Can Rippling of a Silcone Implant Correct Itself Without Surgery?

I'm 3 months post op after a breast lift revision (Capsulectomy) that affected my right breast. I have subglandular placement of smooth round silicone implants 375cc L, 397cc R. I am happy with the revision but may have been a little overzealous with aggressive messages right after the surgery. Now I have rippling on the interior (cleavage area) of the right breast, and I can also feel the side of the implant over my skin. Can this rippling correct itself or does it warrant further surgery?

Doctor Answers 15

Rippling

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.

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Orange County Plastic Surgeon
5.0 out of 5 stars 108 reviews

Rippling

Rippling may improve over time, but I suspect you may not have enough tissue over your implant in this area.  Several options exist for improvement, depending on the area involved.  The options may be replacement into a sub muscular plane, fat grafting, and placement of tissue grafts (acellular dermal matrix, or ADM).  This situation should be discussed with an experienced plastic surgeon.

Jeffrey D. Wagner, MD
Indianapolis Plastic Surgeon
5.0 out of 5 stars 10 reviews

Rippling with breast implants at 3 months

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. It can happen in one or both breasts.

If you notice the rippling at 3 months after surgery, I often recommend waiting until around the six month mark as your breasts may continue to change during that recovery period.

Should rippling persist, here are some options:

1)  Some implant styles are more prone such as an overfilled saline implant. Others are less prone such as a shaped silicone implant. So one approach is to change an implant to one that is less prone to rippling.
2)  Another 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.
3)  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 continue to follow up with your plastic surgeon and discuss options should your concern persist.

Rippling with a breast implant

First off I would wait another 3 months to see if this improves. I doubt it will and you will most likely need corrective surgery. I would consider using 5th generation silicone implants placed under the muscle. You may also need further lifting for pocket reduction or an ADM or fat grafting.

Ripples around the breasts after silicone implants

The ripples may improve with time. There are some minor corrective steps, including fat grafting, that can help the area if needed in the future. 

Best, 

DR. Karamanoukian 
Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 85 reviews

Can Rippling of a Silcone Implant Correct Itself Without Surgery

Three months, one may notice further changes in the shape of your breasts and this may also affect the rippling.  You may wish to have a good discussion with your surgeon to see what your surgeon feels is the cause of it.  If it is still present in about six months and it is mild, and if you do not wish more surgery, there is the possibility that fat transfers may help.

Rippling after surgery

It is possible that the ripples may improve on their own without surgery.  If not, you should discuss your options with your surgeon.  Placing the implants under the muscle or adding acellular dermal matrix may help to to improve the result.

David Stoker, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 37 reviews

Rippling of Breast Implants?

Unfortunately, it is not possible to give you good advice without direct examination.

Generally speaking, palpability  and rippling of breast implants may be related to several factors. These include the amount of soft tissue and breast tissue coverage over the breast implants, the position of the breast implants (submuscular versus sub glandular), the type of implants (saline versus silicone), and the degree of overfilling of saline filled implants. Generally, weight loss will extension weight any rippling/palpability  of the implants.  Deflation of the implants will also increase the rippling/palpability of the implants.

Correction of the rippling may involve further surgery including implant pocket exchange if possible ( sub glandular to submuscular), implant exchange if possible (saline to silicone), and/or the use of allograft to provide an additional layer of tissue between the implant and the patient's skin. Patient weight gain (if possible) may also be helpful.

Best wishes.

Silicone ripples in breast augmentation

I would be less concerned with the palpability of an implant rather than the visibility of the wrinkles or ripples. Discuss your concerns with your plastic surgeon. From your description, it is difficult to make any recommendations. Massage generally helps rather than makes it worse.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 69 reviews

Breast revision for rippling

The only way you can mask the ripples above the muscle is to gain weight and cover the implants with thicker tissue.  Otherwise you need to go under the muscle or use Strattice to cover the implants.

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.