Does Silicone Ripple Less Than Overfilled Saline?

I went for my first consult last week and I was unfortunately told that I am not a good candidate for saline due to being thin and having only a small amount of breast tissue. I am 5'2", 104 lbs, 32 A with a 28 inch ribcage, 36 years old, some deflation of upper-pole from BF 2 kids but not really any sag. He said saline implants might look good for 1 or 2 years but then I would likely have rippling. He suggested 325-375 HP silicone to get me to a full C. Does this all sound accurate to you?

Doctor Answers 31

Silicone gel implants vs. overfilled saline implants for rippling

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Silicone gel implants generally ripple less than saline implants.

Overfilled saline implants can appear too round in some patients.  It is generally better to stick to the manufacturer's recommendations for filling guidelines.

Patients with thin skin are better off with slightly smaller silicone implants.  This minimizes exposure of the implant and rippling.

Unfortunately, rippling can not be completely eliminated in many thin patients with small amounts of natural breast tissue.  As you can see from red carpet pictures, even those patients with the most beautiful breasts have rippling.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 194 reviews

Gel vs. Saline filled implant

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An overfilled saline filled implant in a thin patient is not a good idea. The implant can look to round and it increases the risk of rippling along the edges of the implant.  If you are thin and your breast is going to be more implant than you then you will always do better with a gel filled implant.  Atlanta Plastic Surgeon, Dr. Z

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Silicone vs Saline implants

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In my opinion, overfilling saline implants beyond the manufacturer's recommendations is not advisable.  However, I am a proponent of filling the saline implants to the maximum allowable volume that is recommended.  Silicone implants do have a lesser tendency to ripple than properly filled saline implants.  For thin women with a paucity of breast and soft tissue coverage, placing a silicone/gel implant under the muscle would give the most natural result in most cases. 

John L. Burns Jr., MD
Dallas Plastic Surgeon
4.7 out of 5 stars 56 reviews


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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.



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in general, the "rippling" in silicone is not actually rippling but rather folding. saline is the only implant that has ripples and whether or not you see them has more to do with the thickness of your skin than the implant. the fact is all saline implants ripple but you don't always see rippling

Rippling saline implants vs silicone implants

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Women with less of their own natural breast tissue,  or implants placed under breast tissue and over muscle
with larger implants are more of a risk of developing rippling. However reputable surgeons apply techniques that minimize this risk.  

Cohesive silicone implants are less prone to rippling, but it is still a risk. 

Rippling of Breast Implants

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Thank you for the question.

Generally, silicone breast implants tend to “ripple” lesson saline breast implants. However, significantly overfilled saline implants tend to ripple less sense to local gel breast implants ( these overfilled saline filled implants however can be very firm).

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.

I hope this helps.

Avoiding high profile implants for a tear-drop beautiful shape

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I would absolutely agree with avoiding Saline implants, but would think carefully about high profile implants and submuscular placement.  Usually high profile implants in that range are too narrow to fill up a natural breast footprint.  I prefer to use lower profile implants and shape the implant into a wide circle at the bottom that tapers to a teardrop at the top.  This is achieved with subfascial placement.  I use my own version called 'cold-subfascial' placement that allows me to create this natural shape and offer my patients the long term support of an internal brassiere of fascia.  Make sure the implants have sufficient base width to give you full breasts!


All the best,


Rian A. Maercks M.D.

Silicone gel implants ripple less than saline implants

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Silicone gel implants definitely ripple less than saline implants.  Overfilling saline implants by up to 10 or 15% will reduce rippling.  However, overfilling by 25% or more may paradoxically increase rippling and will cause your implants to be firmer than you may like.

Even overfilled saline implants ripple more than silicone gel implants.  

If you decide upon saline implants, they will ripple far less when placed under muscle (rather than above muscle) because the muscle adds a layer of camouflage.  I would also consider an overfill of up to 10 to 15%.

Ronald Friedman, MD
Plano Plastic Surgeon

Saline vs. Silicone for Rippling

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Typically, silicone tend to ripple less than saline.  That being said, any implant can ripple.  This is especially true in thin women.  Placing the implant under the muscle may also help hide the implant and decrease rippling.  Best to see a few board certified plastic surgeons.  Take photos with you of what you might want to look like.  Please have reasonable expectations.  Together you and the plastic surgeon can make an appropriate decision.

Jeffrey J. Roth, MD, FACS
Las Vegas Plastic Surgeon
4.6 out of 5 stars 17 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.