What to do about breast rippling? (photos)

Question

I’ve had my breast augmentation in August 19. A little over a year of my op I noticed visible rippling in my breast. I have not lost any weight since my op. I have seen my surgeon twice now and have been recommended to put on weight. After explaining I can’t put on weight as I’ve tried for many years it’s been left to no answers of what to do next. I am very insecure about wear tops that you can notice my breast. I’m so unhappy. What should I do?

Donald R. Revis Jr, MD · Answer

Good evening,
You have rippling in the very worst location, and telling you to gain weight is a ridiculous recommendation. You have several options- if you are over the muscle then simply switching to under the muscle will do the trick. If you are already under the muscle, then the addition of Strattice mesh can thicken your natural tissues and reduce or eliminate rippling in this area. As a final step, not sure what implants you have, but in this location silicone tends to ripple more than saline, because of the lower internal pressures in the silicone implants. You could switch to a more highly cohesive silicone gel or an overfilled saline implant, both of which tend to ripple less than standard silicone gel implants.

Mathew C. Mosher, MD · Answer

Your implant rippling is in a very frustrating location for you. There are no easy solutions but there are options to consider and would require a consultation. All breast implants have the potential for visible rippling but the risk can be minimized with better (thicker) tissue coverage and with implant selection. The most common solution would involve repositioning your implants to below chest muscle. Less effective solutions for your thin tissues would involve the of cadaveric dermal and fat grafting. Gaining weight is not a practical option that will result in any meaningful improvement.

Richard Baxter, MD · Answer

Rippling is usually a combination of features of the implant and the degree of tissue coverage. If your implants aren't under muscle, then moving them under will help. Fat grafting sometimes helps but isn't usually a definitive solution. Exchanging to an implant with a more cohesive gel often helps. If mesh such as Gala or ADM like Strattice are available, they can be extremely useful in this situation.

Daniel Barrett, MD · Answer

Dear Trustworthy9324,
Saline implants tend to ripple more than silicone implants in general. Rippling can result due to many factors including thin skin, poor implant position etc. Sometimes, you can over fill the saline implant to help a bit, but this may not feel as natural. Another option is fat transfer. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will et more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Kenneth Hughes, MD · Answer

Visible rippling can be improved by placing the implant under the muscle, switching to silicone, fat grafting to the breast, or the addition of a dermal matrix. Consult with another plastic surgeon for a second opinion.

Connie Hiers, MD, FACS · Answer

If you have saline implants, then change to gel. If your implants are in front of the muscles, which they appear to be, then have them placed behind the muscle for better coverage and more upper breast fullness.  If your implants are gel and are placed behind the muscle, then Alloderm can be helpful.

Garrett A. Wirth, MD, MS, FACS · Answer

As surgeons, we all feel a bit differently about which type of implants show less rippling over time.  Please discuss with a Board Certified Plastic Surgeon about a different type of implant, possible fat grafting (which will usually be done in stages) or possibly a product called Renuva.

Frederic H. Corbin, MD (license restricted) · Answer

Sorry for your problem but more information is needed such as type of implant as more rippling would be seen submammary to sub muscular and with saline implants as opposed to more cursive gel

Dr Corbin

Richard P. Rand, MD, FACS (retired) · Answer

It is generally true that if you are too thin wrinkles and ripples will be visible with implants. However we don’t have enough information to advise you. If your implants are saline these are certainly more wrinkly and if they’re above the muscle they are more wrinkly as well. You definitely need below the muscle implants and a more highly cohesive type of gel to at least get the wrinkles and ripples down to their minimum.

What to do about breast rippling? (photos)

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