Is This More Than Rippling? Cohesive Gel Breast Implants...

6 years ago in Medellin CO. In the last 2-3 years I've noticed rippling. Today I have felt something that I dont know I could categorize as rippling. My left implant is too rippled at the bottom-not smooth as the other. I dont feel pain, just discomfort in feeling this abnormality. So my question is, is this the expected rippling because it's been 6 + years or something more severe? I plan to replace in the U.S. (Carolinas).

Doctor Answers 9

Rippling Becomes Apparent with Tissue Thinning

   Rippling does tend to become apparent with tissue thinning and occurs with time following implant placement. Changing implants may be reasonable.  Adding a dermal matrix or fat grafting may help as well.

Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Rippling in breast implants

Rippling and wrinkling happen when the skin and breast tissue over an implant become thin enough that you can see and feel the implant.  You may need implant repositioning (from above to below muscle, if they're not already below the muscle) or you may need ADM (acellular dermal matrix, like Surgimend) or fat grafting for increased coverage over your implants. Be sure to see a board-certified plastic surgeon who does a lot of implant revision surgeries.

Carmen Kavali, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 43 reviews

Rippling with Cohesive Gel Implants

Hi! Thank you for your question.

I am Dr. Speron, a proud member of both the American Society of Plastic Surgeons (ASPS) and the American Society of Aesthetic Plastic Surgeons (ASAPS).  I am also certified with the American Board of Plastic Surgery.

Rippling of breast implants is when you see folds or wrinkles of the breast implant through the skin. They are usually seen on the bottom or sides but sometimes in the middle, near the cleavage as well.

There can be several causes to the ripples that you can see in the breast, but surprising, not all are related to breast implants. There are some ripples or wrinkles of the breast that we call “Traction Rippling” and this can be seen with any type of implant and even in breasts that do not have implants. Other causes are from the implant itself. Breast Implants are silicone rubber sacs filled with fluid or gel. And like any baggy filled with fluid, there is a chance that it can ripple or wrinkle as the fluid causes folds to appear.

Fluid can be added to saline implants, or capsules can be adjusted to hold the implant just a bit tighter, so with fewer wrinkles. Changing Breast Implant size and shape can sometimes help as well.I suggest that you consult with your Plastic Surgeon.

I have provided a direct link below for additional information as well as a lot of before and after pictures.If you have any further questions, please feel free to call us at 847.696.9900 for a private consultation.

Best of luck and have a great day!

Dr. Speron

Sam Speron, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 1 review


 Breast Implant Rippling most often occurs when there is insufficient soft tissue coverage due to little overlying body fat and breast tissue. Implants placed beneath the muscle help to minimize this phenomena but the lower and outside breast (as pectoralis muscle is no longer present), towards the cleavage where the muscle thins out or on top of the breast where breast tissue is often lacking are the most common places to see rippling. It is often accentuated with certain positions (e.g. bending over,or leaning). Most of the time, rippling is felt along the outer side of the breast and the inner side of the breast next to the cleavage. Breast implant waviness (rippling) that is felt but not noticeable to the eye is very common and should not be a concern. However, when rippling is visible, patients are often self-conscious about their appearance.
Factors that are associated with increased rippling include:
  • Traditional Saline implants (IDEAL® Saline implants less likely)
  • Textured implants
  • Large implants
  • Thin patients with low BMI
  • Implants placed above the muscle
  • Prior history of rippling
Factors which are less likely to have rippling include:
  • Heavier and larger breasted women
  • Using a highly cohesive form-stabile silicone implants (gummy bear)
  • Smooth implants
  • Smaller implants
  • Submuscular placement
Once rippling occurs it is very difficult to correct. Rippling can be minimized by placing a biologic fabrics (e.g. AlloDerm®, Strattice™, SERI®), submuscular conversion if implants are above the muscle, fat transfer, use of adjacent tissue (muscle or fascia) if available, and in persistent cases implant removal and fat transfer. Seek the care of the best board certified plastic surgeon possible with experience in breast revision surgery.


Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews


Like everyone else, I will tell you I can't answer your question without examining you, but I would ask you a question. Have you experienced significant weight loss? If you did not have rippling before, but you do now, then one has to wonder why, and the most common answer is weight loss. If you have not lost weight, then it may not be common rippling.

Gregory Sexton, MD
Columbia Plastic Surgeon
4.9 out of 5 stars 73 reviews

Rippling in cohesive gel implants

Rippling occurs with folds in the implant seen through a thin skin envelope. It is best to be exained in person to evaluate this properly.

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

Rippling with silicone implants

Over time, implants can ripple and even fold in some areas.  A fold feels more "pointy" than a ripple, but can be easily pressed in.  If implants fold, their shells become weak in that area and have a higher chance of leaking.  A good physical examination by an experienced plastic surgeon should be able to give you a diagnosis without having to resort to x-rays or ultrasound evaluations.  Hope this helps.

Victor Ferrari, MD, FACS
Charlotte Plastic Surgeon
5.0 out of 5 stars 36 reviews

Rippling of Cohesive Gel Implants

This may be due to capsular contraction or even rupture of the implant. An exam and radiographic studies will help to show what is going on. Last resort is surgery and implant exchange would be appropriate. Best of Luck   Dr Harrell

Jon F. Harrell, DO, FACS
Miami Plastic Surgeon
4.9 out of 5 stars 49 reviews

Is This More Than Rippling?

Ripples, folds in the implant, are diagnoses by palpation, unless they are also visible. They are quite common. Without the benefit of an exam, I hesitate to comment. An experienced surgeon can answer this at the time of an in person exam.

Thanks, best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 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.