Silicone implants placed in dual plane, rippling baldy for 4 years. Advice? (photos)

Question

Hi, My surgeon went with the dual plan technique. Reference implants is IMP-HR-390. I went to see a new surgeon to see what he could propose me to correct all the rippling and also the fact that the breast is really low on my bust. The surgeon wanted me to have an RMI to see where the muscle was. So it turns out my muscle in juste above the implants, does not cover them even a little. Then I went for an echo and they said my muscle in not atrophied or retracted. I'd like some advice please thank

James H. Rogers, MD · Answer

Implant rippling can be a difficult prolem to correct or improve. Patients a highest risk are those with little breast tissue and body fat. Reoperative surgery is necessary, with attention to restoring pectoralis coverage over the implant. The IMP HR is a textured implant, and changing to a smooth wall implant would reduce the problem. In severe cases, use of tissue substitutes such as acellular dermal replacements, may be necessary to provide thicker tissue coverage.

Tom J. Pousti, MD · Answer

I am sorry to hear about your concerns after breast surgery. Although I cannot provide you with specific advice, some general thoughts may be helpful to you.  
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 implants.
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.  In your case specifically, based on the limited information, I would likely recommend revisionary breast surgery that includes  placement of the implants in the sub muscular position along with the use of acellular dermal matrix and capsulorraphy techniques to keep the breast implants higher on your chest wall.  Best wishes.

Joseph Mele, MD · Answer

Rippling occurs to some extent with every breast implant. Treatment depends on the cause. If capsular contracture has occurred, this would need to be released. If the problem is thin soft tissue coverage, sometime an ADM can help. ADM may also be used to help raise the position of your breast implant, if the implant is too low. Implants with stiffer, more cohesive gel, can also be of benefit in some cases.

Cain R. Linville, MD, FACS · Answer

Best method for improving implant rippling is to use a highly cohesive implant, aka gummy bear implant, and also, to do fat grafting to the skin and subcutaneous tissue above the implant to add more covering.  I do a lot of Pre-pec breast reconstruction, and have zero rippling with those two methods (in combo with Alloderm usually).

Steven Wallach, MD · Answer

Rippling is often the result of thin soft tissue coverage. This can be camouflaged with an ADM like Strattice and/or fat grafting.  As for the position of the implants, I would have to evaluate you in person to see if they are malpositioned now.  This can often be adjusted with a pocket repair. Good luck.

Silicone implants placed in dual plane, rippling baldy for 4 years. Advice? (photos)

Answers (7)

Answer: Implant rippling

Answer: Implant rippling

Answer: Revision breast surgery

Answer: Revision breast surgery

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Everything you need to know about Breast Implants

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Silicone implants placed in dual plane, rippling baldy for 4 years. Advice? (photos)

Answers (7)

Answer: Implant rippling

Answer: Implant rippling

Answer: Revision breast surgery

Answer: Revision breast surgery

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Recommended reading

Everything you need to know about Breast Implants

Our mission is to create a world where every investment in modern beauty is Worth It.