Redo Implants to Fix Wrinkles/Rippling?

Pao,

To treat implant rippling you can choose a more cohesive gel or fat grafting to add fat coverage on top of the implant.

at 5'7" and 123lb you're pretty skinny and therefore any rippling will be more visible than in a heavier patient.  Thus you have two problems:  an implant that is rippling, and skinny body that does not hide implant imperfections well.  To address the first problem, you can chose to go with a more cohesive (harder) implant.  It feels less natural but has less rippling.  To address the second problem, if you have any areas that can be used to collect fat  (at your height and weight that may be unlikely) fat can be injected under the skin over the rippled area to cover up the rippling.  It is a technique that is gaining a lot of popularity because of it's results.  However, once again, you need to have sufficient fat that can be used for this purpose.

Sincerely,

Martin Jugenburg, MD

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

#BreastImplant Rippling in tall , lean womenRippling can be reduced with higher fill implants, #Inspira or saline overfilladding fat , #hybridbreastaugmentation,tightening skin.Fat, and ADM of some type i.e. #belladerm

If your implants are under the muscle, then switching to silicone is the simplest option, and will certainly help. I would go with the same size or larger.

The high profile implants have a lower tendency to ripple and I would possibly adivse the use of a 350 high profile silicone gel implant to minimize the visibility of the wrinkling. Fat grafting is an option but not without risks and I would advise proceeding with implant exchange first. 

Since you have rippling with saline breast implants, I would recommend converting to a silicone gel implant which has a lower incidence of rippling/wrinkling.  You can also decrease the size of the implant slightly as you are relatively thin and this will help.  Furthermore, you may need a synthetic skin (acellular dermal matrix) placed in between the implant and your tissue to help camoflauge the implant, this can be done with either Strattice or Alloderm. Hard to say exactly what you need without seeing you in person, but these changes should help.

Please consult with a board certified plastic surgeon for a comprehensive exam and review of your treatment options.

Best wishes,

Dr. Bruno