I had saline 430 cc implants for 15 years, BF 3 kids and just recently had them exchanged for silicone natrelle 492cc under muscle. lots of rippling before with the sailine and now its 100 times worse, plus they have dropped and are saggy . breast size before any implants was a 32A. I am 5'6 and weigh 125 lbs, zero breast tissue, thin skin small upper frame. my breast look too big for my body. I have met with many different PS in my area and have been told different things...
June 16, 2014
Answer: Rippling after breast augmentation Rippling is a terrible problem after breast augmentation and occurs for a variety of reasons. It is a challenging problem and can be corrected in a variety of ways, and this is likely why you have got different recommendations from different surgeons.In addition to rippling, you have complaints that you are both too big and too droopy. Addressing these issues along with improving rippling can be complicated, so it is good that you take your time and do some research before having a revision surgery. Be sure that you see plastic surgeons certified by the American Board of Plastic Surgery.If you feel too big, then certainly you need smaller implants. If you feel too droopy then you may need a lift, and if you have rippling, you can combine certain techniques together with an implant size change and lift to create the best results.Rippling can be attributed to various things:1) Thin breast tissue/skin2) An implant with a liquid filling3) An implant that is the wrong size for the breast pocket - too big or too smallLooking at each of these issues that can lead to rippling one at a time:1) Thin breast tissue skinFat transfer or autologous fat grating can thicken the tissue to camouflage rippling, but you mush have some good fat deposits in another part of your body to get the fat from. This technique alone may mask the rippling, but will only add to the overall size of your breastsThe tissue can be thickened with addition of a tissue matrix - Alloderm (human skin) and Strattice (pig skin) have been used for these purposes. They are both collagen matrixes with all the cells removed, and they become a part of you as the body grows into them. This can thicken tissue to mask rippling.2) An implant with a liquid fillingImplants are ALL made from a silicone shell, but the contents vary greatly. In general, the more liquid the filling of an implant, the more the risk of rippling. Saline implants ripple the most. Next on the list are round silicone gel implants made from a 4th generation silicone gel (Alllergan and Mentor round silicone implants). Next are round silicone gel implants made from a 5th generation slightly firmer silicone gel (Sientra). Next on the list are the anatomically shaped tear drop shaped so called "gummy bear" implants which are all made from a highly cohesive firm type of 5th generation silicone gel (all three implant companies make these Sientra, Allergan and Mentor). Allergan's 410 anatomically shaped silicone implant is the firmest and therefore, may have the lowest risk of rippling. In general, the firmer the implant, the less likely you are to have rippling, the tradeoff is that they have a firmer feel. The other consideration is a nuance that plastic surgeons take into consideration is the "fill of the implant" how much silicone there is in an implant relative to what the shell can hold - some companies have implants that are under filled to a varying amount and this may contribute to rippling.3) An implant that is the wrong size for the breast pocketIf an implant is way too big for your breast size, it may fold on itself to create rippling - this can be treated by decreasing the size of the implant. In a similar sense, if the implant is way too small for your breast size, it make be loose and wrinkle on itself - and this can be treated by tightening the implant pocket with the use of a tissue matrix to hold it in a smaller more perfect space.Putting all of these things together: to decrease rippling and decrease drooping in size, you may consider choosing smaller implants made from a firmer gel - especially the anatomically shaped highly cohesive gummy bear type implant. A breast lift will help to decrease the extra skin, and use of a tissue matrix such as Strattice may help hold a smaller implant inside a smaller supported pocket. This will keep a nice perfect pocket around a smaller implant with a low risk of rippling . . . in a way that gives you a very long lasting result.Take your time and talk to several surgeons about which of these factors will help you get what you are looking for. Weigh the pluses and minuses of each of these factors to ensure that your revision surgery gives you the most ideal result.
