How Much of an Issue Is Rippling For Someone With a Lot of Breast Tissue?

I am choosing between saline & silicone implants. I am thin but have a lot of breast tissue. I will be going under the muscle with implants under 200 cc to go from a B cup to about a C cup. How much of an issue is rippling for women with fair amount to a lot of breast tissue? I don't know the volume range for the saline shell so I'm not sure if 170-200 cc would allow overfilling to lower the chances of rippling. Over the years, is rippling inevitable regardless of the amount of breast tissue?

Doctor Answers 14

Rippling and Breast Augmentation

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Congratulations on your decision to have a breast augmentation.  For patients with small frames who are thin, rippling from breast implants is a potential problem.  All breast implants have ripples since we do not yet have a perfect implant.  The density of the breast tissue may help hid the ripples slightly but really it comes down to how much "coverage" you have.  It is like a ball under a sheet as compared to a ball under a quilt.  There is nothing you can do to change your body so what I recommend for patients like you are the gummy bear implants since they are form stable and have less rippling.   The implants from Sientra have been shown to have the least ripples of all the gummy bear breast implants.

Interestingly, with Sientra implants, if you get some rippling in the first few months after surgery, it seems to improve at around 6 to 12 months after surgery as your scars improve.  This is because the texture of the implant will "Velcro" to your body.  A very nice implant.  In addition, this implant lends itself well to going above the muscle so that you avoid an even worse problem than rippling, and that is animation of your breast from the muscle pulling on your implant.  

I hope that helps.

Best regards

Rippling is less likely-

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Visible rippling is most likely in women with very little breast tissue, placing the implant over the muscle and when using a large saline implant.  Visible rippling is less likely in women who have more breast tissue, placing the implant under the muscle and when using a conservative silicone size implant.  It sounds as though you fall into the latter category.


Rippling, is it an issue?

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There have been many reported cases of rippling with the use of saline implants.

In terms of breast tissue coverage there are two types of rippling that can occur: visible and palpable.
- Visible rippling is a lesser issue with silicone implants, particularly the form stable devices. 
- Palpable rippling can occur with both types of implants particularly in the lower, lateral aspect of the breast.  This is due to less muscle coverage and thinner breast tissue.

Rippling can sometimes be confused with implant palpability which is also a factor of implant size and the amount of breast tissue.

Rippling and saline implants

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From your description, body type and size of the implants rippling should not be a major issue but there still is a possibility of getting rippling especial as time goes by and the saline implant may lose some of its volume. Correction at that point should be straight forward.


Best of luck!

Small saline implants with a lot of your own breast tissue greatly reduces the chance of noticeable implant rippling

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Thank you for your question.  

Long sentence.....If you have and maintain a good amount of your own breast tissue and the implant you get is at least 1 cm narrower than your breast base diameter, then there is a very low risk of getting rippling with a saline breast implant as long as it is a small implant (which 170-200cc is).

I hope this helps.

Rippling with implants

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Patients with a fair amount of breast tissue often do not get rippling. If there is not alot of volume and the skin  becomes thin, rippling then is more common.


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Individuals with more breast tissue tend to not have rippling with augmentation. Women with very thin skin and small amounts of breast tissue have a higher risk for contour irregularities. Silicone implants are less likely to ripple when compared to saline implants as well. Our practice combines breast augmentation with fat grafting for those women who may have a slightly higher risk for rippling and this may be an option for you as well.

Rippling not likely

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Is unlikely that you will have rippling after a small size breast augmentation as you described.  It is important that the correct profile implants are used in the submuscular position (under the muscle) with a board certified plastic surgeon.  Additionally, slightly overfilling within the range accepted by the manufacturer is recommended to decrease the chances of ripplig.  Best of luck.

Rippling with saline implants

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Saline implants were the predominate breast implant used in the United States for many years and there are many satisfied patients with them.  The more breast tissue and/or body fat you have the less likely you will be to feel and certainly see the ripples.  If you have a fair amount of breast tissue, in my opinion you will not have an issue with a conservative sized implant below the muscle.

Thank you for the question and best of luck.

Ripples in breast implants

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Because of the thicker more viscous nature of silicone gel as compared to saline ripples are less common with gel implants. Ripples are more likely to be noticed the implant is large and if the natural tissue covering the implant is small.

Thus, ripples or less likely to be noticed when:

1. silicone implants are used rather than saline.

2. implants are placed below the muscle

3. small implant is used

4. a relatively larger amount of soft tissue including breast and muscle is present.

 With a B. cup breast as a starter, and a relatively small implant as you have chosen, significant ripples seem unlikely to occur. Good luck.

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.