How should I address this issue? Over the muscle breast implants!

I just had my second revision with over the muscle silicone implants. I had a 350 moderate plus style. My right breast was causing me discomfort and had CC. Since we were redoing the right we did both and Increased size. He went with a high profile and used a 425. I now have a great deal of rippling on the top, center and around bottom. I just don't even know how to address this issue. After the fact I questioned myself why would he put a high profile in a pocket that had a moderate plus prior. Thanks

Doctor Answers 4

I'm sorry to hear of your dilemma

but if your healing doesn't improve your results you will have to consider options down the road.  I assume your capsule was removed and you must be on the thin side.  The implant itself is probably not causing the ripples and instead the traction of the weight on your skin (think water balloon held by the tied end).  If things do not improve, you have to consider going under the muscle to diminish the upper pole rippling and if rippling severe, even consider the textured anatomic implant.  Know your surgeons revision policy and make sure your surgeon understands your concerns so that most may be addressed with revisions.

Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

CC and Rippling

If I understand your question correctly, then the solution might be changing the site of the implant to below the muscle and using a textured implant.  

Earl Stephenson, Jr, MD, DDS, FACS

Solutions for rippling with over muscle implants

Under muscle implants benefit from coverage over the upper portion of the implants so going over will make ripples more visible. High profile implants are also more prone to traction ripples on the upper pole. The solution often requires adding support from below and coverage above. This can be done with an internal bra using SERI Scaffold or an acellular matrix such as Strattice. Once you have gone from under to over muscle, especially with a capsulectomy for capsular contracture, it is difficule to re-elevate the muscle to put impl;ants under again.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 reviews

Rippling is more common above the muscle and with larger implants.

Placing implants over the muscle leaves less natural tissue to hide the inherent ripples in an implant. A larger implant will also make the ripples more noticeable as there is more implant (with ripples) showing compared to natural tissue (which has no ripples).

There are solutions to your problem. Unfortunately, they all require more surgery and more money. Ask your surgeon about converting to under the muscle implants, using an acellular dermal allograft, or using a more form stable implant.

The high profile implant in a previously moderate plus pocket is not causing any problems.

Armin Moshyedi, MD
Bethesda Plastic Surgeon
4.6 out of 5 stars 21 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.