Juvederm to Reduce Rippling After Breast Augmentation?

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 implantsLarge implantsThin patients with low BMIImplants placed above the musclePrior history of ripplingFactors which are less likely to have rippling include:Heavier and larger breasted womenUsing a highly cohesive form-stabile silicone implants (gummy bear)Smooth implantsSmaller implantsSubmuscular placementOnce 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.#rippling#breastaugmentation

This is not advisable, and nor are fat injections. Both may cause complications that could require surgery. 

I do not think that Juvederm is a good option for rippling seen after breast augmentation. It is temporary and expensive and not really designed to be used for the breast. If you have saline implants, exchanging them for silicone gel implants may help. Also, moving from the subglandular to subpectoral position would be something to consider. Fat grafting is another option that is becoming more popular recently. 

Although Juvederm is good for facial wrinkling, it is not usually used to treat wrinkling or rippling around breast implants.  Although a minimally invasive approach to this problem would be very appealing, generally attempts to correct rippling will involve additional implant surgery or fat grafting.

There are multiple reasons why the use of hyaluronic acid fillers such as Juvederm are poor options for breast implant rippling. The first is that Juvederm is a temporary filler. After 12 months, the results would go away. Second is cost. Juverderm comes in 1cc syringes. The typical fat volume used for grafting of rippling is in the range of 30-60cc. Depending on the surgeon, 1cc of Juvederm can cost $1000. If rippling is an issue, multiple options exist:


Site change to submuscular if currently subglandular

Use of a dermal matrix for soft tissue coverage

Increasing size of the current implants

Decreasing capsule size with internal capsulorhaphy

Switching from saline to silicone implants

Subcutaneous soft tissue augmentation with fat grafting


 

Thank you for your question.

I do not think that injecting Juvederm is a good option for rippling reduction.  There are many different options available to patients depending on the specific situation.  If you currently have saline implants, switching to silicone gel will be helpful.  If your implants are currently above the muscle, placing them below the muscle will be helpful.  Sometimes, the use of AlloGraft helps place an extra layer of coverage between the skin and the implants.

Visit with well experienced board certified plastic surgeons who can show you their work in regards to revisionary breast surgery.

There are better solutions.  It would be very expensive to get a sufficient volume of juvederm to camouflage rippling after breast implants.  There are many strategies than an experienced plastic surgeon can employ to help you.  If you have saline implants, switching to gel implants will help..  Sometimes the pocket needs to be adjusted.  Sometimes camouflage in the form of acellular dermal matrix or fat grafting can help.

Juvederm would not be good to camouflage rippling. Some surgeons would recommend a different pocket location, silicone implants, strattice, or even fat grafting.

Juvederm is not effective in reducing rippling after augmentation.  If you have saline implants, you may want to exchange them for silicone.  If you have silicone already and they are above the pectoral muscle, you may consider having your surgeon replace them under the muscle. 

The injection of juvaderm would not be cost effective as the amount you would likely need would be extremely expensive and would have to be repeated time and again. If your implants are saline consider changing them to silicone gel which ripple much less. Hope this helps!