Renuva or fat grafting to correct implant rippling?

Question

I had my 18 year old saline implants replaced with silicone implants, under the muscle, 6 weeks ago. They look great, but one of the reasons I had my saline implants exchanged is because I was unhappy with them rippling, and now my saline implants are rippling, especially the right one. I am thin and muscular (5’1, 110 pounds). What can I do to correct this? Has anyone used fat grafting or Renuva for this? I’d rather not go under the knife again.

Jason Emer, MD · Answer

Renuva is a highly effective solution to correct implant rippling, and is superior to fat grafting in many ways:

• Renuva is an off-the-shelf treatment that requires no anesthesia or downtime. It's injected right in our office and most patients are back to their regular activities the following day.

• Renuva creates a honeycomb-like matrix made of naturally-occurring growth factors and collagen that are used by your body to build fat cells in the injected area.

• 100% of the fat cells that grow in the Renuva matrix, thrive.

• Since your body's own fat grows within the Renuva matrix, it is ideal for women who don't have enough existing fat for fat grafting.

Dallas Buchanan, MD · Answer

Thank you for your questions. Unfortunately, in patients who have very thin covering over the implants, rippling can be a concern. And often, as time goes on and the swelling goes away, rippling can get worse rather than better. The options to improve this would be to improve the covering over the implant with mesh (ADM) or fat grafting. Or the other option is to try an implant with the least amount of rippling potential like a highly cohesive gel implant. Even with all these methods, there is no assurance that rippling will not continue to be a concern. Renuva could be an option but this treatment is new, unproven, and can be costly. Hope this helps!

Richard Baxter, MD · Answer

Only the upper and inner parts of an implant are covered when under the muscle, so rippling tends to be more visible on the outside and bottom especially in thin patients. The problem with fat grafting is that it is placed into a very thin tissue plane so there is not always as much coverage as you want. ADM works very well but is a big procedure and costly. High fill ratio implants and firmer gels such as Allergan Soft Touch and Sientra 107 help also.

Curtis Wong, MD · Answer

If you must be completely without rippling, you can pursue more surgery at more costs and at potential risks to your implant that may require more than one procedure.  If that isn't going to be tolerated well by you, best to live your life and move on as implants are not perfect products and if your tissue coverage is on the thin side as you suggest, it may be impossible to completely resolve the rippling issue.  So in the end, you have to decide if its really worth it to go down that path.

Anna I. Wooten, MD, FACS · Answer

Amy,
Fat grafting can be a great solution for visible "rippling" around saline breast implants. Some patients who are very thin may even feel that their silicone implants show a visible edge. In cases such as these, fat transfer can be a wonderful, long-lasting, and natural solution to enhance the feel and appearance of an augmented breast.
Thank you for your excellent question!

Ellen Marmur, MD - Account Suspended · Answer

Renuva is a great solution for smoothing breast implant rippling, especially for patients who don't have enough fat for fat grafting. Renuva is an off-the-shelf treatment that requires no anesthesia or downtime and is injected right in our office.Once injected, Renuva creates a honeycomb like matrix, or scaffold, that uses naturally-occurring growth factors and collagen that are used by your body to build fat cells where the Renuva was injected. You will see immediate results, that give you an idea of what your final results will be in 3 months post treatment – at which point you the Renuva injected will have been eliminated by your body, leaving only your own new fat cells right where you want them.

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