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

Although gel tends to ripple less than saline it can still occur.  They key to natural implants is to put them as deep in the body as possible.  The only solution for your problem is fat grafting or converting to submuscular placement or both.

Both saline and silicone gel implants can ripple

It is less common for silicone gel implants to ripple

The factors thet increase rippling with gel implants include:

Surface texturing

High profile

low profile

Thin overlying tissues

So the teratment will depend on the above

The implants may need to be changed .If the tissues are thin they can be thickened with fat injections beneath the skin  or the addition of mesh to the capsule

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. 

Rippling occurs because the tissues are very thin. An implant under the muscle will have better coerage superiorly but still may develop ripping. Sometimes strattice or even fat injections can help minimze this.