Does Rippling Get Worse?

I am 5'7'' and I weight about 118 pounds. Before I got my implants (about 1.5 years ago), I was a 36 B weighing about 145 pounds. Since my weight loss, I can feel the rippling of the silicone implant, but cannot REALLY see it very much. I am still very happy with how they look. I am nervous that the rippling will become visible as time moves on though. I don't really have the money to get another surgery right now. Will the rippling become worse?

Doctor Answers 15

Rippling Can Appear After Weight Loss

With breast volume loss from aging, weight loss or changes after pregnancy, women may notice more rippling.

Options:

  1. Leave it alone, if it doesn't bother you much, especially if it is a matter of feel rather than visible ripples;
  2. Consider improving tissue coverage with fat grafting: fat is taken from the tummy or thigh and injected to thin areas of the breast;
  3. Surgical placement of Acellular Dermal Matrix (a collagen graft) over the area of rippling.
  4. Remove the implants;
  5. Gain weight.

Obviously their is a hierarchy of practicality and appropriateness to your situation to consider together in consultation with your surgeon.


Denver Plastic Surgeon
4.5 out of 5 stars 26 reviews

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.

#rippling
#breastaugmentation

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 99 reviews

Rippling with breast implants and weight loss

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.  With weight loss and age, you lose some of your native breast volume and you may find your rippling feeling or visibility may get worse.

One 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. 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. 

If your rippling becomes a greater concern, I would visit with a board certified plastic surgeon to discuss your options in more detail.

Thin skin, lack of soft tissue coverage and saline implants are not a good combination

It is always possible that the rippling along the lateral edge could get worse if your soft tissue coverage over the implant thins out.  If it becomes a visible problem many patients elect to use a gel filled implant.  These tend not to ripple like the saline filled implants.  Thin skin, lack of soft tissue coverage and saline implants are not a good combination. 

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 14 reviews

Rippling

From your description, the rippling is noticeable now because of weight loss, and inadequate tissue coverage over the implant. It will probably not change unless your weight changes. There are surgical options, but they can be costly.

Silicone implant rippling is minimal vs saline

As you describe your height and weight I am thinking that it is not surprising that you feel some rippling from the gel implants.  Your weight is low enough than it would be normal for you to feel some rippling.  If you had chosen saline the rippling would be much more apparent.  

In answer to your question of, will it get worse?  Your body will continue to age and you will lose more breast tissue just as you do in your face and the back of your hands.  So, yes you may see or feel a little bit more rippling.  What would you think of letting it go and enjoying your new breasts and try not to worry about tomorrow.  

Robert B. Winslow, MD (in memoriam)
Folsom Plastic Surgeon
1.0 out of 5 stars 2 reviews

Rippling of breast implants

Thank you for the question.
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.

Having discussed these issues,  PREVENTION of rippling/probability is of critical importance.

Much of the final “look” achieved after breast augmentation surgery  depends on several factors:



1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation “look” and "feel" will be optimal.




2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.  Make sure you're working with a well experienced board-certified plastic surgeon.



3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.




4. The size and model of breast implant used may  make a  significant difference in the final outcome,  including the presence of rippling/palpability  of the implants.

 I hope this helps.

 

Rippling

Rippling is more noticeable in a very thin patient and very difficult to correct. It is often less visible with silicone.  It can be corrected with alloderm in many cases.

Steven Wallach, MD
New York Plastic Surgeon
4.5 out of 5 stars 22 reviews

Visible rippling of breast implants: causes and solutions

In general, weight loss can make rippling more visible but does not generally result in more rippling. I see this quite frequently with some of my patients who can lose as little as 5 pounds and have more noticeable rippling particularly over the upper portions of the breast. Some surgeons use selective fat grafting for this purpose. Alternatively, implant removal and replacement with higher profile silicone implants may be another option

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

Rippling of Breast Implant

Silicone ripples less than saline.  Placing the implants under the muscle can help place more soft tissue over the implant and decrease visible rippling.  Weight loss can decrease the soft tissue over the implant and make rippling more vi sable.  Most women will feel rippling on the sides when they lean over.  You may see more rippling as you get older as soft tissue thins our with time naturally.  I would wait to make any changes until you see rippling that bothers you.  Always good to check with the plastic surgeon, (preferably who put them in for you), to be sure.

Jeffrey J. Roth, MD, FACS
Las Vegas Plastic Surgeon
4.5 out of 5 stars 14 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.