Does Saline Implants Cause Rippling in Women with Little Breast Tissue? (photo)

I am 31 yr old mother of 3 wanting to go from 34A cup to 34 full B cup, borderline barley C. I was told by my PS due to my measurements that I should use silicone to avoid rippling. He also decided on 275cc no more than 300cc high profile. I almost feel this would be too big and that is my biggest worry. I am athletic and want to remain that way. I also feel saline would be safer just due to the fact u know when it ruptures. So saline? or silicone? Or does it not really matter?

Doctor Answers 22

Do Saline Implants Cause More Rippling that Silicone

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I would agree with your plastic surgeon. The saline implant does in fact cause more rippling than the silicone implant. We have numerous patients that insisted on the saline implant because of concerns about leakage with the silicone and many of them have returned to have the salines removed and replaced with silicone. I would suggest the following:

  • The Sientra High Cohesive Gel implant is now available.  If a rupture does occur they would be minimal extrusion of the gel.  
  • There would be minimal to no rippling with this implant
  • Hard to tell from your photos but if you are an athlete I would tend to go with a 275cc implant that would give you a C- cup.   Implant size is also determined by you height and weight.

The link below might be helpful. 

Eau Claire Plastic Surgeon
4.7 out of 5 stars 22 reviews

Saline breast augmentation - TUBA

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Dear Kate,
Thank you for your question and posting the pictures. You actually are nearly an ideal candidate for saline implants. You have some breast tissue and do not like to be very large.  The balance of your own breast tissue with smaller saline implants will minimize rippling. If you're looking to be a B cup you would likely benefit from a moderate profile smooth saline implants in the 250 mL range. Additionally, small size difference between breasts is better managed with saline implants with adding more volume to the right side as compared to the left ending with a much more even postoperative results.  You should look at the TUBA procedure which removes any visible scar with placing the implants under the muscle.  Breast of luck. 

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
4.7 out of 5 stars 112 reviews

Go With Saline If You Prefer, and Try on Breast Implant Sizers

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It's true that you can generally detect ruptures faster with saline. If this is a priority for you, then you should go with your gut and stick with saline. However, you should know that saline does tend to ripple more, although this can be minimized by placing it in the submuscular position and filling it close to its maximum capacity.  To test for size, bring a bra in your preferred size to your next consultation and try on implant sizers (they should have them in your desired volumes). This will give you a better idea of how your body will look after surgery. Then, if you think that the size your surgeon recommended is too big, you can always request something smaller. However, just a note: in my experience, rarely do patients regret having gone too big. They usually regret having gone too small!

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Implant choices

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Well I think you decided upon saline vs silicone and as for volume you can always do a baggy test to see what you like.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Saline vs Slicone Breast Implants

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As far as safety goes, I would choose the silicone implant. Both are extremely safe and reliable. However, with the new cohesive gel silicone implants, you are probably less likely to need revision surgery to replace a ruptured implant. This means that the risk of another surgery is reduced. The silicone is also somewhat less likely to ripple. As far as size goes, talk to your surgeon and use sizers to determine what to use.

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Saline or silicone

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With the size you are looking at both choices are fine and in my opinion have the same chance for wrinkles. When the implant  overloads the tissues then silicone a better choice to reduce wrinkles. You should pick what you prefer and sub muscular is better for long term stability. God Luck!

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 62 reviews

Rippling and breast implants - saline or silicone?

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Saline breast implants will ripple more than silicone, because they are not as viscous.  They both may do so with very thin patients, especially out at the sides, where the breast implants are not covered by much breast tissue.  In fact, in most breast augmentations the implants are a little wider than the breast and this is pretty common.  That is why smaller is better, and if you are thin your implants should be smaller.  This  is counter-intuitive, because a small breast is not going to fully cover any implants beyond 250cc, and most patients want to be bigger than that.

Gregory Diehl, MD, FACS
Long Island Plastic Surgeon

Rippling in thin women

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Ultimately, the choice of implant is up to you and should be based on what makes you comfortable.  Both saline and silicone implants can have rippling in thin women -- mainly because thin women have less body fat and breast tissue to camouflage the implant.  Placing the implant underneath the muscle can help in some patients.  However, both types of implants can also have a good aesthetic result.  I would suggest that you consult with a board certified plastic surgeon -- discuss your concerns regarding implant size and saline vs. silicone.  Good luck!

Anureet K. Bajaj, MD
Oklahoma City Plastic Surgeon
5.0 out of 5 stars 21 reviews

Rippling Less Likely With Silicone Implants

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You will be less likely to have visible rippling with silicone implants, especially considering your paucity of upper pole breast tissue.  Either way I would strongly suggest also that you have your implants placed under the muscle.

John Whitt, MD (retired)
Louisville Plastic Surgeon

Saline or Silicone Breast Implants

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Regarding rippling, Saline implants do ripple more but rippling is also possible with silicone implants to a lesser degree. If you are very thin with little breast tissue then the chances of rippling is higher. To have more coverage of the implant placement under the muscle or dual plane (partial under the muscle and partial under the breast gland) is advisable. The smaller size the implant the less visible it may be. Higher profile implants tend to ripple less. Silicone has been considered to be a safe option for augmentation and was approved to be used in 2006 by the FDA, but if you are still concerned want to be as worry free as possible and avoid the MRI studies and exchanging the implants at 10 years then go with the saline implants (they feel less natural and look less natural).


Good luck 

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.