Minimal Chance of Rippling with Small Saline Breast Implants?

I'm 24 and going to be getting a periareolar breast lift with breast implants. I'm happy with my size and wouldn't even mind being a little bit smaller. I'm currently 36A/34B. My breast tissue is all near the bottom of the breast. The moderate implants will go under the muscle and was suggested 175-200cc. My main concern is achieving nice upper pole fullness without going up in size/or projecting. I can't decide if these will be too big or too small. I'm 5'6" and 130 lbs. Sagging measures at 22 for one breast and 21 for the other. If I decide to get saline with an implant that small will the possibility of rippling be very minimal?

Doctor Answers 17

Breast Implant Rippling

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Breast implants may cause rippling in areas where there is little buffer between the implant and the skin. The most common areas of rippling are the lateral edge of the breast where there is no pectoralis muscle coverage of the breast implant. Size will not predict implant rippling, rather, the amount of soft tissue buffer between implant and skin.

Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Breast Implant and Lift

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That is a pretty small implant that we are talking about. Yes smaller implants will have less rippling, especially if it is kept within the width of your breast tissue. Silicone implants tend to have less rippling and I feel give a better upper pole advantage.

A lift will tighten your breast but it will not give you the upper pole that you desire over time. Yes the upper pole will be fuller initially but once the swelling has resided, you will miss the fullness and your idea of an implant is the right decision.

When doing a lift, you can have some breast tissue removed and a larger implant placed without being larger in general and have more upper pole than a smaller implant can give you. It can get pretty complicated but you need to see a surgeon that has experience doing this.

Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews

Don't get breast implants if you don't want your breasts to be larger!

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1) You can get good upper pole fullness just with a breast lift without implants. But the breast lift has to be done right. Often a lift is still done by tightening the skin, but skin stretches and you don't get good long term shape (this is why surgeons use implants).

2) You need an INTERNAL lift, where the breast tissue itself is shaped and lifted from the inside, and you have a lollipop scar (Lejour lift or vertical lift). You remain the same size, or is you want, a little smaller.

3) Saline breast implants can produce rippling, but the risk is reduced by overfilling the implants

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

Silicone Ripples Less than Saline

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It sounds like you have thought about this surgery a lot. And it sounds like you are making good decisions.

However, have you thought about silicone rather than saline? The best ways to avoid rippling are...

  • smaller implants (You have already chosen implants that are about as small as are available.)
  • placement under the pectoralis muscles (Another good choice that you have already made.)
  • silicone rather than saline

I use silicone on 90% of my patients. We all prefer the look and feel of silicone. The newest silicone products are safe and durable.

Michael C. Pickart, MD
Ventura Plastic Surgeon

Saline implants and rippling

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You have some conflicting issues. To stay the same size or to be smaller, you shouldn't have implants but to get upper pole fullness, you do. Rippling is always present with saline implants but if the implant is hidden by your natural breast tissue you will see and feel less of the rippling. This suggests that your size should be determined by the dimensional width of the implant.The volume is less of a concern although the lower percentage of final breast that is the implant, the more natural you will look and feel. I would suspect that you should go with the smallest saline implant that will fit your breast dimension and use the lowest profile. The difference between nipple position in either breast is quite slight and a periarolar lift might even it out or might cause other asymmetries like areolar diameter. You might just accept the difference,avoid the periareolar lfit and just see what things look like after the augmentation and do a lift secondarily if you are dissatisfied. Remember that scars are permanent

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Rippling in small saline breast implants

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ALL breast implants ripple, but saline implants ripple MORE than silicone gel implants. The amount of VISIBLE rippling depends on the thickness and ability of your own tissues to cover the actual ripples of the underlying breast implant. The more "stuff" you can put on the implant, the less visible the implant will be.

So -- yes -- if we quantified the ripples (which we do not) as ripples PER cm squared surface - the larger the surface area - the more ripples.

175-200cc are VERY SMALL implants which will produce a very small result. They are very rarely used by most American Plastic surgeons. Although they are likely to be completely covered by your breast tissue, I cannot help but think that you may be disappointed by your result.

Good Luck.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Upper pole fullness with an implant and breast lift

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The size of the saline implant is not a factor in wrinkling and rippling. It is more the body fat and breast volume of the patient and whether the implant is minimally filled or overfilled. As to the size you have chosen, there is a good likelihood that you will feel slightly too small in the upper pole after a year has passed with those implant sizes.

Implant choice for achieving upper pole fullness

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Hi Star,

All excellent questions. The implant size you have selected seems very appropriate for achieving upper pole fullness without causing a significant increase in breast cup size. In all likelihood, it will not be too big - in fact, it's as small as an implant as is made. If you're truly happy with your current cup size, it shouldn't be too small.

Saline definitely has a higher propensity toward visible rippling. Placing it under the muscle will help lessen the rippling. If you have any soft tissue cover over the upper pole of your breast, that will help camofluage the rippling as well. If you are hollow over the upper pole, you will likely see some rippling.

Hope this helps. Best of luck.


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It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the below link.


Too big or too small

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I like to have a number of implants in the operating room when performing a lift with implants, its just impossible for me to predict exactly which volume is best, this means putting trust in your surgeon though!

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.