What is the Best Solution for Visible Ripples at the Cleavage After a Mastopexy/aug 625cc Subglandular, Smooth Round?

6mths Postop. 125lbs, age 50,very little breast tissue, sorry no photos

Doctor Answers 11

Visible Rippling

The best way to avoid rippling is to go under the muscle. This gives  you the added layer of muscle on top of the implants  In addition changing from saline to silicone will help.  Changing pockets can be a challenging operation and you will need to go with a larger implant to achieve a similar size.

La Jolla Plastic Surgeon
5.0 out of 5 stars 32 reviews

Ripples post-op

In general, a combination of putting the implants under the muscle, using silicone gel implants, adding fat and/or the use of an acellular dermal matrix such as Alloderm or Strattice is most likely to be successful in addressing ripples.  They are most common in - as appears to be the case with you - subglandular implants in women who have relatively little tissue (breast, fat) of their own.

I hope that this helps and good luck,

Dr. E

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

What is the Best Solution for Visible Ripples at the Cleavage After a Mastopexy/aug

Fat injections may correct the rippling,alternatively acellular dermal graft or mesh may benecessary

Hilton Becker, MD
Boca Raton Plastic Surgeon
4.6 out of 5 stars 15 reviews

Correction of Rippling of Subglandular Breast Implants?

Thank you for the question.

 As you can imagine, precise advice would necessitate direct examination. However, generally speaking, sub glandular breast implant rippling can be improved significantly with “conversion” of the breast implant position to the sub muscular position. Also, the use of acellular dermal matrix may be a helpful tool in this regard.

 I would suggest in-person consultation with board certified plastic surgeons who can demonstrate significant experience helping patients in your situation.

 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,484 reviews

Subglandular Augmentation with Little Breast Tissue

    Subglandular augmentation in a person with little tissue and rippling is to be expected.  A switch to a submuscular plane will help to some degree for the portion of the implant that is covered by muscle.  For the remainder of the ripping, fat grafting or dermal matrices are your two alternatives for camouflage.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews


Implants, especially the size you have, do much better behind the muscle.  You should have your implants converted to the submuscular position.

Ary Krau MD FACS


Ary Krau, MD, FACS
Miami Plastic Surgeon
4.8 out of 5 stars 318 reviews

Rippling after breast augmentation

Rippling after a breast augmentation can best be treated with conversion of a submammary augmentation to a subpectoral position.  If rippling still persists,  I would consider fat grafting to the rippled areas, or a revisional operation in which acellular dermal tissue such as Alloderm or Surgimend would be placed under the skin to add some support and contour to the rippledd area.  Always contact your Plastic surgeon for further advice in this regard.


Best of luck to you.


Frank Rieger M.D.  Tampa Plastic Surgeon

Rippling after subglandular aug with mastopexy

Rippling can develop over areas that have little soft tissue coverage.  If thisis in the upper pole, then you may consider implant placement under the muscle.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 27 reviews

Rippling Less Likely With Submuscular Implant Placement

You are less likely to have visible implant rippling with silicone implants placed under the muscle.  Your implants are also very large which will also lead to a higher incidence of problems.

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Under muscle to minimize breast implant ripples

One of the primary reasons that most implants are placed under the muscle is to minimize visible ripples. Another thing to consider is whether the diameter of the implants is large relative to the anatomic base diameter of the breast, especially with relatively large implants. Acellular matrix such as Strattice can be helpful.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 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.