MP or HP Breast Implants for Less Rippling?

Question

I am 5 foot 3 and 92 lbs.  I currently have moderate plus smooth round gel implants but am now considering switching to high profile.  Since I was flat prior to my Breast augmentation without breast tissues, I am concerned that High Profile implants will overstretch or thin out my breasts and cause damage to the chest wall in the long run.  What do you think?  I have heard different views in terms of rippling and am now very confused.  Which Silicone implant profile ripples less? I hope to hear agreeing opinions at leas.

Steven Teitelbaum, MD · Answer

The biggest factor that reduces rippling is tissue coverage ---it is not the implant!
 
Putting high profile implants in someone who was "flat" is a recipe for tissue thinning and implant visibility, be that rippling or even the edges of a non-rippling implant.
 
High profile implants have their role for reconstruction after mastectomy, but in a 90 pound woman it is a prescription for a round, fake look, and tissue thinning over time which will be unable to conceal the presence of underlying implants.
 
I don't know what size you are now...but if you were sized appropriately for your tissues, then you should not change your implants simply for size.

Young R. Cho, MD, PhD · Answer

Thank you for your question. If you are changing styles of implants but not the volume, then impact on skin stretching above and beyond what has already happened with the first breast augmentation should be minimal.  If you go larger, then you will continue to stretch your tissues.  Rippling can be seen when the surface of an implant shadows through the tissue, often found where the breast tissue coverage is thin.  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 such as the shaped silicone implants.  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.  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 you notice the rippling soon after surgery, I often recommend waiting until around the six month mark as your breasts may continue to change during that recovery period. I would visit with a board certified plastic surgeon to discuss your options in more detail.

Larry S. Nichter, MD, MS, FACS · Answer

The larger the implant, the more likely you will stretch and thin your soft tissue covering it an more likely to have additional waviness. I would follow the advice of your board certified plastic surgeon. It is very difficult to determine the exact size, profile type, and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the following link.

Trevor M. Born, MD · Answer

Dear Imnyc
You ask a very good question in regards to all breast implants- whether saline or silicone and shape of the implants.  The bottom line is that if you have very thin breast tissue then the visible or palable rippling of the breast implant is likely no matter what type of implant in used.  If you change to a high profile implant you will most likely end up with a very prominen and  round  shaped breast- more visibly augmented than a 'natural' shape of breast and no change in the rippling.
With Warm Regards,
Trevor M Born MD

Jeffrey E. Schreiber, MD, FACS · Answer

Unfortunately, rippling is something that all implants my do regardless of what kind you get. If the skin is stretched out too much with either HP implants or very large ones then yes, you may feel the rippling more. Nonetheless, as your swelling goes away and the implants settle you may feel rippling. This is true even if you get the implants underneath the muscle. When rippling does happen it's usually painless. However, if the rippling is caused by severe scar tissue, you may need the scar tissue removed. Good luck!

George Marosan, MD · Answer

As you describe that you were "flat" prior to augmentation and you are 92lbs tells me that you do not have a lot of fat and only minimal breast tissue at best. Rippling is seen most commonly with saline implants, but it can be seen with gel implants as well. Rippling is a result of thin or inadequate tissue coverage and also a traction pull phenomenon that the weight of the implants can cause especially in someone with a thin skin envelope. Going to a larger implant will solve this for you in the short run, but you will end up with rippling. A possible solution would be to place a sheet of Alloderm inside the capsule to thicken up the tissue coverage over the implants and mask the rippling. You might want to discuss this option with your surgeon. Best of luck.

Robert W. Kessler, MD, FACS · Answer

I definitely feel the moderate profile implants ripple more than the moderate plus and high profile implants but I am not convinced there is a significant difference between the moderate plus and the high profile.If you are trying to improve the rippling present with your moderate plus by increasing the profile I will caution against this. The problem I assume you are having is more likely related to the breast tissue and skin than the implant.A high profile implant with the same base diameter is going to have a greater fill volume which will place more tension on the skin and breast tissue. This may look better initially but will give you more problems down the road as the overlying tissue continues to stretch and thin making the implant more apparent over time.I would return to your Plastic surgeon and get their opinion on how to address your specific concerns. 
I hope this was helpful.

John LoMonaco, MD, FACS · Answer

But the thickness of your overlying skin and breast tissue does.  So does the use of a textured implant (generally more wrinkling)   vs.  a gel implant (less wrinkling).
Sometimes rippling is inevitable in thin individuals with little breast tissue, regardless of the type of implant, especially when you lean forward or raise your arms.
You are right that an implant that is not sized appropriatey for your amount of  skin can damage the skin or result in an unnatural breast shape or abnormal breast implant position.
Discuss these concerns in detail with your surgeon.

Nina S. Naidu, MD, FACS · Answer

Hi,
I've used many different types of breast implants, and I have not seen a difference in rippling between moderate plus versus high profile implants.  I would agree with one of my colleagues on this forum that moderate implants and textured implants do seem to be associated with slightly more rippling.  The amount of rippling you may see is also influenced by how much tissue is covering the implants.  Since you are very thin, I would recommend having the implants placed beneath your chest muscle for better coverage and therefore less potential for obvious rippling.  Moving to a high profile implant may stretch out your skin a bit more, so you should consider if you are willing to accept this in return for more projection with the higher profile.  Good luck.

Christopher L. Hess, MD · Answer

There is no difference in the rippling of different implants. Because you have so little breast tissue over the implant is the reason that the ripples are evident. Going to a high profile implant will stretch the overlying breast tissue more where the implant is. The more pressure the implant places on the breast tissue the thinner it will get as well as thinning of the ribs.

MP or HP Breast Implants for Less Rippling?

Answers (16)

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