Is it possible for submuscular gel implants to ripple?

Question

I had a breast augmentation in 2017 which came out beautifully. In 2019 I had my first baby, breasts tissue certainly changed as I breastfed successfully for a year. Had my 2nd child in 2023 and breastfed for 9 months. My breast are much smaller than they were, with more droop. I noticed that I have rippling mostly on the lower pole when I bend over but also on the top near my nipple. My question is, is it possible for submuscular gel implants to ripple? Concerned.

Chet Mays, MD · Answer

Thank you for your inquiry!   If you have thin skin, sometimes you can see some rippling.  There are options to help with that. We would love to meet with your to discuss your options.  Schedule a consultation with a Board Certified Plastic Surgeon!

Joe Gryskiewicz, MD, FACS · Answer

Hello,
Rippling may be noticeable after the fluctuation of your breast tissue. It will also depend on which type of implant you have. Some implant profiles are more natural and have wrinkling to them, whereas some are precision filled. I would suggest checking which implant style you have and go from there.
All the best,
Dr. Joe

Daniel Barrett, MD · Answer

Dear Mermaid508,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Brian K. Reedy, MD · Answer

Thanks for your question! I am unsurprised to hear that you have rippling (even under the muscle). The muscle only covers about 2/3 of the implant, and with the softening of your tissues from child-rearing, it is absolutely a normal occurance to have rippling. You could always seek replacement with a more cohesive implant or add fat to the breast to help the rippling. Good luck!

Richard Zienowicz, MD · Answer

Hello and thank you for your question. Unfortunately, due to how the muscle covers the implant, there are still aspects of the implant that do not have muscle coverage that can lead to more visible rippling. The implant itself may have undergone changes since 2017, and the changes in both your skin and glandular breast tissue with pregnancy and breastfeeding and time may contribute to the visible rippling as well. If you are finished having children I would consult with a board certified plastic surgeon to review your options to help mitigate the rippling. If you would like imaging of the breast to see if the implants are intact you can also seek counsel with your plastic surgeon or OB or primary care. Best of luck to you!

Jonathan Heistein, MD · Answer

It is not unusual to have rippling in the lower part of your breasts, even with gel implants.  Gel implants ripple less than saline implants, but there still can be some.  After pregnancy, sometimes the breast volume gets smaller and thinner, so that there is less to cover the implants.  Then you can feel the implants more than you could before pregnancy.  Talk to your PS as there are several ways to improve this.  The easiest way is to use more cohesive implants, but I would not suggest doing this until you are done having children.  Best of luck!

Richard Baxter, MD · Answer

The pectoral muscle does not cover the lower or lateral part of the implant, so it is possible to have rippling there. Options to improve rippling include placement of an internal bra with Galaflex mesh or Strattice, and possibly using more cohesive implants. It sounds like you might also benefit from a breast lift with the changes from pregnancy and breastfeeding.

Camille Cash, MD · Answer

Yes, rippling can occur even with gel implants placed under the muscle.  The muscle does help provide some camouflage but it only covers a portion of the implant.  Those with thinner tissues are more susceptible to see these characteristics of the implant.

Connie Hiers, MD, FACS · Answer

Yes, as you have lost breast tissue volume, you have less tissue to cover the implants and they may ripple even behind the muscle.

Sean M. Bidic, MD · Answer

Submuscular breast implants can certainly ripple, especially after two rounds of breast engorgement with pregnancy and breast feeding. Also, fuller fill breast implants that came out after 2017 would also decrease the amount of rippling. A photo would be helpful, but many women often get breast lift with implant replacements after childbearing is completed.

Is it possible for submuscular gel implants to ripple?

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