Dear smcst8,There are a few things that can cause the appearance of irregularities along the lower inner aspect of the breast following breast augmentation with implants. 1. If the implants are placed under the pectoralis muscle, the lower inner margin of the muscle is usually released to allow the implant to settle into the lower breast pole. If the muscle is not released quite enough along the inner aspect, the lowest remaining fibers can act as a tether and push the implant outward. Usually, this makes the implant/breast look more flat rather than rounded, but it can cause contour irregularities that would look like a dent or tether in the overlying skin. 2. In thin patients, rippling of the implant can be seen through the skin because there is simply less breast tissue and fat tissue to cover the implant. Implants that are less filled are more prone to this.3. If an implant is insufficiently supported by the breast tissue, it can begin to bottom out with time. The weight of the implant (usually seen with larger implants) or poor tissue tone (usually due to genetics and aging) can cause the lower breast tissue and skin to stretch and allow the implant to slide downward. This is more common with implants placed above the muscle because there is less tissue to support the implant in the lower breast pole. 4. A combination of these things In your case, it looks like the implant may be bottoming out somewhat and may benefit from being repositioned (a capsulorrhaphy) possibly with mesh placement for additional support. I recommend following up with your surgeon for an in-person exam so they can help guide you on what, if anything, should be done. All the best,Dr. Victoria Aimé