Will Rippling Be Fixed with Larger Implants?

To help improve rippling we have many options, changing the implant to below the muscle, switching to a form stable textured device, fat grafting on top of the implant, as well as covering with a skin substitute

Silicone implants tend to ripple less than saline implants.  Textured implants tend to ripple more than smooth implants.  Implants above the muscle tend to ripple more than implants under the muscle.  Therefore, I would definitely go below the muscle with smooth silicone implants, and if the rippling is at the bottom of your breasts, then placement of an acellular dermal matrix (ADM) should eliminate the rippling. 

A larger implant unfortunately can lead to traction rippling, and therefore I think placement of a larger implant would not be a good idea. 

A larger implant will cause more risk for rippling. Procedures which can help rippling are moving the implant below the muscle, grafting a material inside the breast (dermal matrix), changing the implant to a "form stable" implant, and sometimes fat grafting.It would help to discuss and evaluate your options in person.

Going with a bigger implant is not the answer.  Most implant have rippling and it's just a matter of how much coverage you have to cover up the implant imperfections.  Going under the muscle makes things better (muscle is an extra layer on top of the implant thus making ripples less visible).  Using a smooth implant is better (because a textured implant sticks to the overlying tissues and is more likely to show rippling.  A fuller fill (whether saline or silicone) means less rippling.  For saline implants surgeons often overfill them to minimize rippling.  Now both Mentor and Allergan have silicone implants that are filled fuller than previous silicone implants thus minimizing rippling.  And finally, tear drop implants (anatomic/form stable implants) have the most cohesive type of silicone which maintains it's shape the best and thus ripples the least.  However, in my experience, tear drop implants are often 'too natural' for most breast augmentation patients as they lack upper pole fullness.  I no longer recommend these implants for cosmetic purposes.

Without examining you, as a general statement I'll say Mentor Cohesive II and Allergan Inspira True Form 2 silicone implants, placed under the muscle, are you best bet to fight rippling.

Martin Jugenburg, MD, FRCSC
Toronto Cosmetic Surgery Institute

Dealing with rippling can be a difficult issue.  Silicone gel implants (especially form stable if available) are a great first step in decreasing visible rippling.  Another option is placing the implant in a different pocket.  Often placing in a submuscular position will help due to muscle coverage.  If the rippling still occurs despite muscle coverage or occurs in an area where muscle coverage is not possible, acelluar dermal matrices (ADMs) are a very good option.  Several options of ADMs exist and some are very thick.  The downside is the expense of these materials.  Sometimes increasing the size of the implant can help with rippling.  But there is a significant drawback with going to larger implants.  The larger implant will stretch your tissues further and eventually thin them more.  This will lead to possible visible rippling again in the future as well as other problems such as ptosis (drooping) of the breasts. 

as you can see from the answers provided here.  Your best chance at diminishing rippling is using a form stable gel implant and if you want to minimize rippling in the upper pole, consider going under the muscle. Fat grafting can be considered to diminish or camouflage your rippling as an alternative.  Regardless, you should get a second opinion if your doctor is telling you to go bigger!

Unfortunaately a larger implant will produce even more thinning of the breast tissue and ripple even more. The least ripple is the gummy bear or form stable implant. You trade stiffness for smoothness but is something to consider.

I'm sorry to hear of your situation. Before you make another very costly and potentially unrepairable mistake you should have a better understanding of the interaction of breast implants with the breast.

First, here are a few implant FACTS:
- ALL breast implants RIPPLE
- Saline filled implants ripple MORE than Silicone filled implants
- Underfilled Saline implants ripple MORE than fully filled saline implants
- Textured surface implants implants ripple MORE than smooth surface implants (This makes textured saline implants (especially underfilled ones) the worst rippling implants out there)

- There is NO WAY to smooth implant ripples EXCEPT to cover them with as MUCH breast and muscle tissue as possible. The more breast tissue you have the better cover and less palpable and visible the ripples would be. If you do not have a lot of breast tissue, you should have silicone filled implants and they should be placed UNDER the muscle. Sometimes, we also need to place additional shetts of biological tissue such as Strattice (VERY expensive) both to support the implant and to add cover to hide the ripples.

Putting a breast implant (much less a larger one) OVER the muscle (where it will have LESS cover) in a woman who ALREADY has ripples makes NO SENSE in my opinion.

Please consider your next step very carefully.

Peter A Aldea, MD
Mem,phis, TN

All implants have rippling but more in saline implants.  Patients with thin skin and minimal breast tissue to cover the implants, have more noticeable rippling. I use far grafting to increase soft tissue coverage of the implants.  Going under muscle will help the upper pole rippling but not the side ripplings. 

Rippling may be treated by over filling a saline implant.  Placing them under the muscle especially in the upper pole may help. Also strattice may help.