What should I do about rippling?

I am 5'3 weighing 104 pounds with and had a periareolar incision. My implants are natrelle saline filled implants. the bag im guessing was 390cc and filled up to 480cc. the style is 68mp and am looking to have my breasts either taken out completely or have them redone. I have heart horror stories about silicone implants but want to get rid of the rippling. My breasts are too big and am looking for a solid solution and the most aesthetically pleasing look for my overall body figure. Pics in my profile

Doctor Answers 9

What should I do about rippling?

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ALl implants ripple some oresent more than ohers depending on the patients chest. Typically in thinner patients you will notice more rippling. You may want to consider the IDEAL implant. 

Toronto Plastic Surgeon
4.9 out of 5 stars 517 reviews

What should I do about breast implant rippling?

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The new silicon gel implants are safe and you should not be concerned.

Placement of new silicon gel implants and converting the pocket to beneath the chest muscle and possibly using a smaller implant may be your best option.Please see an experienced board certified plastic surgeon.

Need new implants

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First silicone is safe.In many of my patients who come to me for re do's I will put silicone in and then do fat grafting to the upper part of their breast and along their sternum or breast bone.This will help to eliminate the rippling.This can occur with saline and if your tissues are thin it almost always will happen.Food for thought.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 69 reviews

What should I do about rippling?

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Thank you for your question and photographs.  There are a number of options available to you to try and improve your rippling symptoms.  The first would be to downsize your implant and narrow the implant pocket. You may need a lift at this time to remove excess skin that may be present.  Moving the implant underneath your chest muscle and converting them into silicone implants would also be good options.  Lastly if despite these options your skin remains thin enough to see implant edges then using a synthetic scaffold internally to augment your skin can be done.  I hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

What should I do about rippling?

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Hello!  Thank you for your question!  Given your description, you are at risk for rippling and visibility of the implant since you are petite with likely little breast tissue. The large, saline implants accentuate this. Surgical correction would be needed.  Removal of the implants is always an option as you stated, but there are some revisionary methods that may ameliorate the problem. Other techniques include changing the position to a plane beneath the muscle, exchange for silicone implants and/or form stable shaped silicone, fat grafting, and placement of a dermal matrix. You will likely need a combination of some of these modalities. Hope that this helps. Best wishes!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

Large saline implants are likely to ripple in thin patients

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I'm sorry you are not happy with your result, but as other surgeons have said, you are at high risk for rippling because you are thin and don't have a lot of breast tissue. 

I I have many patients that are concerned about silicone, but they are actually very safe devices. I personally waited 7 years before getting implants just so silicone was available again. 

The "form stable" or "gummy bear" implants (released on 2012 here in the US but used in Europe and Canada for over 20 years) have the lowest rates of rippling. However, those have a very different look than you have now.

There is a newer (again only new to the US) implant called the Inspira that has a thicker gel and is overfilled to minimize rippling for even post mastectomy patients. 

If if you want the lowest chance of rippling, it may indeed be necessary to consider a sling of graft material to cover the bottom part of your breast, and if you downsize significantly, you may even need a lift to make sure the implants sit in the right place on your chest. But these are all issues best addressed during a formal consult with a board certified plastic surgeon. 

Best wishes. 

Dana Goldberg, MD
Jupiter Plastic Surgeon
4.9 out of 5 stars 41 reviews

Rippling with Saline Implants

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Thank you for your questions.  There are several options that you have regarding surgery.  I would highly recommend silicone implants.  They are safe and offer the opportunity to have less rippling.  I have been using the Inspira overfilled implants from Allergan.  The overfilled nature can decrease rippling.  Placement of an Allograft may also be helpful.  Overall, it is important to be seen by several board certified plastic surgeons to understand all of your options.  Sometimes, the best option is to simply remove your implants.  Best of Luck.

Aaron D. Smith, MD
Colorado Springs Plastic Surgeon
5.0 out of 5 stars 30 reviews

What should I do about rippling?

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I am sorry to hear about your concerns after breast surgery. Although I cannot provide you with specific advice, some general thoughts may be helpful to you. You may also find the attached link, dedicated to revisionary breast surgery concerns, helpful to you as you learn more.
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. Generally, weight loss will extension weight any rippling/palpability of the implants. Deflation of the 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), and/or the use of allograft to provide an additional layer of tissue between the implant and the patient's skin.
In-person consultation with board-certified plastic surgeons who can demonstrate significant experience helping patients with this type of revisionary breast surgery will be your next best step. Best wishes.

Saline rippling

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Thank you for your question. From your story I see two major reasons for your rippling: 1) saline implants and 2) you are very thin. For someone with your height and weight, I am guessing that you started without much breast tissue (preop photos would be helpful here). You are the classic setup for rippling because you chose a saline implant without much breast tissue to cover. Besides the firmness, the rippling with saline implants are one of the most common patient complaints. The rippling in your photos is classic for submuscular placement as you do not have muscle to cover the outer portion of the implant.
The horror stories you hear about silicone are just stories. They are very safe devices with years of safety data. Please do not believe the myths/lies that have been perpetuated since the early 1990's. My wife has silicone implants and if I did not think they were safe I would not have used them on her. You may do well with a smaller form stable (anatomic or gummy bear) implant depending on your breast dimensions and goals. There is always some risk of rippling with implants, but it is much less in a silicone device.  Best to be seen in person by a board certified plastic surgeon for optimal advice. Good luck.

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.