2.5 Weeks Post Breast Lift/Implants. Now Have Rippling?

I'm 2 and a half weeks post op a breast lift with implants. I received 350cc silicone implants over the muscle. I expressed to my doctor that I wanted a natural look. Before the surgery I asked him if we could go under the muscle, he assured me that going over would be fine. But now Im experiencing rippling on the top of my breast witch I feel wouldn't be there if he would of went under the muscle. Was he just taking the easy way out? Most surgeons recommend going under the muscle so I'm confused.

Doctor Answers 7


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.


Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

Wait three to four months

Wait three to four months to assess your results. If at that time you still have rippling, return to your surgeon to discuss your results.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 179 reviews

Rippling After Breast Augmentation Surgery?

I am sorry to hear about the concerns you have after breast augmentation surgery. At this point, given that the decisions have already been made and the operation performed, there is not much online consultants will be able to help you with.

 Your case does demonstrate why preoperative education is extremely important. Patients undergoing breast augmentation surgery should consider the pros/cons of  of the options available to them. Doing so, will allow true informed consent and avoid “confusion” and/or dissatisfaction postoperatively.

 Allow yourself 6 months before evaluating the end results of the procedure performed.  If the location and/or extent of the breast implant rippling remains a concern,  revisionary breast surgery may be helpful to you.

 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 reviews

Over the muscle

Hello there 

Rippling occurring so soon after surgery is unusual . It might be that what you are seeing is some irregularity of the pocket . I would wait a bit longer to see if this resolves. If it persists it is always possible to shift the implants behind the muscle at a later date. 



Terrence Scamp, MBBS, FRACS
Gold Coast Plastic Surgeon
4.8 out of 5 stars 7 reviews

Rippling after Breast augmentation 2.5 weeks

Implants palced in a sublgandular pocket are more likely to ripple in the upper pole than those placed under the muscle.  Sorry for your problem.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Rippling 2.5 weeks after breast lift and implants

Unfortunately, I can't answer your question as to whether your plastic surgeon was taking the "easy way out," because he had the benefit of evaluating you and formulating a surgical plan after seeing your in person. However, there may be several factors that are currently contributing to your rippling. The first factor is obvious. Implants placed under the muscle will have less rippling at the upper breasts compared to implants placed above the muscle. Also, if your breast tissue is somewhat atrophic and thin and saline implants were used, then rippling can be more apparent. I recommend discussing your concerns with your surgeon. Hopefully, he will come up with a solution to your problem. Thank you for sharing your concerns. Best wishes.

Gregory Park, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 164 reviews

2.5 Weeks Post Breast Lift/Implants. Now Have Rippling?

There are pros and cons of going above and below the muscle with the implants. In the US most surgeons prefer under the muscle placement, but that is not the case everywhere. Ripples are not too common with silicone, and less so when under the muscle. On the other hand, animation deformities (movement of the breast with arm motion) occur only with under the muscle implants. 

It is not a question of an easy way out  In fact, I find under the muscle placement easier

A discussion of the rationale for the position choice by your surgeon seems in order. All the best/.



Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

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.