Under muscle silicone implant showing. Can anything be done about this? (Photo)

Question

I am 5ft, 100 lbs. I had small A cup breast that inflated to D cups during all 3 pregnancies that quickly became deflated A cups. I had 300 cc utm low profile+ silicone implants put in. At about 3 weeks post op, I started to notice a ripple in my right breast. This has only continued to get worse on that breast and it can be felt on the left now. My PS said its because I do not have enough tissue to cover the whole implant, and there is nothing that he can do about it. Is this true?

Randal Haworth, MD, FACS · Answer

You obviously need additional soft tissue coverage : that can be done surgically by implanting an acellular dermal matrix  (such as Alloderm, Strattice or Belladerm) or with a off the shelf filler such as Renuva

Chul Hwan Seul, MD, PhD · Answer

Through revision surgery, it seems that the current rippling can be improved to some extent by partially closing the implant pocket in the area where the tissue is thinning, changing the diameter of the implant to a smaller one, and transplanting autologous fat in the area where the tissue is thinning.

Paul E. Chasan, MD, FACS · Answer

A large portion of my practice is dedicated to revision breast surgery.  The lower the profile of the implant, the more the wrinkling.  In your case, switching to a higher profile silicone implant and fat transplantation to the center of your breast would help you dramatically.  It may not be perfect, but it would improve your situation by at least 70 to 80%.  Best wishes to you.

Daniel Barrett, MD · Answer

Dear Plucky676873,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went 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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Antonios Mitsakos, MD · Answer

Assuming the implants are placed in a submuscular plane there is no other tissue layer to use for coverage. Unless the implants used are the type that is not completely full (most manufacturers have this option as they give a more natural look on some patients) any other change would not necessarily have a great result. If that is the case though a different type of implants would help. Otherwise the other option would be some fat transfer into the area to conceal the rippling

Connie Hiers, MD, FACS · Answer

Unless fat is added to that area or mesh to cover, you don't have anything to cover the implant. If your tissue there is very thin, mesh grafting may be best.

Darryl J. Blinski, MD · Answer

Only 1 posted photo showing the ripple effect from limited tissue covering the implant. Implants inferiorly are rarely ever covered by muscle this if "thinned" skin the ripple of the implant shell can be seen whether saline or silicone implants. To try to avoid this might offer micro/macro fat grafting under the skin where the implant is using ultrasound guided injections or Sculptra/Radeisse fillers injected under ultrasound. Fee from $5,00-$10,000. Best to virtual consult with...

Hilton Becker, MD · Answer

tt appears that the skin is a little thinner  on the R side  causing the implant to be visible.
Fat grafting may be a good solution

Kenneth R. Francis, MD, FACS · Answer

Dear Plucky,
Rippling can occur with almost any breast implant, regardless of type, or filling material.  It is most commonly visible in patients that are very thin, as you appear to be.  Some options are: an overfilling of saline implants; newer, more filled models of silicone implants; fat transfer to provide more coverage of an implant; and insertion of certain mesh/graft materials to provide more coverage of the implant.  Discuss these options with your surgeon.  Good luck!

Under muscle silicone implant showing. Can anything be done about this? (Photo)

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