What treatment would you recommend to correct severe rippling and bottoming out? (photos)

Last September I had revision surgery for capsular contracture. My doctor gave me 500 cc low profile implants to close the gap between my breasts and placed the implants over the muscle to attempt to give me the round, "fake" look I asked for. Now I have extreme rippling and it appears to me the left breast has bottomed out. I want the look of a high profile implant, what's the best solution (alloderm, internal sutures, under the muscle, or even a full lift or overfilled saline)?Thank you!

Doctor Answers 5

Support and high profile implants sub muscular

Thanks for your question. You have a difficult problem, and I would go
back to your surgeon for a revision or seek a board certified plastic surgeon who does a lot of breast surgery. If you had longstanding large implants and a recent capsulectomy, it can lead to a typical scenario of a very thin lower pole that leads to ripples and bottoming out. You will probably need sub muscular implants with a neosubmuscular pocket and support with either a dermis product (alloderm/flex hd) or more recently a silk product (Seri). Both add cost to the revision but there is really no other good way to hold up the implants and thicken the lower Breast envelope. After years of implants, further revisions are more like reconstructive cases to obtain good results.  

Santa Barbara Plastic Surgeon
4.8 out of 5 stars 17 reviews

Breast revision

As you may already be aware you will need a revision operation. You ask good questions regarding available options and techniques. The answer depends on many factors such as your existing breast tissue quality, the quality and usability of your inner capsule and your expectation about your final outcome.

It will take a combination of techniques to allow you to achieve your vision.

A lot of things are possible. 

John M. Anastasatos, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 29 reviews

Correction of severe rippling and bottoming out after breast augmentation

I'm very sorry to see your result.  Of course an in person examination and evaluation is necessary to give you a proper answer.  However based on your photos  The use of textured breast implants placed in the submuscular location with the addition of AlloDerm or other matrix for support and most likely a revision of your breast lift with further skin excision is necessary.  Please consult and experienced board certified plastic surgeon.

You will need a dermal matrix

From your photo you will at least need an Alloderm type matrix to treat the bottoming out.   This issue should be approached using breast reconstruction techniques.  Your problem has a solution that can be determined with proper examination.

Dev Wali, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 56 reviews


Thank you for the photos and I would suggest using a protein matrix, Submuscular placement and textured Sientra implants that don't ripple but a full exam is really needed

Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 61 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.