Is It Normal to Have a Ripple Effect in One Breast After Replacement.? I Am 53 Years Old.

Is It Normal to Have a Ripple Effect in One Breast After Replacement.? I Am 53 Years Old.

Doctor Answers 9


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.


Rippling with breast implants

Thank you for your question. Rippling can be seen when the surface of an implant shadows through the tissue, often found where the breast tissue coverage is thin. It can happen in one or both breasts. Some implant styles are more prone such as an overfilled saline implant. Others are less prone such as a shaped silicone implant. So one approach is to change an implant to one that is less prone to rippling. Another approach would be to add some thickness to the breast tissue. This can be done by fat grafting where fat is carefully layered between the skin and the implant. Another is to add a dermal matrix sheet between the breast and the implant where the rippling is visible to blunt the impression of the implant on the overlying skin. If you notice the rippling soon after surgery, I often recommend waiting until around the six month mark as your breasts may continue to change during that recovery period. I would visit with a board certified plastic surgeon to discuss your options in more detail.

Ripple post aug

This depends oin the type of implant and can occur more with saline versus silicone.also alot depends on the amount of breats tissue you still have present.the more breast tissue you have the less likely this will occur.

Robert Brueck, MD
Fort Myers Plastic Surgeon
5.0 out of 5 stars 54 reviews

Rippling after breast revision.

Implants always ripple, the question is whether or not you can see it through the breast tissue. If the breast is small, or the tissues are thin, the rippling of the implant shell can be easily seen. Correction often involves placement of the implant underneath the muscle. When the implant ripples in the lower pole of the breast, options are more limited, but can involve the use of a dermal matrix (Strattice) or fat grafting to try and increase the thickness of the soft tissue to help camouflage the implant.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 19 reviews

Breast implant rippling after replacement

Breast implant rippling after implant replacement is most commonly  caused by:

  1. Thin, soft tissues over the implant.  Often, replacement is due to capsulectomy, and the tissue removed with the capsulectomy may be significantly thinned reducing the amount of  breast overlying the implant.
  2. Saline implants in the sub glandular position
  3. Implants that are too large for the breast base width

Less commonly, rippling may be caused by

  1. Relative under inflation on the implant, i.e. the implant is much softer than the surrounding tissues and folds in the implant shell are palpable.
  2. Over - inflation of the implants with hard "scalloping" at the edges, which may be felt on the sides

The actual source of the rippling would have to be determined on a case by case basis.

Mario Diana, MD
Plano Plastic Surgeon
4.6 out of 5 stars 27 reviews

Ripple after breast implant replacement

The degree of ripple or show through from any breast implant will depend on the location of the pocket, under or over the muscle, and the amount of breast tissue covering the implant. We have learned that patients can detect a ripple with silicone implants as well as saline, and larger implants also can be more ripple prone. A ripple can be 'normal' for some.

Best of luck, peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.1 out of 5 stars 39 reviews

Ripple after Breast Augmentation?

Thank you for the question.

Unfortunately, there is no way of knowing in your specific case why the rippling is present.

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 the implants 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. Patient weight gain (if possible) may also be helpful.

I hope this helps. 

Rippling on one implant

Patients will experience ripples (fold of implants) if they have thin tissue overlying the implants.  Ripples are more palpable in thin breasts and subglandualr implant placement.  For patients who have implant revision surgery (and/or capsulectomy), they tend to feel more ripples as well.  If you have less breast tissue on more side vs. the other, you may feel more ripples on one breast.

Ripples after implant replacement

If your tissues are thin and especially if you have saline implants or are above the muscles, it is not uncommon to have ripples.  Sometimes they are only on one side especially if that is the thinner side.

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.