Should I Replace my Saline Implants if They Have Ripples?

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!
 

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.

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 certifiedPlastic surgeonHoffman EstatesBarringtonOakbrookChicago

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.

Breast Augmentation has extremely high satisfaction rates,
but occasionally rippling can occur following this procedure.This can occur with either saline or silicone
breast implants.Several factors have
been associated with rippling following breast augmentation.These include saline implants, large implants,
thin soft tissue and placement of implants on top of the muscle.The
potential for rippling can be decreased in several ways.It’s important in high risk patients to avoid
using implants that are large relative to the patient’s native breast
tissue.Firmer implants such as silicone
and cohesive gel implants can also decrease the potential for this
problem.Submusclar placement decreases
rippling by increasing the soft tissue coverage over the implants.Surgeons should avoid over dissection of the
pocket and avoid implants that are wider than the patient’s breast tissue.Finally over filling the implant when using
saline may help to minimize rippling.Despite
these maneuvers, rippling may still occur. It’s important to realize that in
the vast majority of patients, rippling isn’t a problem and even when it does
occur most patients are still very happy.In your
case, it might be reasonable to replace your saline implants with firmer
implants.In this situation, silicone or
cohesive gel implants might improve your rippling.If
you’re concerned about rippling following breast augmentation, consultation
with your plastic surgeon is appropriate.Depending upon the specifics of your previous procedure your surgeon
should be able to formulate a treatment plan that’s appropriate for you.

Rippling is an expected complication or effect of saline implants. The ripples may be palpable or even apparent on the skin surface. Weight loss or scant breast tissue make ripples more likely. There are several alternatives to correct rippling:


exchange to saline implants

use of acelular dermal matrix

fat grafting


Each separately or all three together may be indicated. Consult with a board certified  plastic surgeon to obtain the best advice after a thorough consultation and exam.

Sounds like you were fine before your recent weight loss. Fat, muscle, or breast tissue surrounding breast implants contribute in keeping visible rippling at a minimum. Without pictures or an exam-you have 2 options.

1. Save yourself the cost of another surgery by re-gaining the 10lbs or if that is not an option

2. Replace implants with gel implants under the muscle

Best wishes, Dr. H

Many subpectoral pockets are created in a dual-plane fashion, meaning that a portion of the implant lies under the muscle, and a portion of the implant is covered only by subcutaneous tissue. The muscle provides additional coverage over the upper and medial implant. But the lateral and inferior portions of the implant are covered only breast and/or subcutaneous tissue. It is for that reason that rippling is more likely in the inferior and lateral parts of the breast. And for thinner women, who have minimal breast tissue and little subcutaneous fat, rippling will be more likely because the tissue covering is thin.

The weight loss you describe may certainly be a contributing factor. The soft tissues of the breast became thinner with your weight loss and made the ripples more evident. You are probably helped by the subpectoral placement of your implants, and the rippling would likely be worse if you had subglandular implants. In my opinion, saline implants should never be placed in the subglandular space, for that reason.

Rippling is a risk of breast augmentation surgery, regardless of the implant or pocket used. And rippling with saline implants is almost inherent. The characteristics of saline as a fill material are such that almost every woman with saline implants experiences some rippling and/or palpability of the implant somewhere. I’m not saying that this is always problematic, bothersome, or noticeable, but just a reality.  (In a sitting position, if you examine the inferior pole of the breast just in front of the inframammary fold, in a woman with saline implants, you can almost always feel some ripples in the implant shell.)    There is no guarantee that you won’t have some rippling with a silicone implant, but the characteristics of the gel filler make rippling less common.

As mentioned by other physicians -- ADM is an option to provide additional coverage over the implant, but does add significant cost to the surgery. Discuss this option with your surgeon to understand if this is necessary and how much it will help you. And, crease/fold failure will only be more likely to occur if the implants are improperly sized. If the implants are too big for the pocket the implant shell is forced to fold, and this fold along the margin of the implant eventually undergoes a stress failure. Once a saline implant shell fails, the implant begins to leak, and the size of the breast begins to shrink quickly enough that the failure is usually recognized fairly quickly.

Best wishes. Kenneth Dembny

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!

 

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.