From overs with rippling to under. Any suggestions? (photos)

Hallo I am very skinny and I my surgeon put 520 implants OVER the muscle 6 months ago and I can see already I have rimplings on my right breast and is getting worst.What can I do now?change implant under the muscle?is it complicated if i have 500 over the muscle now?thank u

Doctor Answers 8

I am assuming you wanted that size

and if so, you are experiencing the limitations with body tissue is limited.  If you're trying your best to eliminate the ripples, you must choose the super cohesive smooth round implant or the textured anatomic implants and going under the muscle would be preferred to eliminate the upper and medial pole rippling.  Did you also choose the pocket to be above the muscle and if so, WHY?

Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Wrinkling implants

Your body fat is very low and you will see more through your thin tissues. I would recommend silicone implants under the muscle and possibly also under the current capsule to put more tissue between the implant  and  the outside world.

Talmage Raine MD FACS

Talmage J. Raine, MD, FACS
Chicago Plastic Surgeon
4.5 out of 5 stars 8 reviews

Implant rippling

Unfortunately, what you are experiencing is a natural consequence of using implants that are too large for your frame and breast tissue.  In order to correct this, your current implants will need to be removed and replaced with a smaller implant, and a lift will likely be needed to take up the extra skin.  Alternately, you can have the implants removed and let the skin contract for a few months before replacing them with a smaller device.  However, this means you'll have to live without implants while this is occurring. Discuss these options with your surgeon.

Jason J. Hall, MD, FACS
Knoxville Plastic Surgeon
5.0 out of 5 stars 10 reviews

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From overs with rippling to under. Any suggestions?

Thank you for your picture and question. I think that unfortunately, this problem is very common in situations like yours. Implants that are very large for your frame, placed over the muscle, in a very thin person with little soft tissue coverage are at very high risk of causing problems with palpability and rippling. This is something your surgeon should have discussed with you before surgery. I would say that to revise this, you need a pocket exchange to a submuscular pocket and probably a change to a smaller implant, possible shaped silicone, and likely a small mastopexy to take up the redundant skin now there from the overly large implant.

Best of luck!

Breast implant rippling and what to do about it

I think you've got very large implants with minimal soft tissue coverage - rippling is a consequence of that scenario. Consider downsizing your implants to a form stable cohesive gel implant and placing implants behind the muscle. This will likely solve the rippling problem for the most part.

From overs with rippling to under. Any suggestions?

I'm sorry to hear of this situation because any surgeon should know this is totally predictable. I hope your doctor is willing to correct the problem with under the muscle placement at his expense. That would be placement of silicone implants also, and you would do well to downsize considerably to an implant that is properly fitted to your small torso. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

Over the muscle with rippling

Rippling is often caused by not having enough breast tissue over the implant. The treat of of rippling usually requires movement to a submuscular position. The use of products such as acellular dermal matrix can also be beneficial. Best of luck.

Jon E. Rast, MD
Kansas City Plastic Surgeon
5.0 out of 5 stars 28 reviews

From overs with rippling to under. Any suggestions?

Thank you for the question and  photographs.  Based on your description and photographs, I think that you have a very good plan in mind.  Conversion of the breast implant space from the sub glandular position to the sub muscular plus/minus the use of acellular dermal matrix may be necessary to improve your outcome. Successful results do depend, to some degree, on the surgeon's experience. Therefore, best to make sure that your plastic surgeon can demonstrate significant experience helping patients with this type of revisionary breast surgery. 

 As I mentioned, the use of acellular dermal matrix for lower pole support and/or coverage of "rippling". Closing off the existing breast implant pocket is a technique utilized to help prevent the breast implant from moving back into its previous space. Patients undergoing these types of conversion operations should understand that they may experience movement of the breast implants when the pectorals major contracts (flexion or animation "deformity").  In my opinion, this is the only downside associated with breast implants placed in the sub muscular (dual plane) position.

Generally speaking, the best online advice I can give to ladies who are considering revisionary (downsizing) breast augmentation surgery is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "down a cup sizes” or "C or D cup" etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. 

3. Once you feel you have communicated your goals clearly, allow your chosen plastic surgeon to work with you in determining the best plan to achieve your goals.

I hope this, and the attached link (dedicated to revisionary breast surgery, specifically downsizing breast augmentation surgery concerns), helps. Best wishes.   

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.