What Will Lessen The Chances of Rippling?

I am 5'4", 140 lbs and currently a deflated, mildly sagging 34C. My base width is 14.5cm. I'm scheduled to get 469cc textured silicone implants (14.1cm) in a few days. My PS and I have decided on dual plane, inframammary. I am wondering if there is any way to determine the likelihood of rippling... especially since my weight tends to fluctuate within about 10 lbs (breasts usually don't fluc. a lot as far as I can tell). Should I go with less cc's/smaller diameter to reduce this chance? Thx.

Doctor Answers 17

Form stable Cohesive gel breast implants

Form stable cohesive gel breast implants are probably the least likely to cause rippling. Women most likely to have an issue with rippling are slender women with very lisle breast tissue to camoflauge the breast implant.

It is critical that these breast implants are placed appropriately. If they are placed too high, too low or too far apart, the result will not be ideal When the right size, shape and style of a breast implant is sleeted the result can be very beautiful and natural. I have attached a link to my before and after photo gallery


Raleigh-Durham Plastic Surgeon
5.0 out of 5 stars 92 reviews

PHOTO: Options for diminishing tendency for rippling.

You have adequate breast tissue to minimize the visibility of rippling. Dual plane will also diminish this tendency. Use of high profile implants are also associated with less tendency for rippling. The use of textured silicone implants in the USA is not as popular and once a fold or ripple develops with these implants, the texturing may make the rippling more prominent.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 69 reviews

Ripping

It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the below link.

#breastaugmentation
#findingtherightsize
#BA

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 99 reviews

Silicone gel breast implants under the muscleless likely to cause rippling

Thank you for your question. Generally speaking Saline breast implants placed beneath the breast gland in thin individuals with little breast tissue are more likely to cause rippling than are silicone gel breast implants placed beneath the muscle.

Rippling of Breast Implants

Thank you for the question and picture.

Generally speaking, 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  sailing implants will also increase the rippling/palpability of the implants.

I think you and your plastic surgeon have a good plan  with the dual plane silicone gel breast augmentation.

Best wishes.

Which Breast Implant and Placement would give me the LEAST Rippling?

Regarding: "What Will Lessen The Chances of Rippling?
I am 5'4", 140 lbs and currently a deflated, mildly sagging 34C. My base width is 14.5cm. I'm scheduled to get 469cc textured silicone implants (14.1cm) in a few days. My PS and I have decided on dual plane, inframammary. I am wondering if there is any way to determine the likelihood of rippling... especially since my weight tends to fluctuate within about 10 lbs (breasts usually don't fluc. a lot as far as I can tell). Should I go with less cc's/smaller diameter to reduce this chance? Thx
."

The best way to avoid implant rippling is to avoid breast implants completely. Since all breast implants ripple (saline more than silicone and textured and anatomical more than smooth), the worst rippling implant would be an over sized, textured shell saline implant placed under the gland while the least rippling or better, least conspicuous would be a properly sized smooth high profile silicone gel implant placed under the muscle.

In your case, I would go with a smooth Mentor high profile implant. I would pick a size which would be completely covered by your breast and muscle tissues even if doing so would require a small Breast Lift procedure.

Good Luck.

Dr. Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 90 reviews

Rippling with gel-filled breast implants

Silicone gel-filled breast implants are not inherently ripply feeling like saline-filled implants are and will not ripple because of over-filling or under-filling as they are pre-filled. Actual ripples in your situation would only be created because of the textured surface of the implant (which there is no need for) or from a problem with the capsule space that heals around the implant. The risk of capsule problems is minimized by the subpectoral positioning and by making sure the size of the implant fits behind the breast and the space created for it is adequate. Beyond that are only factors that can't be totally controlled such as seromas or capsule contracture. 

Skip the textured surface implant and use a round, smooth surface implant and make sure the width of it is about 3/4 to 1 cm less than the width of your breast upright with arms down. The forward projection determines the overall volume which makes your breast look about 1 - 2 cup sizes larger depending on the profile choice. 

Scott L. Replogle, MD
Boulder Plastic Surgeon
4.0 out of 5 stars 1 review

How to lessen the chance of rippling with silicone breast implants - smooth vs textured prosthesis

Although it is impossible to absolutely determine the likelihood of rippling, there are several factors that come in to play. One is the type of implant and the other is the placement and the amount of breast tissue that overlies the prosthesis. That being said, a submuscular or predominantly submuscular placement of a smooth silicone prosthesis, is least likely to result in either visible or palpable rippling. I no longer use textured implants since there is a higher incidence of folds and no true improvement on capsular contracture rates. In your case a slightly smaller implant would also be of some benefit, and because you do not show a great deal of glandular ptosis on your photo, then you do not really need a full biplanar augmentation, just a little inferior release which would maintain more complete coverage of the prosthesis.

Smooth Silicone Gel Implants and adequate tissue cover will minimize rippling

I agree that you have adequate breast tissue (tissue cover) to have a ver low likelyhood of visible rippling.  I agree with a dual-plane subpectoral approach in terms of the pocket created for the implant; however, I disagree with the use of textured silicone implants because i find that the "grow" into the capsular tissue and are more prone to "fold flaws" and creating visible or palpable rippling/wrinkles.  The truth is that almost all saline or silicone implants have "ripples" around their perimeter when they are placed, the difference is whether they can be seen or felt through the skin.  So I think the most important criteria is adequate tissue cover and I think you have that, even though personally I would have selected smooth instead of textured implants.

I hope this helps!
 

Sincerely,

James F. Boynton, M.D., F.A.C.S.

Which Implants?

My suggestion for most patients is a smooth, round, moderate profile silicone breast implant placed under the muscle.  However, every patient is different and the surgeon needs to modify their technique for each patient to achieve the best results.  Good luck.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 70 reviews

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.