Wavy breast implants. Is it possible to check on my implants or is removal the only option?

Question

I did my breast augmentation back in 2013, i started noticing "waves" around my implants. I can feel when i touch them, i lost certificate of implants but I remember they were brand called Mentor. Im not sure if it silicone or saline. My question is: Is it possible somehow to check what i have inside or it's only possible to know if i remove them? Thank you for answering

Kenneth Hughes, MD · Answer

Implant complications include displacement, rippling, and rupture.  The most common implant-related complication remains implant displacement with subsequent breast asymmetry. This complication ranks second only to capsular contracture as the major source of dissatisfaction.   Implant rupture occurs at a rate of 1% per implant per year. If you are getting regular MRIs to detect silent rupture, then silicone implants do not have to replaced until clinically indicated.  Visible rippling can be improved by placing the implant under the muscle, switching to silicone, fat grafting to the breast, or the addition of a dermal matrix.  Implant records are kept by the surgeon's office in your chart and you should be able to sort this out.

Richard H. Fryer, MD · Answer

What you are describing is "rippling" of the implant edge.  This is normal and does not mean that there is anything wrong with your implant.  Saline ripples much more than silicone, but silicone can still ripple.  If you feel any "sloshing" when you jump or run then almost certainly you have saline.  You could have an ultrasound done to determine if you have saline or silicone, but it would not be able to determine the size very accurately at all.

Daniel Barrett, MD · Answer

Dear Hrvatica,
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. Only after 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

Pejman Aflaki, MD · Answer

Hello and thank you for your question.  In terms of the implant type, you can try and get the implant information from your surgeon's office, as this should have been documented in the OR records. A physical examination can also determine the implant type. In terms of the "waves" you have been noticing, it would be hard to give you a definitive advice without an examination. They can be caused by capsular contracture, implant deflation, bottoming out, etc. Depending on the cause, revision surgery can involve open capsulotomy and at times capsulectomy, changing implant pocket, changing the implant or a breast lift. I would see your surgeon or another  board-certified plastic surgeon for a full evaluation and advice. Best,
  
Pejman Aflaki, M.D.
  
Johns Hopkins-trained double board-certified plastic surgeon

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question.  If you have lost your implant card you can either call Mentor to try to obtain the exact style of implants used, or reach out to your surgeon's office as they should have the details listed in your medical history.  Hope this helps.

Connie Hiers, MD, FACS · Answer

You can have your implants checked first by a plastic surgeon and then get a mammagram with or without an ultrasound. If you have saline implants, the X-rays won't be necessary for your implants. Your plastic surgeon should be able to tell you what kind of implants you have by feel.

Clayton L. Moliver, MD · Answer

There are many options for improving the look and feel of your implants/breasts. From changing the style of implant to possible fat grafting in the areas where you may not have enough of your own breast tissue to camouflage the rippling the implant has. You can contact the surgeon for your implant information.

Brian Widenhouse, MD · Answer

I suggest you see the PS who did your breast augmentation for a thorough exam. He will have all information on your implants. Sometimes rippling can indicate a rupture or leak. Other times it can indicate a capsular contracture. In any event, an exam is warranted.Best of luck!

Camille Cash, MD · Answer

To find more information on your breast implants you can contact your surgeon who performed your augmentation, the facility where surgery was done, or contact Mentor directly.  Regardless I encourage you to visit a board certified plastic surgeon near you for an examination.  Any time there is a change in the condition of your breasts and/or implants it's always wise to investigate the issue.

Tom J. Pousti, MD · Answer

You have several options available to you, short of  breast implant removal.   Check with your plastic surgeon's office for the breast implant information. The breast implant manufacturer may also be a resource to you. Follow up with your plastic surgeon or another board-certified plastic surgeon; physical examination usually suffices when it comes to determining the type of breast implant in place. Options for revisionary breast surgery (it sounds like you are experiencing breast implant rippling) can be discussed also. Some general thoughts may be helpful to you.  
Palpability and rippling of breast implants may be related to several factors. These include the amount of soft tissue and breast tissue coverage over the breast implants, the position of the breast implants (submuscular versus sub glandular), the type of implants (saline versus silicone), and the degree of overfilling of saline filled implants. Also, breast implant displacement problems (such as bottoming out or lateral displacement) may play a role when it comes to increase breast implant rippling.
Generally, weight loss will extension weight any rippling/palpability of the implants. Deflation of saline implants will also increase the rippling/palpability of the implants.
Correction of the rippling may involve further surgery including implant pocket exchange if possible (sub glandular to submuscular), implant exchange if possible (saline to silicone), capsulorraphy (adjustment of the surrounding breast implant capsules to prevent displacement) and/or the use of allograft (acellular dermal matrix) to provide an additional layer of tissue between the implant and the patient's skin.   I hope this helps.

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