What is going on - rippling and displacement? (Photo)

I have severe rippling in the cleavage and also sides of breast. Also my nipple points to the right. What is going on? 32a before augmentation 325cc silicone unders textured

Doctor Answers 8

Rippling of implants

it's not clear from your post how long ago your surgery was performed. Rippling and wrinkling can occur even with silicone implants although this is rare in comparison to saline. There may be remedies for this but you would have to discuss them with your board certified plastic surgeon.


Perth Plastic Surgeon
4.0 out of 5 stars 23 reviews

Rippling of implants

We will sometimes see rippling even in silicone gel implants along the cleavage area and laterally when bending over. The more overlying breast tissue there is, the less we see rippling. If it bothers you, sometimes fat grafting or placing a barrier like Strattice between the skin and implant can help. As far as the location of the nipple, without a preoperative photograph to compare to, it's hard to say. Usually, what I see, is in an attempt to create a narrow cleavage in a breast that sits on a wide breastbone, the breast implant now rather than being centered on the nipple is too far to the inside with the nipple looking like it's pointing outward. Discuss these options with your plastic surgeon.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 44 reviews

Rippling and nipple asymmetry

Mary,

Thanks for your question and for the photo.  Sorry you are having issues with your breast augmentation.

It is not uncommon for women with thin skin or saline implants to experience rippling at the medial lower cleavage, inferiorly and at the lateral borders of their breasts.  This can be addressed with revision silicone augmentation and/or addition of an ADM to pad the area.  Your issues with the nipple position are a combination of:

1.  The implants placed close to the midline which gives you better cleavage
2.  The probable lateral inclination of your nipples pre op (would be able to confirm this with pre-op photos)

Breast augmentation augments both the good qualitites of your breasts and enhances the bad qualities as well (asymmetries in size and shape).   

Douglas Taranow, DO, FACOS
New York Plastic Surgeon
4.8 out of 5 stars 52 reviews

Rippling

Rippling can occur along the lower  pole in patients that have a thin skin coverage.  Sometimes an ADM of fat grafting is necessary to camouflage this.  As for the nipple position, implants only exaggerate the differences between the two breasts.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Rippling

In thin patients, rippling may be more visible. Switching to smooth round or higher fill implants with biological mesh or fat grafting may be a consideration.

Close follow up with your plastic surgeon is recommended to discuss your options and expectations.

Rippling

If you started with an A cup, the issue could be that you do not have enough breast tissue to mask the underlying implant. This is the area where the muscle is not covering the implant, and therefore, the implant is more exposed. Potential solutions include fat grafting, and placement of certain mesh sheets to help manage this rippling. Ultimately, you need to visit your plastic surgeon to get and examined for the best advice possible.
Best of luck!
Dr. Subbio
Board-Certified Plastic Surgeon
Newtown Square/Philadelphia, PA

Christian Subbio, MD
Philadelphia Plastic Surgeon
5.0 out of 5 stars 52 reviews

Breast Implant revision to correct position and rippling

Thanks for your question about breast implant revision.

I am sorry to hear that you have concerns about your result.  From your photo it appears that the issue is related to the thickness of your breast tissue over the implant.  More detailed photographs and a detailed exam are important to review what may be the best way to address your concern.  In many cases the implant pocket can be modified to control the position of the implant on your chest and improve symmetry.  In my practice I have patients that are referred to me for corrective surgery and many times the addition of a mesh for tissue support like Galaflex is helpful for implant position control, in other cases the problem can be addressed with fat grafting to improve the coverage over the implant.  I suggest you visit with your board certified surgeon to discuss your concern.

Best Wishes

Steven Camp MD
#HappyCamperMD

Steven M. Camp, MD
Fort Worth Plastic Surgeon
4.9 out of 5 stars 87 reviews

What is going on - rippling and displacement?

I am sorry to hear about your concerns after breast surgery. Although I cannot provide you with specific advice, some general thoughts may be helpful to you. You may also find the attached link, dedicated to revisionary breast surgery concerns, helpful to you as you learn more.

Palpability and rippling of breast implants may be related to several factors. These include the amount of soft tissue and breast tissue coverage over the breast implants, the position of the breast implants (submuscular versus sub glandular), the type of implants (saline versus silicone), and the degree of overfilling of saline filled implants. Generally, weight loss will extension weight any rippling/palpability of the implants. Deflation of a saline implant will also increase the rippling/palpability of the implant.

Correction of the rippling may involve further surgery including implant pocket exchange if possible (sub glandular to submuscular), implant exchange if possible (saline to silicone), and/or the use of allograft to provide an additional layer of tissue between the implant and the patient's skin.

In-person follow up with your plastic surgeon will be your next best step. Best wishes.

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.