Breast implant removal (explantation) of the problematic breast implant or both: unilateral or bilateral
The main issue appears to be the relative lack of tissue. You could consider higher profile implants with lower tendency for rippling, lipoinjection to cove r and disguise the ripples, Alloderm to diminish tendency for capsular contracture and enhance thickening of the tissues, complete implant removal with downsizing and replacement wtih smaller implants or volume restoration with autologous fat grafts.
The rippling may be a result of thin breast tissue or capsular contracture. The best solution i have seen is doing micro fat grafting to the breast to increase the soft tissue coverage.
If you have a capsular contracture then other remedies are indicated- open caapsulotony or oral singulair to release/soften the capsule.
With Warm Regards,
Trevor M Born MD
If you are concerned about rippling, you may need the implants removed and exchanged to a different pocket plane. If they are already under the muscle you may need another layer of coverage like Alloderm. Yes, it may be a good idea to have both implants exchanged.
I would not say that is the solution to your problem. It sounds like you are having problems with inadequacy of soft tissue coverage of your implants.
What you need is better coverage and adjustment of your implants, in size perhaps. Alloderm or other such products are helpful in that they add soft tissue coverage to persons like your self to help with rippling affect.
Make sure you see a board certified plastic surgeon that does breast revision work.
I would recommend replacing both implants
Replacing both implants is probably your best bet, as you will have a better chance at achieving symmetry. In terms of the rippling, another option to help hide the rippling would be to use a product like Alloderm. Alloderm is human skin which has been treated-- what is left is a collagen matrix, and it comes in sheets of different thickness and sizes. At the time that the implants are replaced, I would suture the Alloderm in the pocket, between the implant and the skin in the area of rippling. While it does not 100% guarantee that you will not see any rippling, I think it would be your best chance.
If your implants are older, or if the correction on the affected side requires a differently sized or shaped implant then a bilateral exchange makes sense.
Rippling can be a tough problem, especialy in thin individuals, and you already have gel implants under the muscle. Hard to go beyond that, except perhaps total muscular coverage which has it's own set of problems.
Leaving the implants out for a year is good if the pocket and or skin has been stretched and you want to let things return to their shape as much as possible before moving ahead. Not sure it would help your situation that much.
Fixing a deformed breast implant
Correction of the problematic breast implant should be performed with possible explantation and correction of the deformity. Explantation and delay is reserved for rare cases of infection.
The answers to your questions depend upon the cause of your problems. If it is mainly contracture, then a one stage operation might work out well. If your tissues have become thin, it is harder to fix. Multiple operations are more likely in this case. See what your surgeon says and go from there.
John Di Saia MD