Can Rippling of a Silcone Implant Correct Itself Without Surgery?

Rippling after breast implant surgery is due to insufficient soft tissue coverage over the implant and also different properties of the breast implant itself.
Thinner patients tend to have thinner breast tissues, which means more of the characteristics of the implant will be visible. Imagine placing a tissue paper over a baseball vs placing a comforter over the same baseball, which one would you notice every stitch and groove?
As far as implant properties, more cohesive implants ripple less
Best,
Dr. Richland

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

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.

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.

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.

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

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.

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.

                  Several
factors are associated with the development of rippling following breast
augmentation surgery. These include sub-glandular implant placement, saline
implants and inadequate soft tissue coverage.

                  In
the majority of cases rippling doesn’t improve with conservative management or
the passage of time. Even with surgery this problem can be difficult to
correct.

                  In
many cases, the only option is surgical intervention. Surgical management
varies from patient to patient and depends on the cause of the rippling.

                  When
patients have sub-glandular implant placement, rippling can be improved by
moving the implant to a sub-muscular position. When saline implants have been
used, rippling can be improved by switching to silicone implants. Finally, when
the problem is related to inadequate soft tissue coverage, added support can be
provided by using supplemental materials like alloderm and strattice.

                  Without
pictures or a physical examination it’s virtually impossible to make a specific
recommendation in this situation. Your history suggests that moving your
implant to a sub-muscular position would be an appropriate first step.

                  Consultation
with your surgeon is appropriate as well. Your surgeon should be able to make
an appropriate recommendation to address this problem. 

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.