Is It Normal for Silicone Implants to Ripple? (photo)

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

Sorry for the "rippling" of the silicone implants as demonstrated in your photo posted. Two issues are present, the inherent risk in the implant to "ripple" as described in the manufacturer's literature. And the implant placement above the muscle. So I bet you can see where I'm going! The ways to correct are either live with this, change pocket location to below muscle, or try fat grafting along the rill pled areas - risky for rupture or puncture. Hope that helps. Great question Follow up would be nice. 

Thank you for the question  and pictures.

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 accentuate any rippling/palpability  of the implants.  Deflation of   saline implants will also increase the rippling/palpability of the implants.

In your case, it is very likely that revisionary surgery may be helpful to you. This operation may involve replacing the breast implants into the sub muscular (dual plane) position and/or the use of allograft  material (if necessary). Of course, precise advice will necessitate direct examination and a full communication of your goals.

Best wishes.