Is it normal to have deep puckers indentations in the breast?

When will my puckers deep in the breast go away I am 10 Weeks post opt I dont see them unless I bend over slightly one breast has more dents or deep puckering inside the breast!!! Not actually on the nipple but to the side LOOKS TERRIBLE if I bend over. Hard to get a photo of It I dont go back to my surgeon till July 25th kinda looks like my tissue was ripped out to make that puckering deep into the tissue I have been doing some massages anything else I can do will it go away on its own

Doctor Answers 3


I am not sure what you are describing as puckering.  Is it rippling?  Is it a double bubble. Best to be seen in person to be properly evaluated.

New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Change and breast shape when bending overy

If you have saline filled implant it is due to the change in the shape of the implant when you bend over.  It is also likely that you have thin skin which is exacerbating the problem. The only solution would be to use gel implants.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 16 reviews

Deep puckers and indentations after breast augmentation.

What you are describing 2 1/2 months post-op breast augmentation seems to be what most of us call rippling. This usually occurs as swelling diminishes, and is most commonly associated with saline implants, more so if they are underfilled. This means that if your surgeon used 400cc saline implants and filled them to 400cc (sounds correct, doesn't it?), you have a much higher likelihood for this visible rippling, and in my humble opinion, also a higher likelihood of eventual leak and deflation requiring re-operation. Rippling is also worse if your implants were placed above your muscles (but you conversely have a somewhat higher risk for capsular contracture).

Saline implants are made on the same implant molds (mandrels) that silicone implants are manufactured with, but obviously the filler material is saline instead of cohesive silicone gel. To minimize rippling, reduce the higher potential for creasing in the shell that can lead to leak and deflation, as well as the visibility of these pronounced ripples (dents and puckering), "over"fill by about 10% is widely recognized by most plastic surgeons experienced in breast augmentation as appropriate, and is even labeled that way on the saline implant packaging. Some surgeons stubbornly refuse to accept this, and even tell their patients that "over"fill will void manufacturer's warranties. This is false.

Overfilling is also how surgeons are able to achieve 1000cc or larger augmentations, since the largest implants come in 800cc sizes. But then the implants feel hard!

Massages won't help you. Unfortunately, unless your scar capsule tightens a bit, this will only get worse as your tissues heal and soften. Then, the only solution is switching to silicone gel implants, going below the muscles, or (rarely) adding thickness via acellular dermal matrices such as Alloderm or Strattice.

You should discuss this in detail with your surgeon, who can discuss the options and appropriate timing for any revisionary surgery, if recommended. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 238 reviews

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