Once You Notice Rippling in Breast Implants, Will It Continue to Get Worse?

Once You Notice Rippling in Breast Implants, Will It Continue to Get Worse? The answer is usually yes. However, I have a few patients that are aware of rippling with as little as 5 lb wegiht loss but notice that it is less visible when they put the weight back on.

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 implantsLarge implantsThin patients with low BMIImplants placed above the musclePrior history of ripplingFactors which are less likely to have rippling include:Heavier and larger breasted womenUsing a highly cohesive form-stabile silicone implants (gummy bear)Smooth implantsSmaller implantsSubmuscular placementOnce 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#breastaugmentation

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. 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.Should the rippling persist, there are several approaches to address this:  One 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.I would follow-up routinely with your plastic surgeon to monitor your progress and discuss options should the need arise.

Larger implants tend to wrinkle more, especially under thin soft tissue coverage. I've treated a few women with visible implant wrinkling using fat grafting in the sub-cutaneous plane. This is typically a low-volume grafting procedure- 50-60 cc per breast has worked in the past. Other options include very expensive dermal graft products like Strattice or Alloderm. Fat is free!

Thanks for posting this question. Use of ADM (natural dermal substitute) and high profile silicone gel implants under the muscle are the best fixes for rippling after augmentation. Rippling will not resolve without surgical intervention. Hope this helps.
Good luck.
Dr B