Is the rippling in my breasts caused by exercise? Are my breasts saggy or the correct shape for tear drop implants? (photo)

450/400 cc tear drop shaped silicone implants placed under muscle almost 1 year ago. My doctor chose tear drop bc I had no breast tissue at all after nursing my son. I have rippling in my cleavage area and feel like my breasts look droopy. I am concerned that I changed the outcome of my breasts because I am very active (running (10ks) and yoga daily) Or is this how tear drop shape implants are supposed to look? Thank you!

Doctor Answers 4


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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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Because you are so thin this may be an example of traction rippling or the textured implants pulling on the overlying tissues, its not harmful but I agree fat grafting may be a niice choice to camouflage it

All implants ripple. It is a question if you can see and feel the ripples .

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Since all implants ripple it is a question of how to prevent the ripples from showing or being able to be felt. Saline implants ripple the most, smooth wall gel implants less rippling and textured gel implants ripple least. Putting the implants under the muscle minimizes the possibility of ripples, under the breast has the highest possibility of seeing ripples and under the breast and under the muscle (dual plane) is in between. Since you have gel implants under the muscle you could improve the ripples by placing a textured gel implant under your muscle but I don't believe that will resolve your problem. What I have found that work relatively well is to harvest fat from your own body and fat graft the soft tissue in the areas of the ripples. This doesn't prevent the ripples but by thickening the soft tissue over the ripples it can and often does hid the ripples. Unfortunately patients who get ripples are often thin and have little fat to graft, but I can usually find enough fat in the medial thighs if that is the only place available . 
Ask your surgeon about fat grafting over the soft tissue where you see and feel the ripples. Make sure your surgeon has experience with fat grafting because if it is not done well the fat will not survive and there will not be any benefit. If done correctly there should be a 60-80 % take of the fat and it should last indefinitely.

Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 17 reviews

Breast augmentation rippling

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Rippling can occur for a variety of reasons and is more often seen with patients with very little native breast tissue. For this reason, rippling will often become worse with a larger implant since the tissue is being stretched thinner. Other factors that may increase the wrinkling or palpability include subglandular positioning, textured implants and saline implants.  Though we as surgeons attempt to minimize this issue, very thin patient with little breast tissue are at a greater risk particularly along the lower outer edge of the breast where the muscle does not adequately cover the implant. Your options include thicken of the tissues through the use of fat transfer or changing to a smooth round silicone implant which still may not completely solve the issue. Thanks for your question and I hope this helps.

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