Fat transfer on a thin patient, could 200cl really be enough to cover severe rippling? (Photo)

Question

I have saline implants over the muscle (unfortunately the attempt to put them under the muscle after 10 years of them over the muscle was unsuccessful). I have been advised far transfer is my best option despite only 200cl available fat (slim build: 163cm/53kg/BMI just under 20). Please advise 1) could 200cl really be enough to cover severe rippling? 2) should I consider travelling to a country where ADM can also be added (could this avoid 2nd fat graft?) 3) can mamoplexie improve rippling

John L. Burns Jr., MD · Answer

placing fat between the implant and skin would help with the rippling.  I think 200cc is a reasonable volume.

Daniel Barrett, MD · Answer

Dear trianglesquare,
based on your photo, it looks like fat transfer would improve your rippling issues. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

The reason you have rippling is your skin envelope is quite thin and right underneath that is the implant. An attempt to fat graft this may result in implant damage or contour deformities. A donut mastopexy may be done to tighten the skin and mask some of the rippling and make it better.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ronald J. Edelson, MD · Answer

You should find out if your have textured implants because they are more prone to rippling. If so you could switch to saline or silicone. I doubt fat transfer will be successful in the long term

Hilton Becker, MD · Answer

There are several ways to treat rippling with prepectoral implants 
1 Cautery of the capsule to cause contraction
2  Micro Fat grafting combined with PRF
3 Vertical mastopexy

I do not use ADM  in these cases

Connie Hiers, MD, FACS · Answer

Fat is your best option since more breast tissue is needed to hide the implants and fat will actually increase your own tissue.

Michael S. Kluska, DO · Answer

Implant Rippling is extremely common, especially with saline implants on top of the muscle in a slender build. In my opinion, if you wanted to improve the Rippling, I would advise you to change your implant from saline to gummy bear combined with a Fat Grafting. The other option is to remove the implants for approximately 3 to 4 months and then go back and put them under the muscle Plus or minus some form of mastopexy.

Mats Hagstrom, MD (license on probation) · Answer

If your implants are rippling, then I don’t think grafting fat is going to stop your implants from rippling. It appears you have thin layers of subcutaneous, fat and breast tissue between the skin and the implants and this means only limited amounts of fat can be grafted successfully.
I’m guessing most plastic surgeons would recommend converting to silicone implants because they have less rippling.
High profile implants tend to ripple more than low profile implants, so that is something to consider as well.
Fat transfer may help build up the soft tissue coverage of the implant slightly, but if you can get the implant to not ripple that will have far greater impact than trying to add more tissue.
The importance of provider selection cannot be overemphasize.
Best,
Mats Hagstrom, MD

Fat transfer on a thin patient, could 200cl really be enough to cover severe rippling? (Photo)

Answers (8)

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