What's the best choice for my breast implant rippling situation?

I have 400 cc mentor round mod + gel textured implants (subglandular placement). I'm training with heavy weights that's why I went on top of the muscle. But I asked for my surgeons opinion, if I had enough tissue to cover up or no and he said yes. But just 2 weeks after my op the rippling in the cleavage area has started and it got worse day by day. Now I'm 1 month post op and don't know what to do. They are not really big, in fact they're way smaller than I expected. What are my options?

Doctor Answers 3

What's the best choice for my breast implant rippling situation?

Generally speaking, 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.

Correction of the rippling may involve further surgery including implant pocket exchange if possible ( sub glandular to submuscular), implant exchange if possible (saline to silicone), and/or the use of allograft to provide an additional layer of tissue between the implant and the patient's skin. Patient weight gain (if possible) may also be helpful.  I hope this, and the attached link, helps. Best wishes.

Options to minimize rippling with over muscle implants

You have several options to improve rippling in the cleavage area but each has trade-offs:

  1. Convert to the split muscle plane. This would provide coverage where you need it most but minimize animation deformity. (Split muscle plane is not dual-plane.)
  2. Internal bra. The best material for this is Strattice, but it is expensive.
  3. Exchange the implants for a higher fill ratio type (Allergan Inspira or Sientra). These have less rippling.
  4. Fat grafting. In my opinion this is the least effective.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 47 reviews

Wrinkling

Wrinkling that appears in the cleavage area with some glandular placement of implants can be a troublesome problem. Certainly, a submuscular placement would hide most of these wrinkles. The downside for this approach in you is the animtaion deformity that weightlifting can produce. If you cannot move them under the muscle, than the other two options that have worked are fat grafting of the inside portion of the breast to thicken it and try to hide the underlying implant and the placement of an ADM. ADM's usch as Strattice have sometimes been useful in not only thickening the tissue but creating a smooth border that the implant can fall into. Ask your chosen plastic surgeon about the pros and cosn of each of these options. Best of luck.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 44 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.