Left breast rippling - more visible on the left than the right side. (photos)

Question

What could be the cause of this rippling on the left side of my breast when I bend over. It's more visible on the left than the right side. My left breast if naturally bigger and had 300cc vs the right breast was smaller and got 330cc but less ripping.

Martin Jugenburg, MD · Answer

All implants experience rippling, but to various degrees. It is just a
matter of whether one can see them or feel them. It is common when one bends over. 
Saline implants are indeed more prone to ripple compared to silicone
implants because it is not cohesive like silicone. Let us understand rippling a
bit better.
Rippling is the appearance of ridges, wrinkling, or scalloping on the
implant that may be visible through the skin. It often develops on the outer
perimeter of augmented breasts: on the side, bottom, or in between the breasts.
Rippling can be caused by the under-filling of the implant, or because of pull
on the tissue capsule that is attached to thin overlying soft tissue (i.e.,
skin and subcutaneous fat tissue, and breast tissue). Unfortunately, rippling worsens with time as the implant
puts pressure on the breast tissue and thins the overlying tissue. Rippling is
common in patients who are very skinny, have very little fat to hide the
implant, and have small breasts compared to the implant itself. Weight loss may
worsen the situation. Since you are experiencing rippling on the left side more, this means there is less soft-tissue coverage there.
To correct
rippling there are solutions depending on their applicability:
If someone has under-filled saline implants, have them over-filled
moderately. This is more of a preventative measure. Over-filling prevents the
shell from folding onto itself although, it can result in unnatural firmness.If someone has textured implants, have it changed for a smooth
surfaceIf someone has large implants, have it changed for moderate sized
implants so that breasts can better conceal the implantIf someone has saline implants,
have it changed for a silicone implantIf someone has the implant placed above the muscle (subglandularly),
then have it placed behind the muscle (submuscularly)Saline implants ripple more over the muscle (subglandularly), but
the rippling can be hidden behind the pectoralis major muscle due to a thicker
layer of soft tissue that conceals 2/3rd of the top of the implant.
Rippling may still appear on the outer side of the breast, just above the
breast fold and this is especially true if you lean forward or bend to pick up
something off the floor.Fat transfer to the breast to add soft tissue for additional support and
volume to area where the implant is visible may help. This is the only surgical option, but there is unpredictability in
the outcome due to less than 60% fat graft take. Also note that rippling is
often a problem for thin patients, and such patients have very minimal fat for
fat transfer.Please refer back to your surgeon to share your concerns and have them addressed.

Jerome Edelstein, MD · Answer

Hello,Thank you for your question and photos. Unfortunately, for patients who have thin skin and minimal breast tissue or fat, the likelihood of seeing rippling is greater. The outer sides and under the breast are common areas where one might feel or see rippling. The appearance of rippling is typically greater for saline implants as well. You could ask your Plastic Surgeon about fat grafting to help camouflage the implants or switching to silicone cohesive gel implants.All the best

Farah Naz Khan, MD · Answer

Hard to say since you didn't mention the type of implant you received or it's location. In general, saline implants tend to ripple more than silicone. Also, implants placed in the subglandular position may ripple because of less tissue thickness on top of the implant compared to one placed underneath the muscle. Best to talk to your operating surgeon to discuss ways to improve/revise your result if the rippling is too bothersome. Good luck!

Christopher J. Davidson, MD, FACS · Answer

Thank you for your question and photographs.  The rippling that you are describing is often the result of minimal breast tissue covering the implant and sometimes more prominent with saline implants as well as implant placement (under the muscle vs. on top of the muscle).  Best to follow-up with your plastic surgeon to consider your result.  Good luck.

Eric Schaffer, MD, FACS · Answer

Rippling can occur when using Saline implants that do not have complete muscle coverage.  Saline implants are great when using different volumes to account for breast asymmetry.  Rippling is sometimes noticeable when bending over but not when standing upright. Photos you submitted appear as if you have a very nice result.

Otto Joseph Placik, MD · Answer

Hello and thank you for your question. It is common for patients to complain about rippling with Saline Implants. You didnt provide information about what type of implant was utilized/ the implant placement so it is hard to say but if your implants are over the muscle (subglandular) that can be another cause of them being more visible. I hope this helps.

Brian M. Kinney, MD, FACS · Answer

Thank you for your question. It is likely that the implant doesn’t have enough tissue covering it. This is usually due
to an implant diameter greater than the breast width. Saline implants cause far
more rippling than silicone. But when there’s not enough tissue covering it,
even silicone can show rippling. You either need more cover over the implant or
a smaller implant diameter. Hope this helps!

Ralph R. Garramone, MD · Answer

Ripping is most common in thinner patients with less soft tissue coverage.  That is little body fat and breast tissue.  It is more common with saline implants and less common with the newer highly cohesive silicone gel implants.  It is more common in textured than smooth implants. It is always more common in the bending forward position when the implant has the least support.  You should follow up with your plastic surgeon since some of those issues may be treatable with a different implant.

Frank Conroy, MBChB, MRCS, FRCS(Plast) · Answer

Rippling can be a result of a number of factors.  It is far more common with saline filled implants than with silicone implants and unfortunately you do not mention which you had put in.  Silicone implants tend to ripple less as the gel is typically quite cohesive.
Rippling is also more obvious in breasts which have very little soft-tissue.  A large implant in a small breast containing little breast tissue will struggle to camouflage the implant and any rippling will be more obvious.
Rippling can also be worsened by capsular contraction.
Rippling can be improved by using a silicone implant with a cohesive gel.  Fat grafting can be used to camouflage any rippling as can acellular dermal matrices.  I would recommend that you revisit your PS and tell him/her your concerns.

Robert N. Young, MD, FACS (retired) · Answer

You didn't mention what type of breast implants you choose (saline or silicone), or whether they were placed under the muscle or above. In general terms, saline implants do tend to create ripples more often than silicone breast implants, and it is usually more noticeable when you lean forward. Thin women, or those with very thin skin, tend to show rippling more. Saline implants tend to ripple more when they are underfilled. Because you have the problem only on one side, you may benefit from a saline fill. Rippling can worsen with time, especially if you experience any type of capsular contracture. I would encourage you to express your concerns with your surgeon and have him/her give recommendations on what the best alternative is based on the type of implants you have, implant placement, size of implants, amount of fill in the implants, amount of tissue you have, and other factors that play a role in determining why your implant is rippling.

Left breast rippling - more visible on the left than the right side. (photos)

Answers (11)

More Breast Augmentation Questions

WE SEND PRETTY
EMAILS

Answers (11)

More Breast Augmentation Questions

Natural breasts very close together - how to separate?

Will my breasts get larger as they "drop and fluff" or will they shrink in size? (photo)

Should I try this to avoid capsular contracture?

Is this normal bruising 5 days post-op breast augmentation? (Photos)

Moderate or high profile for athletic build? (Photos)

I am 2 weeks post op and have noticed this week that I am extremely tired, is this normal? How long will it last for?

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS