Rippling and Slight Denting in Breast Implants?

Hi there I had my implants put in nearly 20 years ago (im now 39). I am more than happy with them, they are silicone. However recently i have noticed rippling and denting on the inside cleavage area .. . is this somehing to be concerned about? and what causes this? I have had some weight loss in the past six months . .. my implants were never "large" (34C). Just wondering if i need to seek help? Sitting up straight diminishes the appearance nearly, but i can feel with my hands dents

Doctor Answers 3

Breast Implant Rippling and Denting Can Be Improved with Fat Grafting

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Thank you for your question.

Rippling and denting of Breast Implants is common long term and your weight loss likely made it worse.

There is nothing dangerous or unusual about this so you do not have to do anything about it if you are happy with your look and not terribly concerned about the appearance.

If however, you sre distressed by this and want correction there are options.

The new technique of Fat Grafting, when done by an expert can conceal the rippling and provide a good solution. This avoids surgery on the implant pocket-which could cause new problems.


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Breast Implant Rippling most often occurs when there is insufficient soft tissue coverage due to little overlying body fat and breast tissue. Implants placed beneath the muscle help to minimize this phenomena but the lower and outside breast (as pectoralis muscle is no longer present), towards the cleavage where the muscle thins out or on top of the breast where breast tissue is often lacking are the most common places to see rippling. It is often accentuated with certain positions (e.g. bending over,or leaning). Most of the time, rippling is felt along the outer side of the breast and the inner side of the breast next to the cleavage. Breast implant waviness (rippling) that is felt but not noticeable to the eye is very common and should not be a concern. However, when rippling is visible, patients are often self-conscious about their appearance.
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
Factors which are less likely to have rippling include:
  • Heavier and larger breasted women
  • Using a highly cohesive form-stabile silicone implants (gummy bear)
  • Smooth implants
  • Smaller implants
  • Submuscular placement
Once rippling occurs it is very difficult to correct. Rippling can be minimized by placing a biologic fabrics (e.g. AlloDerm®, Strattice™, SERI®), submuscular conversion if implants are above the muscle, fat transfer, use of adjacent tissue (muscle or fascia) if available, and in persistent cases implant removal and fat transfer. Seek the care of the best board certified plastic surgeon possible with experience in breast revision surgery.


Rippling and Slight Denting in Breast Implants after weight loss.

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Almost all implants have ripples. They are more noticeable in these settings:

  • Saline implants
  • Implants above the muscle
  • Implants in thin patients

Your ripples may have been there for years, and with weight loss and presumably some loss of breast volume they are now easier for you to notice. 

This is not a sign of something bad going on. If it bothers you, find a surgeon in your area to consider the options you might have.

Best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

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.