Is Rippling with Saline Implants Permanent?

I had saline implants placed under the muscle 6 years ago. I have only noticed rippling in the last year. I have always been very thin, 5'9 and 120 pounds and realize that the rippling is due to limited breast tissue. My question though is is the rippling permanent? Would changing to a silicone implant alleviate the issue? I am very unhappy with the shape, size and asymmetry, along with the rippling, so am leaning towards having them redone but was told the rippling could be permanent.

Doctor Answers 13


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.


Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

Replacing saline breast implants with silicone gel breast implants under the muscle may reduce visible rippling

Thank you for your question. As a general rule silicon gel implants do tend to cause less rippling than do saline implants.. Placing the new implants beneath the muscle and is necessary covering them with acellular dermal matrix may solve your problem.

Correction of implant rippling

There are several factors that cause implant rippling

1 Saline implants ripple more than silicone gel implants( Moderate profile plus  have the least tendency to ripple)

2 Textured implants ripple more than smooth implants

3 Rippling is more common when the overlying tissues are thin

4  Rippling is more  common in the  sub glandular  than the sub muscular position,however surgeons often release the   muscle leaving the lower half of the implant covered with skin only, this will predispose to rippling

I therefore use smooth round moderate profile plus  silicone gel implants placed beneath the fascia

I reinforce thin tissue with mesh if necessary,and inject fat to thicken the skin

Hilton Becker, MD
Boca Raton Plastic Surgeon
4.6 out of 5 stars 15 reviews

Rippling of breast after implants

It is not just the fact you don't have much breast tissue, but the fact that it seems that you have very little fatty subcutaneous tissue.  Put another way; your body fat is very low.  Because of this you have very little tissue over the implalnt.  This would definitely be helped by switching the implant to silicone and changing the position of the implant; either under the muscle and/or under another layer of capsule tissue.  Consult a board certified plastic surgeon

Note that no wrinkling cannot be guaranteed.

Talmage Raine MD FACS

Talmage J. Raine, MD, FACS
Chicago Plastic Surgeon
4.6 out of 5 stars 9 reviews

Silicone-Filled Implants Ripple Less than Saline-filled Implants

As a rule, silicone gel filled implants have less rippling than saline-filled implants. In very thin women who have less breast tissue, rippling may be visible with both types of implants and a third option are the "form-stable" silicone gel implants. Since these implants are designed to hold a "teardrop" shape, they tend to have the least amount of rippling but typically are a bit firmer than the round silicone gel implants.


If the rippling persists after changing to a different implant style or implant projection, other strategies including use of fat grafting, or use of a material known as acelular dermal matricies (Alloderm, Strattice) may be an option.

Lawrence Iteld, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 39 reviews

Rippling with implants

Rippling occurs because the tissues are very thin.  Gaining weight can cause it to appear less, strattice or pocket repositioning may  help.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Implant rippling can be permanent

If your tissue has thinned, even after submuscular augmentation, detectable ripples can be permanent. Weight gain can help, and sometimes fat grafting can help if practical. Facts are that a silcone implant (except the gummy bear) might have a visible ripple as well so take your time before you decide on a switch.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews




If you have thin skin and you went with a pretty big size implant you will have rippling. Even though your body is still making scar tissue so the rippling should get better with time.


Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon
3.3 out of 5 stars 9 reviews

Fat grafting to the breast can help you to cover the rippling

All saline implants have rippling. Patients will small amount of soft tissue will have more obvious rippling. you can have revision with silicone gel implants. I offer fat grafting over the implants if there is thin tissue over the implant in combination with implant exchange to gel implants.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 122 reviews

All implants ripple and saline implants ripple more than silicone gel filled implants

Since all implants ripple and saline filled implants ripple a lot more than silicone gel filled implants, the question becomes can you feel or see  the ripples. Placing the implants under the muscle decreases the chance of feeling or seeing the ripples but as in your case it doesn't prevent them. Replacing your implants with gel filled implants will help but not necessarily prevent rippling. It all depends on the amount of soft tissue over the implants. If exchanging the saline implants with gel filled implants doesn't completely do the job of hiding the ripples then you could consider having fat grafting to the soft tissue to hid the ripples. This will give you bigger and nicer breast and works very well. The limit here is do you have enough fat to graft. 

Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 15 reviews

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.