Why did this happen? (Photo)

Hi I had a breast enlargement when I was 20 years old I am now 25 and in the last year I have noticed a rippling effect in both breasts. Should I be worried? Is this normal? How is it corrected? I do have to say that my breasts have shrunk almost 30% of what they previously were, I put that down to them eventually settling and the swelling reducing, however I am now wondering if I should have went bigger and if I do go bigger will this happen again?

Doctor Answers 11

Why did this happen?

Thank you for the question and the pictures.   You are seeing the rippling in your implants, it is not an unusual occurrence in women who are thin and just don't have a lot of natural padding.   If you are considering another surgery I think gel implants would be a better option for you.    Good luck.

Virginia Beach Plastic Surgeon
4.9 out of 5 stars 54 reviews


Rippling is a common side effect for Saline filled implants. It has a tendency to show more in thinner patients. The only way to not have this is to have them changed to silicone.

Lawrence Bundrick, MD
Huntsville Plastic Surgeon
5.0 out of 5 stars 7 reviews

Breast Implant Rippling

Dear Marielou, Thank you for posting your photos with your questions. It appears that you are thin and have rippling of your breast implants on the outer portion of the breasts where their is no pectorals muscle coverage. This most often occurs with saline filled implants in thin women. You can exchange the saline filled implants for higher filled silicone gel implants. I recommend that you have a consultation with an experienced Board Certified Plastic Surgeon who can examine you and determine your best surgical option. During your consultation, you can discuss increasing the size of your implants; However, the larger the implant, the less the tissue coverage. Best wishes, Dr. Richard Swift

Richard Wellington Swift, MD
New York Plastic Surgeon
5.0 out of 5 stars 24 reviews


You have rippling which is more common in very thin patients. Sometimes fat grafting or placement of an adm can soften its appearance.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Redo breasts augmentation

Dear Marie,
 Thanks for submitting your pictures, though , a front picture would have been very helpful.
  From your pictures, it appears that you have rippling of the skin. That condition can occur with saline implants or silicone implants alike.
  This is due to the thinness of the skin laterally. Most likely, the lateral pocket was , either dissected excessively laterally by your surgeon or the weight of the implants dissected the pocket to under the arm pit.(my patient wear bra at bed time for 1 month after surgery, so that the capsule strengthens and supports the implants in the right place).
  The solution for that problem is  as follows:
  1. Medial capsulotomy ( scar release , if needed) to get nicer cleavage, by allowing the implants to move medially .
  2. Lateral capsulorrhaphy (internal bra ) which will give more support to the implants and tighten the skin internally.
  3. Slight increase in implants size in order to tighten the skin.
  Always, consult with experienced board certified plastic surgeons who do lots of redo breasts augmentation in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent and attractive with natural look.
                     Best of luck,
                                         Dr Widder

Shlomo Widder, MD
McLean Plastic Surgeon
4.8 out of 5 stars 127 reviews


The ripplings in the saline implants I assume you had placed five years ago have been there but the overlying breast tissue was thicker and hid them. As you noted, your breasts are smaller. Since the implants did not change ,it is most likely that the amount of breast tissue decreased and thinned making the rippling more visible.

John S. Alspaugh, MD, FACS
Virginia Beach Plastic Surgeon
4.7 out of 5 stars 21 reviews

Rippling is nothing to worry about.

To give a more complete answer it would help to know if you have saline or silicone implants.  Saline implants have a increase incident of rippling due to what they are filled with.  The rippling does not mean anything is wrong, it just means there not much tissue coverage over the implants so you can see the rippling.  Going larger will not correct this.  Changing to a highly cohesive gel implant may be of benefit to reducing the rippling and the visibility.  Inserting a acellular dermal matrix such as Strata or fat grafting would not be something I would recommend due to cost and unpredictable results.  Ask your plastic surgeon about these options.

Jeffrey M. Darrow, MD
Boston Plastic Surgeon
5.0 out of 5 stars 102 reviews

Why did this happen?

Thank you for your question and photographs.  A bit more information is needed to make the best recommendation but it appears that you had saline implants placed when you were 20 years old.  Over time saline implants have a greater tendency towards ripples and wrinkles than silicone implants.  Depending on the amount of original breast tissue you had the loss of thirty pounds as reduced the amount of skin that previously sat over the implant covering it from any evidence of ripples.  Lastly if your implants were placed above your chest muscle this too would lead to an increase in wrinkling.  I would see a board certified plastic surgeon in consultation for the best treatment options.  I would recommend exchanging your implants for a higher fill silicone - Sientra or Inspira - and placement underneath your muscle.  Hope this helps

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 69 reviews


Saline implants in thin people may show rippling. Upgrading to high fill gels will reduce this, in some cases a mesh such as strattice or seri may be indicated. Also if your implants are above or below the muscle- the side area can be difficult to cover with muscle.

An exam and consultation with a plastic surgeon is recommended to discuss your options and expectations. 

Harry T. Haramis, MD, FACS
Montclair Plastic Surgeon
3.7 out of 5 stars 19 reviews

Breast rippling

If you have saline implants, then the implant  is responsible for most of the rippling and you could trade for silicone. If they are silicone this is very unusual amount of rippling to see. This would only happen is you have very thin tissues covering the implant showing every little wave. Larger implants would not help that.You need to discuss with your surgeon. Fat grafting over the visible areas would be one good solution. Good luck.

Scott W. Vann, MD, FACS
Savannah Plastic Surgeon
5.0 out of 5 stars 4 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.