Can Post-op Breast Massage Cause Rippling to Occur?

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 implantsLarge implantsThin patients with low BMIImplants placed above the musclePrior history of ripplingFactors which are less likely to have rippling include:Heavier and larger breasted womenUsing a highly cohesive form-stabile silicone implants (gummy bear)Smooth implantsSmaller implantsSubmuscular placementOnce 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#breastaugmentation

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. Some implant styles are more prone such as an overfilled saline implant. Others are less prone such as a shaped silicone implant. Massage does not impact the development of ripples.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.If the rippling persists, you have several options:  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. Should the ripples persist, I would visit with a board certified plastic surgeon to discuss your options in more detail.

There should be no impact on rippling as a result of massaging your breasts following surgery. Rippling is usually related to other factors, such as thin skin and sub mammary placement.

There is absolutely no way that rippling is caused by massage. Rippling can be seen both in silicone and saline implant patients and is usually due to lack of enough breast tissue over the implant, an implant that may be displaced or hardened (contracture), or an implant that is oversized for the amount of breast tissue.

All implants have wrinkling.  If you visit your surgeon's office to try on sample implants, whether saline or silicone, they all wrinkle when you hold them in your hand.  Wrinkling is less obvious with silicone implants.  Your tissue is evidently thin enough, even though part of your implants are under your chest muscles, to allow the wrinkling to be visible.  You could consider changing to gel, but wrinkling may be part and parcel of having the implant, especially if you are thin.  Sorry you are having trouble.  All the best, "Dr. Joe"

 

Rippling and wrinkling of a saline breast implant has to do with "tissue cover" not massaging. Patients that have thin tissues or patients that have implants placed on top of the muscle (which causes there to be "less" tissue on top of the implant) are the two main reasons patients get rippling or wrinkling.  This is not related to breast implant massage.  I recommend placing silicone gel implants under the muscle to minimize and avoid wrinkling or rippling.  I hope this helps!

Sincerely,

James F. Boynton, M.D., F.A.C.S.

Massage should not have a bad effect on implants

Thin patients , sub mammary placement, large implants, saline implants are all risk factors

Hello,

There are several irregularities that can occur after a breast augmentation.  Rippling is a term that usually refers to the irregularities seen from saline implants.  This can happen when the breast tissue, especially laterally (on the side of the breast) is thin.  It is also more common when the saline implant is over-filled.  Massage will not make a difference in either one of these sources of rippling.  Correcting it usually involves replacing the implant with a silicone implant or possible reducing some of the volume of the saline implant if possible.

All the best,

Dr Repta

Breast implant wrinkling and rippling is not related to implant massage.  Massage does not cause it nor does it worsen it, so continue to massage your implants.  Even though there is no proof that massage helps to prevent capsular contracture (hardening of implants) it does not hurt to continue it!

Rippling often happens when using saline implants in a thin patient.  Breast massage is unlikely to have anything to do with causing or preventing that from happening.  However, many plastic surgeons recommend breast massage after breast augmentation to prevent capsular contracture.  If rippling continues to be a problem, that can be corrected by exchanging the saline implants for silicone gel and placing them under the muscle.  In extreme cases, acellular dermis, a biological compatible tissue matrix, can be placed over the implant to help add coverage and camouflage any ripples.