Should I Replace my Saline Implants if They Have Ripples?

I had saline implants under the muscle 4 years ago and just now am starting to notice slight rippling. I recently lost about 10 pounds and wonder if that is contributing to the cause of this. What are my options? My breast tissue is thin to begin with. I was originally a small B cup and had them increased to a 34C. I love the size but hate the ripples. Will replacing them solve this problem?

Doctor Answers 20

Saline Breast Implants and Ripples

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Unfortunately, you have discovered one of the known down sides of breast iplants - shell rippling. The shell of ALL breast implants ripple from the moment the implants are placed under the breast. The rippling is worse in saline filled than in gel filled implants and worse in textured than in smooth shlee breast implants. The rippling is the prime reason why breast implant need to be picked based on each woman's dimensions - because to achieve an attractive result the surgeon wants to put in an implant whose entire dome (and its ripples) is covered (and hidden) by your breast and muscle tissues.

- The larger the implant and  the less the existing breast tissue to cover the implant ripples
- the greater the weight loss removing coverage of the implant ripples - the MORE visible and palpable the ripples will be.

1. Change Saline implant to (less ripply) smooth silicone gel implants
2. Add to the implant coverage by using a biological sheet of Strattice (pig skin dermis extract)
3. apply fat grafts to the breast skin to increase its thickness making the underlying implant.

Good Luck.

Peter A Aldea, MD

Memphis Plastic Surgeon

Replacing Saline Implants to correct Ripples

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Replacing your implants will not necessarily fix the problem. Your recent weight loss may have contributed to the problem if it resulted in further thinning of already thin breast tissues. It is also important to know where the rippling is located. If it is in the upper part of your breast then the implant may be underinflated, or the implant may not be well supported underneath and you could have traction rippling. The solution would then be to tighten the implant pocket with or without the addition of alloplastic material.

If the rippling is along the side, then it is most likely related to having thinned tissues. Changing to a Gel implant may help but it is not a quarantee. Visible rippling can definitely occur with Gel implants although it is somewhat less likely. You could reinforce the tissues again with alloplastic material. The problem is a much if not more related to your own tissues as it the implant, so replacing the implant alone does not necessarily solve the problem.

Should I Replace my Saline Implants if They Have Ripples?Answer:

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It is probably related to a few things, the biggest of which is probably your weight loss, which solution most women do not want to hear! Even 10 lb. in thin women can make a difference. Also, I have seen that after 4-5 years that saline implants can stretch a bit and even lose a bit of fill, both possibly causing ripples. If it is just at the bottom, I would not rush into silicone implants. Don't hate me & I know it sounds bad but see what you think after the holidays, and a few extra pounds!

John J. Corey, MD
Phoenix Plastic Surgeon
4.7 out of 5 stars 48 reviews

Should I Replace my Saline Implants if They Have Ripples?

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Hi JFlower, The less breast tissue you have, the more likely you are to see rippling in your implant shell. Weight loss would have contributed. This isn't a reason for revision, as all implants ripple. But you do have the option to help lessen the possibility of visible ripples. You can make the switch to silicone. The gel in the implant is thicker than the saline and moves more like your own body tissue. For really thin patients with a history of rippling you may be a good candidate for the highly cohesive silicone gels like the Natrelle Inspira Cohesive. They hold their shape the best. Make sure you meet with a board certified plastic surgeon with experience doing revisions that can show you a history of consistent outcomes of patients similar to you.Good luck!

William Aiello, MD
Orange County Plastic Surgeon
4.9 out of 5 stars 65 reviews

Replacing Saline Implants with Ripples

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Rippling iof #saline implant is unlikely a serious issue. If you are very thin or lean, any type of #implant can display some #wrinkling.  However, #positioning under the muscle may help.  Silicone implants do better than saline in this case. Also, adding a mesh (i.e. #ADM or similar) can help. Smaller implants, skin #tightening and #capsulectomy may also treat  #rippling or #wrinkling. Be sure to select a plastic surgeon who is #board-certified and has a great deal of experience with breast #augmentation and the incision type, #implant placement, and implant type. If the implants are ruptured or more than 10 years old, consideration should be given to replacement.  Plastic surgeons who have specialized in breast surgery and cosmetic surgery are suitable to perform your breast augmentation. Aside from checking board-certification, it is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Rippling Effect

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Thank you for your question. Rippling and Implant Edge Visibility are hard to get rid of. One sure way is for the patient to be a small amount of weight around her breasts. Exchange of implant to smooth high filled implant &/or going behind the muscle also can be very helpful maneuvers. Best of luck!

Dhaval M. Patel 
Double board certified
Plastic surgeon
Hoffman Estates

Dhaval M. Patel, MD
Hoffman Estates Plastic Surgeon
4.8 out of 5 stars 100 reviews

Rippling with saline breast implants

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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. So 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. 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 with a board certified plastic surgeon to discuss your options in more detail.

Wt. loss and rippling

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Your recent weight loss may be the reason why you are now noticing rippling in your breasts. Rippling is more likely to be visible with saline implants and in patients with thin tissues. Consider exchanging them for silicone.


Replacing saline implants if they have ripples

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Thank you for your question.  Since you only just noticed the rippling of the implants after you lost weight this is undoubtedly the reason that you are noticing it now. It would be useful to know if your implants were underfilled as this will certainly make the rippling more noticeable. Replacing the saline implants with gel implants may well improve the problem but may not completely eliminate it.  Gaining more soft tissue coverage with ether weight gain or placing an allograft over the area will also help with this problem. 

Donald M. Brown, MD (retired)
San Francisco Plastic Surgeon

Replace Saline Implants due to Ripples?

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The decision to replace them is up to you. If you think you may regain the weight, then hold off and see what happens. If the ripples still bother you, a replacement to silicone gel implants may help. Another option is using acellular dermal matrix to thicken the lower breast tissue.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 76 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.