I am 52 and have had a bi-lateral mastectomy followed by silicon breast implants. I notice rippling at the top of my breast when I lean over. I will have nipples added in a couple of months. Is there anything that can be done during this upcoming surgery that can help cover up the ripples?
Is There Anything That Can Be Done to Reduce Rippling After Breast Reconstruction Surgery?
Doctor Answers 7
Rippling after mastectomy reconstruction
Further, 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. I would visit your plastic surgeon to discuss your options in more detail.
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
- Heavier and larger breasted women
- Using a highly cohesive form-stabile silicone implants (gummy bear)
- Smooth implants
- Smaller implants
- Submuscular placement
Rippling of Implant after Mastectomy Reconstruction
The problem here is that you have thin mastectomy skin flaps and likely muscle covering your implants. This rippling can be addressed by placing a larger silicone implant to fit more snug into the pocket; or tighening the skin envelope, or utilziing dermal matix products to create an internal bra for your implant to fill the empty space causing the rippling, or considering the form-stable cohesive gel implants (Which only a few plastic surgeons have access as part of a national investigation study). Another option would be to consider autologous tissue only reconstruction if this issue really is bothering you. Rippling is sometimes a limitation of implant based mastectomy reconstruction. Talk to you plastic surgeon to learn more about your options.
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The most important thing to do now is to have another consultation with your plastic surgeon. The important question is DO YOU HAVE ENOUGH COVERAGE OF THE IMPLANT? Or is the skin subcutaneous tissue is too thin
Alloderm is used to hide the rippling, but I am concerned because you have a silicone implant and still showing some rippling in the superior aspect of the implant . The superior aspect of the implant, after reconstruction, is usually coverd by the pectoralis muscle, and shoul not have rippling. So, if that is the case is the addition of a thin coverage like alloderm going to be enough to hide the rippling?
or you need more coverage, like a Latismus dorsi flap. These discussions must be made before the nipple areola reconstruction.
Ripling implants after mastectomy
Rippling happens in both mastectomy patients and thin skinned breast augmentation patients. Allderm may be the answer to camouflage the rippling.
Correction of rippling after Breast Reconstrction
All breast implants ripple and Saline breast implants ripple more than silicone gel implants. This is the major fact why implants are placed UNDER the muscle. The idea is for the muscle to add volume and coverage hiding the ripples.
You should ask your Plastic surgeons about increasing the coverage of the implants. IF the implants are over the muscle, putting them under the muscle will greatly reduce the ripples, otherwise using the back muscle to add further cover or placing a cover of AlloDerm may thicken the cover and hide the ripples.
Ripples are more evident when the implants are soft so to some extent you should be happy they are not hard. Implant reconstruction is imperfect and rippling is inevitable. What can reduce it is to hide it behind thicker tissue. Alloderm can improve this to some degree. Some surgeons use fat injections. If you are severely thin, a latissimus flap is available. A larger implant may increase firmness and decrease rippling a bit. It's all a trade-off.