Rippling on New Silicon Implants? (photo)

Your situation is unfortunately all too common: very large implants in a very thin woman.  Whenever the tissue is thinned and stretched, inevitably there will be some degree of rippling.My bet is that your implants are not behind the muscle.  Though you may have been told that they are, my bet is that the left slipped in front of the muscle.  If so, the implants should be put back behind the muscle and an ADM such as Strattice should be used to thicken the tissue and hold the muscle down.  If they are in front of the muscle, thickening your tissue with Strattice is also an option.I've used gummy bear implants for over ten years.  They can help in this situation, but understand that fundamentally you have a problem in tissue thickness and the first priority in remedying it is therefore to thicken it.The gummy bear implants do tend to ripple less. The Allergan Natrelle 410 is the most ripple resistant. However it has a teardrop shape.  If a teardrop implant rotates then it creates a deformity.  That is a rare problem when the tissue is tight, but may happen more often when the tissue is loose.  They also typically don't give the right shape in a breast such as yours.I believe the best implant for patients in a situation such as yours is to use the Sientra Textured Round implants because they have a cohesive filler and the implant shell is maximally filled, thereby allowing for less rippling than many other implants.Your problem is tricky.  Understand that there is no simple solution because there are a number of factors that are contributing to this problem.There are also sections on gummy bear implants.

I am sorry to hear about the problems you are having. Based on your description and photograph, you may be a good candidate for the use of acellular dermal matrix;  the use of this material ( placed between your skin and the underlying breast implant) may be helpful to treat rippling. In my practice, I have used this material for this purpose with good success.  I hope this, and the attached link are helpful to you as you learn more about revisionary breast surgery.  Best wishes. 

I am sorry that you are still having problems with wrinkling, but I do not think a larger implant is the answer. Most likely your new implants were placed in the original implant pocket. For patients who are very thin, this may often result in persistent wrinkling. The best solution is having the implants reposition behind the original pocket or adding a dermal matrix for additional coverage. You should discuss this with your surgeon or get another opinion from one with extensive experience in revisional breast surgery. Good luck.