Helpful
June 16, 2014
Answer: Rippling after breast augmentation Rippling is a terrible problem after breast augmentation and occurs for a variety of reasons. It is a challenging problem and can be corrected in a variety of ways, and this is likely why you have got different recommendations from different surgeons.In addition to rippling, you have complaints that you are both too big and too droopy. Addressing these issues along with improving rippling can be complicated, so it is good that you take your time and do some research before having a revision surgery. Be sure that you see plastic surgeons certified by the American Board of Plastic Surgery.If you feel too big, then certainly you need smaller implants. If you feel too droopy then you may need a lift, and if you have rippling, you can combine certain techniques together with an implant size change and lift to create the best results.Rippling can be attributed to various things:1) Thin breast tissue/skin2) An implant with a liquid filling3) An implant that is the wrong size for the breast pocket - too big or too smallLooking at each of these issues that can lead to rippling one at a time:1) Thin breast tissue skinFat transfer or autologous fat grating can thicken the tissue to camouflage rippling, but you mush have some good fat deposits in another part of your body to get the fat from. This technique alone may mask the rippling, but will only add to the overall size of your breastsThe tissue can be thickened with addition of a tissue matrix - Alloderm (human skin) and Strattice (pig skin) have been used for these purposes. They are both collagen matrixes with all the cells removed, and they become a part of you as the body grows into them. This can thicken tissue to mask rippling.2) An implant with a liquid fillingImplants are ALL made from a silicone shell, but the contents vary greatly. In general, the more liquid the filling of an implant, the more the risk of rippling. Saline implants ripple the most. Next on the list are round silicone gel implants made from a 4th generation silicone gel (Alllergan and Mentor round silicone implants). Next are round silicone gel implants made from a 5th generation slightly firmer silicone gel (Sientra). Next on the list are the anatomically shaped tear drop shaped so called "gummy bear" implants which are all made from a highly cohesive firm type of 5th generation silicone gel (all three implant companies make these Sientra, Allergan and Mentor). Allergan's 410 anatomically shaped silicone implant is the firmest and therefore, may have the lowest risk of rippling. In general, the firmer the implant, the less likely you are to have rippling, the tradeoff is that they have a firmer feel. The other consideration is a nuance that plastic surgeons take into consideration is the "fill of the implant" how much silicone there is in an implant relative to what the shell can hold - some companies have implants that are under filled to a varying amount and this may contribute to rippling.3) An implant that is the wrong size for the breast pocketIf an implant is way too big for your breast size, it may fold on itself to create rippling - this can be treated by decreasing the size of the implant. In a similar sense, if the implant is way too small for your breast size, it make be loose and wrinkle on itself - and this can be treated by tightening the implant pocket with the use of a tissue matrix to hold it in a smaller more perfect space.Putting all of these things together: to decrease rippling and decrease drooping in size, you may consider choosing smaller implants made from a firmer gel - especially the anatomically shaped highly cohesive gummy bear type implant. A breast lift will help to decrease the extra skin, and use of a tissue matrix such as Strattice may help hold a smaller implant inside a smaller supported pocket. This will keep a nice perfect pocket around a smaller implant with a low risk of rippling . . . in a way that gives you a very long lasting result.Take your time and talk to several surgeons about which of these factors will help you get what you are looking for. Weigh the pluses and minuses of each of these factors to ensure that your revision surgery gives you the most ideal result.
Helpful
August 14, 2014
Answer: Breast implant rippling Hi natomeara--I'm sorry to hear you are having trouble with your revision! You identified the contributing factors to the problem in your post above. Your thin skin, lack of breast tissue, and large implants contribute to the problem. The fact that your old implant likely thinned the overlying tissues doesn't help either. Also, when implants are changed, sometimes scar tissue or capsule is removed, which is beneficial in some ways, but thins your tissue coverage over the implant. Finally, the rippling is an implant-specific problem, and is present with most devices. Your thin tissues just don't hide it well. Luckily plastic surgeons have some tools to address this. Fat grafting or acellular dermis can thicken the tissues and disguise the rippling. A change to a newly-available cohesive gel implant helps, since these devices don't ripple or ripple to a lesser degree. Ask your surgeon. In the meantime a supportive bra may lessen this rippling in the upper pole.
Helpful 2 people found this helpful
August 14, 2014
Answer: Breast implant rippling Hi natomeara--I'm sorry to hear you are having trouble with your revision! You identified the contributing factors to the problem in your post above. Your thin skin, lack of breast tissue, and large implants contribute to the problem. The fact that your old implant likely thinned the overlying tissues doesn't help either. Also, when implants are changed, sometimes scar tissue or capsule is removed, which is beneficial in some ways, but thins your tissue coverage over the implant. Finally, the rippling is an implant-specific problem, and is present with most devices. Your thin tissues just don't hide it well. Luckily plastic surgeons have some tools to address this. Fat grafting or acellular dermis can thicken the tissues and disguise the rippling. A change to a newly-available cohesive gel implant helps, since these devices don't ripple or ripple to a lesser degree. Ask your surgeon. In the meantime a supportive bra may lessen this rippling in the upper pole.
Helpful 2 people found this helpful
