Will Textured MP Breast Implants Cause Rippling?

I had a Breast augmentation 3 years ago Saline 300cc subglandular. I had rippling. Then 6 months ago, I had another surgery vertical lift and a re-aug with moderate smooth silicone gel with 275cc subglandular, but I am having problems again with rippling. This time, however, seems even. I went to the doctor and he told me that even if I have another surgery, I would have a big chance of having the same problem again. This time he suggested textured moderate plus implants at 400cc. Do you think this wilopl cause another rippling problem? Could you please give me some other suggestion?

Doctor Answers 8

Moderate profile implants are underfilled and have more rippling.

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Hi! Here are some suggestions:

1) "Moderate" profile implants are really low profile, they are underfilled, and they have a higher risk of rippling. Just switching to smooth walled moderate PLUS profile or high profile cohesive silicone gel implants may help you.

2) Textured surface will increase the risk of rippling. Not a good idea.

3) Implant pockets can be reinforced with Alloderm to minimize rippling.

4) Rippling in upper part of breasts can be improved with implants under the muscle. Changing implant position will not help rippling in the bottom of the breasts.

Manhattan Plastic Surgeon

Rippling of implants

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If you have failed reconstruction because of rippling, you may want to consider alloderm for a thicker coverage over the implant.

Bigger breast implants will likely produce more rippling

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Assuming that rippling is indeed the problem and you have already switched to silicone gel implants, going larger will probably produce more rippling especially if you stay "over the muscle." If you go with "under the muscle" implants this time, I would stay away from textured implants and keep to a similar size to give you the best chance of making things better.

John P. Di Saia, MD
Orange Plastic Surgeon

Rippling is less a function of the implant style

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I suspect that your problem with rippling is a function of the relative size of your implant. There are a number of factors that influence rippling but all implants have rippling, that is one of the imperfections of the procedure. The issue is how to hide it. Smooth implants translate the rippling less because the implant is not adherent to the overlying soft tissue whereas textured implant are designed to make the soft tissue stick to the implant surface.

Implant under the muscle show rippling less than subglandular implants since there is an extra layer of think muscle covering the top half of the implant.

Silicone implant produce less noticeable rippling because of the viscosity of the gel versus saline cushions the folds.

However, if your implants are wider than your native breast tissue, then the naturally rippling implant will show from out beneath the breast. If the proportion of breast is predominantly implant, then your breast will act more like your implant. The key to reducing rippling is choosing an implant that is covered nearly entirely by you own breast and to keep the volume relative low or a minor contribution to your final volume.

Otherwise, I fear that you will be chasing an imperfection and go round and round trying to chase your ripples away.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Change the implant pocket

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If your implants are sub mammary and you continue to have problems with rippling, I suggest you ask your surgeon to move them to a sub pectoral pocket. This will add more coverage between your skin and the implant and always reduces the amount of visible wrinkles.

A textured implant usually is worse for rippling and does not feel as natural, especially on top of the muscle.

Leslie H. Stevens, MD
Beverly Hills Plastic Surgeon

Textured MP Breast implants and Rippling

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Dear Midere,

Having not examined you before your procedures and now I can only speak in generalities which may not apply to you.

ALL implants (but saline MORE than gel filled) are associated with rippling. Textured implants on the US market are associated with more rippling than smooth (saline or gel) implants. Finally, implants UNDER the muscles will project less rippling than implants over the muscle, as you had done.

Personally, I would advise against using a textured implant (either saline or gel). To minimize the likelihood of recurrent rippling, I would advise closing the subglandular pocket and put smooth gel filled implants UNDER the muscle.

Good Luck.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Lessening the chance of breast implant rippling

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In my experience (30 years), rippling is more common with textured implants because the capsule around the implant attaches to the implant making the rippling worse.

I would use a high profile silicone gel implant because the edge contour of the implant makes it less likely to ripple.

Robert Vitolo, MD
Manhattan Plastic Surgeon


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Breast Implant Rippling most often occurs when there is insufficient soft tissue coverage due to little overlying body fat and breast tissue. Implants placed beneath the muscle help to minimize this phenomena but the lower and outside breast (as pectoralis muscle is no longer present), towards the cleavage where the muscle thins out or on top of the breast where breast tissue is often lacking are the most common places to see rippling. It is often accentuated with certain positions (e.g. bending over,or leaning). Most of the time, rippling is felt along the outer side of the breast and the inner side of the breast next to the cleavage. Breast implant waviness (rippling) that is felt but not noticeable to the eye is very common and should not be a concern. However, when rippling is visible, patients are often self-conscious about their appearance.
Factors that are associated with increased rippling include:
  • Traditional Saline implants (IDEAL® Saline implants less likely)
  • Textured implants
  • Large implants
  • Thin patients with low BMI
  • Implants placed above the muscle
  • Prior history of rippling
Factors which are less likely to have rippling include:
  • Heavier and larger breasted women
  • Using a highly cohesive form-stabile silicone implants (gummy bear)
  • Smooth implants
  • Smaller implants
  • Submuscular placement
Once rippling occurs it is very difficult to correct. Rippling can be minimized by placing a biologic fabrics (e.g. AlloDerm®, Strattice™, SERI®), submuscular conversion if implants are above the muscle, fat transfer, use of adjacent tissue (muscle or fascia) if available, and in persistent cases implant removal and fat transfer. Seek the care of the best board certified plastic surgeon possible with experience in breast revision surgery.


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.