What causes the issues like rippling and double double in fake implants?

Ripples are more noticeable in thin women with little breast tissue and saline implants. Gel implants have much less risk of ripples. Initially, I do recommend sleeping somewhat sitting up for the first week to minimize the discomfort when implants are placed behind the muscle. The hardness is related to what type of implant you choose, the size, and if a thick capsule forms around the implant.

Dear Hepburnn,
I understand your concern. It is best that you consult your plastic surgeon regarding post operative care and management (i.e including massage techniques and timing) specific to your case. Your surgeon knows your condition well and has preferences on when and what to use for faster healing and recovery. Post operative care and management depends on the type of surgery performed and the technique used during surgery among other factors.It is best, however, that you follow your plastic surgeon's advice on post operative care management for a smooth and faster healing and recovery.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery