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 17

Saline Breast Implants and Ripples

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
5.0 out of 5 stars 93 reviews

Replacing Saline Implants to correct Ripples

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:

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
5.0 out of 5 stars 29 reviews

Rippling with saline breast implants

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.

You may wish to replace your implants with silicone.

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.

Wt. loss and rippling


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

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
San Francisco Plastic Surgeon
5.0 out of 5 stars 8 reviews

Replace Saline Implants due to Ripples?

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
5.0 out of 5 stars 42 reviews

Should I replace my saline implants if they have ripples?

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:

  1. exchange to saline implants
  2. use of acelular dermal matrix
  3. 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.

Rippling of implants after recent weight loss

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

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.5 out of 5 stars 193 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.