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"