Side breast bulge and ripples - Should I be concerned?

Dear Brnsuga,

Thank you for reaching out—your concern is valid, and you're not alone in what you're experiencing.

What You’re Noticing:
The bulge along the side of your right breast and rippling at the top of the left breast are most likely due to implant folding or wrinkling, commonly referred to as rippling. This is more common in thinner patients or in areas with less tissue coverage—especially laterally. Though less common with silicone implants, it’s not unusual and often considered within the range of normal variation.

Why It Happens:
Rippling occurs when the implant's edges or folds become visible or palpable due to thin overlying tissues. It can be more noticeable over time, especially with tissue changes or aging.

My Professional Insight:
Lateral rippling is not uncommon and doesn't necessarily indicate a problem with the implant itself. There are no universally accepted techniques proven to eliminate rippling long-term. Some emerging strategies like fat grafting or acellular dermal matrix (ADM) reinforcement may help, but these lack robust long-term data. Revision purely for rippling should be weighed carefully.

Potential Solutions
FAT GRAFTING
Transferring fat from another part of your body can add volume and camouflage implant rippling. This method can improve contour and feel, but multiple treatments may be needed, and results vary.
ACELLULAR DERMAL MATRIX (ADM)
These biologic materials add structure and thickness over the implant, especially in revision cases. While they can reduce rippling, they are more commonly used in reconstructive surgery and may not be ideal for every patient.
IMPLANT REVISION
Options include:
Switching to a higher-fill silicone implant to reduce folding.
Changing implant placement (e.g., under the muscle for better coverage).
Using a different implant type or size to improve breast balance.
However, these options involve surgical risks and should be considered only if rippling is significantly affecting quality of life.

Moving forward, I recommend seeking consultations with board-certified plastic surgeons who have experience in revision breast surgery. A tailored, in-person assessment will give you a clearer picture of what’s possible for your body and goals. While complete correction may not always be attainable, thoughtful surgical planning can often offer meaningful improvement—and you're already on the right path by advocating for yourself.

All the best,
Earl Stephenson, Jr., MD, DDS, MBA
ESJ Aesthetics

Dear brnsuga,

I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

You did not post photos, but you may be feeling more of the implant with thinner tissue covering it. If you have ripples on the top of the breasts, you are very thin there and the implant should be placed behind the muscle for coverage.