Should I Still Have Pain and Rippling After 3 Years?

Judging from your comments. I am getting the impression that you are not happy with your decision. A completely normal feeling breast may not be a realistic expectation in your condition. Discuss your goals with your surgeon. Implant removal and replacement with smaller implant or fat grafting may be a better option for you.

Rippling is an inherent property of implants. An implant may look very good when lying flat on a table. However, when upright the upper portion of the implant collapses (wrinkles or ripples) as the implant contents fall to the bottom of the implant & can't support the upper part of the implant. If this is placed on top of the muscle in a thin individual with small breasts the collapsed upper part of the implant can be very unsightly. The collapsed edges appear as rippling when viewed from outside the body. The rippling becomes more apparent after the postoperative swelling resolves & the pocket around the implant shrinks to meet the dimensions of the implant.
When placed submuscularly the rippling is more apparent to the side of the chest wall, where there is no muscle, & when leaning forward because this positions the implant closer to the surface. The greater the ratio of breast tissue to implant volume the better the end result and the less likely rippling will be visible.

It sounds like you may need to go smaller with respect to implant size, move the implants from above to below the muscle and possibly use acellular dermis grafts to cover the rippling. There is now way to know if capsulectomy with implant replacement under the muscle will relieve the pain until after it is performed.

Permanent sensation change is a risk after breast surgery. Temporary sensation changes are common, but usually improve by one year. It is normal to feel your implant. Patients who are thinner will feel the device more. Rippling is a function of surrounding tissue thinness. Larger implants can exert pressure on surrounding tissues and cause thinning over time. Capsular contractures (scar tissue) can squeeze an implant and make it feel firm. In more moderate or severe cases, it can distort a natural breast contour and cause pain. I would see your plastic surgeon and express your concerns so that you can be reassured or provided with a treatment plan to improve your situation.

I am not sure what you want done.  I understand that you have sensory changes and that probably will not get better with further surgery.  Feeling the implant is usually possible in thin patients and sometimes can be corrected in the upper pole by placing it under the muscle.

Rippling is always a possibility after breast augmentation.  The risk is higher if a large implant is used, or the implant surface is textured.

Regarding the pain, I am not sure of the cause without an examination. Sometimes there is no cause and removal of the implant or going to a smaller size may or may not improve the pain.

Regarding: "Should I Still Have Pain and Rippling After 3 Years?
I had sillicone implants 3 years ago and still have problems with the bigger implant .I went back to my ps to check everything ok they just said it will heal,still 3 years on i have no feeling in one,pain underneath bras make it ache and dont know what to do ,i also can feel the whole implant all the way round ,and sometimes its rippling please give me some advice thanks."

Truly sorry to hear of your predicament which unfortunately is common. While it is NOT common to have pain 3 years after breast augmentation feeling the implant and rippling along the bottom and the side can be common.

Every woman considering breast augmentation should know that ALL full, intact breast implant ripple. Saline implants are heavier and ripple more than gel implants, but all breast implants ripple. As a result,
1. Attractive, "natural" breast augmentation can ONLY be achieved when the implants are covered with as much soft tissue as possible to mask and cover the rippled implant shell. This means that while large implants COULD physically be placed in many women, if those women do not possess the amount of breast and muscle tissues required to cover the implants, the "exposed" implant areas will be palpable and visible (as in your case). In some cases, they will be painful due to the pressure by the implant on a thin overlying skin against the bra margin.

2. In effect, the size of a woman's breast before augmentation largely limits the size of the implants that can be used and still achieve attractive, nearly ripple free augmentations. So, while the flat chested A to a DD augmentation may be physically possible, it is far from advisable. Just read the repeated "I did not know" questions on this web site.

If you want to keep your implants, you MAY benefit from fat grafting or placement of a Strattice ADM sheet along the sides to thicken the soft tissue coverage over the implants. Another alternative MAY be to go smaller and perform a breast lift, if needed.

Good Luck.

Dr. Peter Aldea