Will my Rippling Get Worse As my Breasts Settle?

Question

I had my breast augmentation just over a week ago and have noticed some rippling that is not visible but I can feel in the middle of my breasts, only on the left breast. As my breasts settle and drop will this become visible? Is there anything I can do to prevent this happening?

Aldo Guerra, MD · Answer

Thanks for your question. The rippling you are experiencing is likely from swelling unless you have breast implants placed above the muscle. As the swelling goes away, the rippling should be better if implants are under the muscle, but might increase if you have implants above the muscle. Best wishes, Dr. Aldo.

Larry S. Nichter, MD, MS, FACS · Answer

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 implantsLarge implantsThin patients with low BMIImplants placed above the musclePrior history of ripplingFactors which are less likely to have rippling include:Heavier and larger breasted womenUsing a highly cohesive form-stabile silicone implants (gummy bear)Smooth implantsSmaller implantsSubmuscular placementOnce 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.#rippling#breastaugmentation

Kenneth Hughes, MD · Answer

Many women can feel the ripples in the implant, even though there is no visible rippling. Visible rippling can be improved by placing the implant under the muscle, switching to silicone, fat grafting to the breast, or the addition of a dermal matrix.

Raffy Karamanoukian, MD, FACS · Answer

Breast implant rippling may occur from tight muscles, swelling, or thin skin overlying the breast implant. At this time, I would manage conservatively and reexamine in 1 to 2 months with your plastic surgeon. If you have saline breast implants, an option may be to switch over to silicone implants.

Matthew Schulman, MD · Answer

Early rippling may not necessarily be a sign that there will be rippling later on. You are only 1 week after surgery and need to heal more. After a few months, you will have a better idea of what your final result will be.

Stephen M. Lazarus, MD · Answer

Hi,

	Your concern is understandable, but try not to worry too much at this early  time. And no, there is nothing preventive for you to do.

	There will be noticeable positive changes over the next several months as the swelling decreases, the breasts soften, and the implants settle.

	Factors that can increase or decrease the chances of  feeling or seeing rippling include: Thickness of the breast and chest skin/fat layer (can change with weight fluctuations and pregnancies), placement of implant(over or under muscle), gel vs. saline, fill volume of saline implant, and a few others.

	Thanks for your question and best of luck!

Jeffrey Zwiren, MD · Answer

Rippling and palpable folds are an unfortunate consequence of breast augmentation surgery. The more soft tissue that you have covering the implant the less this is a problem. Saline implants in a woman who has a very thin soft tissue coverage is always a problem. Some times it can be improved by adding fluid to the implant. Some times as the capsule forms around the implant this can get better. Since you are only 1 week post op you obviously need to give it more time. Once you get out to 3 - 4 months it would be a good time to re-evaluate your result and see if adding fluid would help or possibly switch out to a submuscular gel filled implant. Fortunately your rippling is not visible so you may be happy with the improvement in size and shape of your breasts.

Norman Bakshandeh Day, MD, FACS · Answer

rippling is an unfortunate byproduct of the implant. The greater the padding or soft tissue coverage ove the implant the less you will feel this

Peter J. Simon, MD · Answer

If you had saline implants, I'd like to know your fill volume and implant size.  I always try to pick an implant that I can fill to its maximum, as this helps avoid rippling.  Hope this helps.

Tom J. Pousti, MD · Answer

Congratulations on having undergone the press patient procedure.

	No, early rippling after breast augmentation does not necessarily mean that this will become more visible as time goes on and, unfortunately, there is nothing that you can do to prevent any rippling/palpability issues that will arise in the future ( possibly with the exception of gaining weight).

	Your plastic surgeon, of course will be in the best position to advise you more specifically.

	 Best wishes;  hopefully you will be very pleased with the outcome of your surgery in the long-term.

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