippling is related to the viscosity of surrounding tissues, the implant shell, and implant fill material.

1) The surrounding tissues

A thick layer of tissue cover, such as muscle or fat, will mask implant surface imperfections. Very thin coverage will easily reveal any underlying imperfections

2) The implant shell itself

Some implant shells are very soft, like the Mentor smooth saline shell, which when underfilled can wrinkle easily. Textured implant shells, which can stick to the tissue capsule like velcro, will also tend to show wrinkling more readily

3) The implant material itself

Then newer cohesive gels are less viscous, so less prone to show wrinkling, and the new "gummy bear" implants by Inamed have extremely low viscosity so are unlikely to show wrinkling. This is why they are preferred in cases of breast reconstruction where there is very thin tissue cover.

Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 98 reviews

Rippling with breast augmentation or enhancement using implants

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There are many factors that contribute to the exiistence or visibility of rippling:

  1. Postion of implant (over or under the muscle)
  2. Position of patient (prone or supine)
  3. Type of implant (moderate or high profile)
  4. Shape of implant (anatomic or round)
  5. Implant material (silicone or saline)
  6. Degree of implant fill (saline)
  7. Soft tissue coverage (
  8. Surface texture (Smooth or textured
  9. Amount of breast ptosis (sag)
  10. Degree of capsule formation or capsular contracture
  11. Weight gain or loss

Depending on the complex interplay of these variables rippling may or may not occur.

To some degree, rippling occurs with all implants but may or may not be visible with changes in position, time, or even weight.

This is a very difficult question to answer and it is best for you to discuss this in the course of your consultation with a board certified plastic surgeon

I hope this helps

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews


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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 implants
  • Large implants
  • Thin patients with low BMI
  • Implants placed above the muscle
  • Prior history of rippling
Factors which are less likely to have rippling include:
  • Heavier and larger breasted women
  • Using a highly cohesive form-stabile silicone implants (gummy bear)
  • Smooth implants
  • Smaller implants
  • Submuscular placement
Once 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 after breast augmentation

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The risk of visible rippling increases:

in women with less of their own natural breast tissue
with saline implants placed In the subglandular position (under breast tissue and over muscle)
with larger implants

however reputable surgeons apply techniques that minimize the risk of rippling. For example, a woman with less of her own breast tissue may decrease the visibility of rippling by opting to place the implants in the submuscular position. However, this depends on the surgeon.

Rippling is much less common with cohesive silicone gel implants because they are semi-solid, but please note that rippling is still a risk. 

Rippling of Breast Implants

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Thank you for the question.

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  sailing implants will also increase the rippling/palpability of the implants.

The wider/larger the breast implants ( especially on a smaller frame patient)  the greater the likelihood of rippling.

I hope this helps.


It depends on how much breast tissue you have

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If you have adequate breast tissue of your own you may have minimal rippling. In a woamn with small breasts, she may see rippling with a 200cc implant. I would discuss your concerns with your plastic surgeon before surgery.

Dr Edwards

Size of implant does not cause rippling.

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1) I very seldom recommend very large implants like 450 cc's for breast augmentation in New York. They look fake and age badly.

2) But size and rippling are not related. You can get rippling with saline implants of any size, and even with underfilled ("moderate profile") silicone implants of any size. Also textured implants can cause rippling. To avoid rippling, I recommend moderate PLUS profile or high profile, smooth walled silicone implants

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Rippling depends on your breast and skin covering

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Imperfections with implants (rippling, firmness, etc) are noticeable in most individuals with poor tissue. Think of the tissue as a drape or a cover. So, if you have a good cover, you can hide the imperfections below. If the cover is thick, then the imperfections are harder to see. If the implants are large, and the breast tissue is small, then more imperfections will be visible.

If you are going from an A cup and adding 450 cc implants, then it is very likely that most of the final result will be from the implant and more imperfections will be visible. Silicone implants have less rippling effects than saline implants. Implants placed under the muscle in individuals with thin cover have less rippling. Good luck with your decision.

Sirish Maddali, MD
Portland Plastic Surgeon

Rippling depends on several factors

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The relative amounts of skin, breast tissue and fat and muscle that cover the implant, the fill of the implant and the covering of the implant shell all go into the degree to which rippling will be seen or felt.

The more of you that is in the final breast, the more it will look like you.

The more of the implant in the final result, the more it looks like the implant.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 37 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.