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.
What Will Lessen The Chances of Rippling?
Doctor Answers 17
The surgical approach to minimizing Rippling
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 little breast tissue to camoflauge the breast implant. Fina a plastic surgeon with experience working with women who start with minimal breast tissue.
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.
Michael Law MD
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Member, American Society of Aesthetic Plastic Surgeons
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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.
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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.
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.
Dr. Peter Aldea
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.
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!
James F. Boynton, M.D., F.A.C.S.
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.