Can my Problem Be Sorted? Rippling/discomfort

i had 340cc implants over the muscle and have severe rippling on 1 breast. i was quite empty pre-op. I experience discomfort and shooting pains on that one despite having surgery 18 months ago. I was told nothing at all could be done when i went back to see them and sent away being told to put weight on which i struggle with, but am the same weight as when i had surgery.can something be done? and is the pain caused by the rippling which is what i was told?

Doctor Answers 6

Rippling

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 implants
  • Large implants
  • Thin patients with low BMI
  • Implants placed above the muscle
  • Prior history of rippling
Factors which are less likely to have rippling include:
  • Heavier and larger breasted women
  • Using a highly cohesive form-stabile silicone implants (gummy bear)
  • Smooth implants
  • Smaller implants
  • Submuscular placement
Once 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.

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Rippling of Breast Implants?

Thank you for the question.

Rippling refers to the visible or palpable “waviness” of a breast implant.  This may be seen with any type of breast implant but is more common with saline  breast implants and more severe if an implant is deflating ( compared to a appropriately filled implant).

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. Patient weight gain (if possible) may also be helpful.

I hope this helps.

Do you have a breast implant capsular contracture.

I would need to conduct a physical exam to provide you with a more specific diagnosis. However, from your description, I would suspect you may have early capsular contracture which can make rippling worse and be associated with pain.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 72 reviews

Rippling

Rippling with implants happens more commonly in very thin patients with little to not soft tissue covcerage over the implants.  Sometimes overfilling the saline implant may help.  Others can benefit from alloderm coverage but it can be very expensive.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 23 reviews

Rippling with Breast Implants

Rippling of breast implants is a common phenomenon when placed in thin women and especially over the muscle.  In thin women, there are few indications to place the implant above the muscle, and one must accept this as an expected outcome.  This can usually be corrected with the use of silicone implants and having them placed beneath the muscle.  The pain, however, is not related to the rippling, but can be related to the breast capsule if it is contracting.  The incidence of contracture is higher with implants placed above the muscle.  Discuss this with your surgeon to come to a solution.

Best of luck

Vincent Marin, MD, FACS

La Jolla Plastic Surgeon

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 40 reviews

Rippling Can Sometimes bve Improved by Moving Implants Below Muscle

There is a higher incidence of rippling with implants which have been placed above the muscle, especially in thin women.  I would suggest moving your implants to a location below the pectoralis muscle and would also suggest changing to silicone implants if saline was chosen initially.

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.