Implant revision for bottoming out now have rippling and deformities. Is my only option removal?

You are very thin and have very little breast tissue.  Your implants are relatively large at 400 cc and they weigh almost 1 lb each.  After 2 failed attempts, it is time to come to the conclusion that implants may not be the best solution for you.  The alternative I recommend is explantation and lift using The Bellesoma Method.  The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained, if not injured during your previous surgery.  Later, fat transfers can be performed if additional volume is desired.  Best Wishes,Gary Horndeski, M.D.

Thank you for sharing your question and photographs.  It appears that your implants are above your muscle and the overall balance of your natural breast tissue to implant is low.  This is resulting in the increased visibility and palpability of your implant.  As a result the best option is to reposition the implant below your chest muscle and possibly add a skin substitute for greater tissue thickening.