Hello, I am only 4 weeks post op, and I realize that it's still early, but I am becoming concerned about my rippling. (Photo)

Post Operative Ripples can occur with any implant. They occur more frequently with saline implants than silicone and  are more likely  with smooth implants rather than textured. They are primarily a function of the lack of soft tissue coverage (breast tissue of the patient) rather than of the surgery, the implant, or the surgeon. Traction ripples (when you are leaning forward) do occur to some extent in all implants. So bottom line is: wait to allow the breast to look and feel softer. Consider textured implants if it really bothers you. Seri and other forms of ADM have been used but most of us feel that this is overkill for this indication. Talk it over with you board certified plastic surgeon on your follow up visit.

Ripplying is mainly seen when large implants, especially saline, are placed in women with little breast tissue.They are mainly from the lack of tissue covering the implant. Sometimes fat transfers can be helpful, but you need to give your breasts more time to heal.  As the tissue heals and the capsule forms, some ripples do improve.  You may always have ripples when you bend over and the implant falls away from the chest onto your thin tissue. You will need to discuss the revision costs with your surgeon. Larger implants typically make the ripplying worse.

I agree with your plastic surgeon.  It would be appropriate to give the wound healing around your breasts at least another two months to be sure of what is going on and to what degree.  At times, when a little bit more capsule forms, the rippling that you see may diminish or vanish.It would appear from your pre-operative height, weight, and cup size that both you and your breasts are very slender.  All breast implants ripple to some extent, and when you have minimal subcutaneous fat, some of this rippling can be seen on the surface of the breast.  I am not a big fan of moderate plus implants as they are underfilled by both American manufacturers, so if you are considering a revision, I would suggest you discuss with your plastic surgeon using a high profile implant.If the problem is truly the thickness of your muscle and subcutaneous tissue, then if you and your plastic surgeon decide on a revision, then possibly wrapping your new implant in Seri may decrease or eliminate any future rippling.With reference to cost for any revisionary surgery, this depends on what you and your plastic surgeon discussed during your pre-operative consultation.