Rippling look on inside of cleavage

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

Patient sitter very thin with little breast tissue sometimes can have visible rippling after the operation. With silicone gel implants it makes little difference whether the implants Are above or below the muscle. Saline implants rippling is more visible if the implants are above so they are preferentially placed below the muscle.

You will not get an adequate answer in an on line Q&A.  Three weeks post-op you are still swollen and what you are perceiving as rippling caused by the implant may be soft tissue swelling.  So a physical examination is necessary to determine what is going on.  Regardless you are early in the healing process and things will change.  Continue to follow up with your surgeon.  The subglandular pocket (above the muscle) is a perfectly reasonable pocket to use in the setting of adequate soft tissue coverage and proper implant selection.

This is why I favor placement of implants under the muscle. Particularly if you have a small amount of breast tissue and thin skin, rippling can result.  The implant will continue to settle. Ultimately it is your decision whether the rippling is something you can live with or not.

This can happen when there is not enough of your own tissue to camoflouge the imperfections of the implant itself.  I typically prefer to go under the muscle because that can help hide any rippling of the implant.  It's only been 3 weeks so your implants still have some time to settle at which time your breasts will change shape and fill out toward the bottom of your breast.  Try to be patient and give it a few months.  If it doesn't soften, then perhaps ask your surgeon about fat grafting.  ac

There are many changes in the breasts that occur in the weeks and months following breast augmentation surgery.  It is beyond the scope of this forum to tell if your situation is normal.  Please return to your surgeon and get your concerns addressed.Best wishes.

Rippling happens more commonly when there is not a lot of soft tissue coverage.  This is more common as well in the lower pole. If you are seeing it at three weeks, it might get worse.

I agree it is too early to make a judgment about what you see as rippling after your breast augmentation surgery.Of course you must share this concerned with your plastic surgeon who is in the best position to answer question.  Visible skin abnormalities early after breast augmentation can often resolve as the implant drops.