Lost 15 lbs and the implant started rippling? (Photo)

Question

Had BA surgery (250CC silicone above the muscle) in September 2023. I lost 15 lbs in the previous 3 months. the implant started to ripple(shown in the pics). How bad is it? I'm not sure weight loss is the only reason since I did some pull-ups, pull-ups, ran a lot and slept without bras slept on my stomach sometimes .Will the rippling just go away by itself?Can I continue doing pull up push up and lose more fat?Besides surgery, r there any other ways to get rid of it? Thank you in advance.

Brian K. Reedy, MD · Answer

Thanks for your question! Unfortunately, one of the risks of going over the muscle is rippling. As you lose weight and body fat, that may get more noticeable. You may be a candidate for fat grafting to help camouflage the rippling. I would suggest reaching out to your plastic surgeon to see what your options are. Good luck!

Stanley Castor, MD · Answer

Hello,
Thank you for your question. When your implants are above the muscle, they are closer to your skin. So, if you lose weight, the skin may show ripples. It doesn't really go away unless you put on more weight so that there is more fat to cover it up. Exercising is not going to worsen the rippling. There is not a way to get rid of the rippling without doing surgery such as a fat transfer to the area or having the implant placed under the muscle. Hope that helps.

Gerald Minniti, MD, FACS · Answer

Everything you see was a predictable outcome. Subglandular surgery has not been considered a good option for anyone for a while, despite some surgeons still performing it. You'll need a revision surgery to replace your implants into the subpectoral position.

Connie Hiers, MD, FACS · Answer

The ripple is showing because of thinness of your breast tissue there. It would be best to place your implants behind the muscle to give more coverage.  The ripple will not go away.

Karl William Schwarz, MD · Answer

Your rippling is now visible for two reasons: One, your weight loss has thinned out the tissue between your implant making the edges of the implant more visible and two, the placement of the implant directly under the breast rather then the chest muscle. By placing an implant under the muscle there is another layer of tissue that can cover the implant and make it hard to see or fee rippling.

There are solutions but unfortunately all of them involve surgery. A simple solution would be fat grafting to the area of implant visibility. A small amount of liposuction can gain some fat and this fat can be grafted to the area to help increase the tissue coverage of the implant. Sometimes a second repeat fat grafting is necessary.

A more invasive approach would be to relocate your implants to the sub-pectoral position, that is under the pectoralis major muscle, (your large chest muscle) and you could also use a material such as Strattice to provide you more tissue coverage of the implant as well and you could also add some fat grafting at the same time.

All of this just depends on how much it bothers you, how likely you are to regain the weight and what your tolerance for recovery is. There is nothing harmful going on so choosing to do nothing is also a viable option if you feel surgery is too aggressive for the problem.

I would sit down with your surgeon and discuss all of your options and take some time to consider things before making your decision.

Camille Cash, MD · Answer

Rippling and wrinkling are one of the risks of breast augmentation.  They are more likely to be seen in patients with implants placed above the muscle, those with thin skin/poor elasticity, and those with minimal breast tissue.  When implants are placed under the muscle the muscle will camouflage a portion of the implant including these characteristics.

Mats Hagstrom, MD (license on probation) · Answer

I think you would not have these problems if your implant was placed under the pectoralis muscle.
UsuallyI think you would not have these problems if you’re implant was placed under the pectoralis muscle.
Usually rippling is seen only in the lower part of the breast, but can form the upper part of the breast when the implant does not have coverage of the pectoralis muscle.
Converting to a sub pectoral augmentation is a pretty big procedure and there’s something to be said about not messing with something that’s working.
The rippling is probably not going to go away on its own.
Lower profile implants tend to have less rippling.
You have to ask yourself how much this bothers you and what you’re willing to go through in order to correct it.
Having repeat revision surgeries can lead down a road of more problems.
 Sometimes revision surgery is clearly indicated.
I generally recommend putting implants under the pectoralis muscle.
The weight loss may have had subtle impact, but I would still recommend patient stay lean because it’s what most patients feel good about being.
Follow up with your provider or schedule if you in person second opinion consultation.
For second opinion consultations come prepared to bring with you a complete set of proper before and after pictures and a copy of your operative report.
These are all part of your medical record that you can request from your current providers office.
Best,
Mats Hagstrom MD

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