Is my silicone subpectoral implant rippling on one side only be due to damage of the implant?

I appreciate your question.

I would recommend you follow up with your surgeon for evaluation and work up.



The best way to assess and give
true advice would be an in-person exam.

Please see a board-certified
plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!



Dr. Schwartz

Hello,It is hard to say why only one implant has palpable rippling.  There could be a number of reasons including thinner soft tissue envelope thickness on one side, implant malposition with greater lateralization of implant and less soft tissue coverage, capsular issues, and actual implant rupture.You should be evaluated by your surgeon to see if he has any suggestions. If you are considering surgery, now is the time you might want to think about form stable implants, as they tend to ripple the least of any implant.Best of luck!

There is not damage to the implant.  The lack of fat is illustrating the rippling.  There is nothing that can be done to prevent your rippling if you get your body fat so low that there is nothing covering the implant.

Although rippling is much more common with saline implants, it can occur with silicone gel implants in extremely thin patients. It does not by itself signify damage to the implant. There are several methods to improve it which include fat grafting and/or placement of dermal grafts. If the rippling is only mildly visible and not that bothersome to you, doing nothing may be the best option. Best of luck.

Hi fstheyn. There are a myriad of reasons for implant rippling. It is not uncommon to see or feel this rippling only on one side. As noted by another physician, implants, de facto, ripple. The saline implants have more of a waviness than silicone, but both implants have rippling. The amount of fill within a given implant, will also effect the degree of rippling -- the higher the fill, generally the less rippling. The silicone implant does ripple less, and the more cohesive the implant, generally the less rippling. The texture of the implant shell can also affect rippling, with the texture tending to ripple more. The position of one's body will also affect rippling, as well as the location if the rippling (especially saline) due to gravity and resultant distribution of the fill material. "Traction rippling" occurs due tethering of certain portions of the capsule/membrane surrounding the tissues and concentration of the fill to the dependent portion of the implant, leaving the top portion of the implant empty. Focal rippling may occur when there are areas of tightness and alternate areas of thinning/expansion of the capsule and scar tissue surrounding the implant. Typically, subglandular (over the muscle) placement will have more appreciable rippling than sub-muscular/sub-pectoral (under the muscle). And most definitely, tne thickness of the overlying tissues will impact to what degree ten rippling is padded vs. palpable and/or visible. Also, most implants placed "sub-muscularly" or "sub-pectorally" are not completely covered by muscle -- the outer portion of the breast is only skin and gland, or even just skin. This is also true for the bottom of the breast if the muscle insertion has been released, as is common practice.  Finally, with saline implants, progressive rippling, especially on the top, may be a sign of leakage. As to your specific question, a change in rippling or the pattern of previous rippling with silicone implants, may also represent an implant rupture or break in the shell integrity. This would be a more uncommon sign, but physical exam with silicone implants is notoriously unreliable.  Therefore, I would encourage you to follow-up with your surgeon promptly and consider a breast MRI to evaluate your implant further. (And, it is FDA-recommended that a surveillance MRI be performed every two years.). There are a variety of treatment option to try to improve rippling (scar/capsule release and pocket redevelopement if needed, implant plane exchange from subgland to submusc or visa versa, implant type change (e.g. textured to smooth, profile change, increased fill volume, etc.), and fat grafting. Results may be unpredictable and the rippling may persist or recur. If the rippling is only palpable or minimally visible, I would caution against a revision -- "The enemy of good is 'better!'"  Good luck!

Everything you have described is fairly normal. Rippling is not necessarily a sign of damage to the implant. In fact, this is usually simply due to the interface between your soft tissue and the implant. The only way to determine if the implant is ruptured with surety is to open the pocket, remove and examine the implant directly. Short of that, an MRI is a very good test to assess implant competency. If you have cohesive gel implants, I am sure your surgeon would have conveyed to you the FDA recommendation for an MRI exam every 2-3 years under normal circumstances. You have had yours for eight years, so maybe now would be a good time to consider having one performed.

Essentially all implants will have rippling along their edges, but it is not visible or palpable in the majority of cases. The muscle, breast gland and surrounding fat cover the implant, creating the overall breast shape. Although silicone gel filled implants have a very low rate of visible rippling when they are placed in a submuscular or dual plane position, visible rippling can occur in very lean individuals. Your low body fat is the likely cause of implant rippling. Your surgeon will be able to determine this during a physical exam. Damaged implants do not usually have any outward signs. For or your reassurance, go see your surgeon for a check up. Best wishes.