Rippling often develops on the outer perimeter of augmented breasts: on the side, bottom, or in between the breasts. It becomes more apparent when you bend over, so if you feel rippling while bending over, then that is common and expected. 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). Rippling, or implant wrinkling which is visible through the skin is common in patients who are very skinny and have very little fat or soft-tissue (breast tissue, fat tissue, skin) to hide the implant. Or it can happen when you get a large implant with a high profile which seems to be the issue in your case. Unfortunately, rippling worsens with time as the implant puts pressure on the breast tissue and thins the overlying tissue to create deformities in the ribs causing them to hold a different position in the chest.Let me discuss the steps that could be taken to minimize rippling.· If someone has textured implants, have it changed for a smooth surface· If someone has saline implants, have it changed for a silicone implant· If someone has large implants, have it changed for moderate sized implants so that breasts can better conceal the implant· If someone has the implant placed above the muscle (subglandularly), then have it placed behind the muscle (submuscularly)o 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.Final 2 solutions can be applied in any case:· Weight gain – weight gain will allow greater soft-tissue coverage – i.e., padding – the better the implants and rippling is concealed.· Fat transfer to the breast soft tissue for additional support and volume to area where the implant is visible o Fat transfer 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 continue to have regular follow-ups with your surgeon to make sure your breasts are healing beautifully. Their recovery instructions should take precedence over all else you read here as they are better informed about your surgical details.Hope this helps.
