Is There a Way to Camouflage Rippling from Breast Implants? What (If Any) Are my Non-surgical Options?

Question

I've recently lost weight and have noticed rippling in my saline breast implants for the first time since I first got them 5 years ago. They were placed under the muscle, so I'm upset with the visible rippling. Is there any way to camouflage this without having to undergo another surgery? If I DO need a revision, how much would it cost to replace saline implants with silicone? I live in the Los Angeles area.

Matthew Schulman, MD · Answer

A surgical revision that includes exchange to silicone implants with placement of acellular dermal matrix such as Alloderm or Strattice would be ideal. Less invasive options would include injection of fa around the edge of the implant. This may help to camoflauge the visible rippling but does involve liposuction to harvest the fat. A totally non-surgical option does exist and i have written about in in The Breast Journal a few years ago. It is the use of injectable Sculptra. I have injected it around visible breats implants with very nice results. It requires several treatments (4-6) done monthly and the results can last several years. This is probably your only completely "non-surgical" option and is obviously not as good as the first surgical option I described.

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

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 implantsLarge implantsThin patients with low BMIImplants placed above the musclePrior history of ripplingFactors which are less likely to have rippling include:Heavier and larger breasted womenUsing a highly cohesive form-stabile silicone implants (gummy bear)Smooth implantsSmaller implantsSubmuscular placementOnce 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.#rippling#breastaugmentation

Amy T. Bandy, DO, FACS · Answer

I agree with the previous posts.  Sculptra can help, but you would need alot of sculptra, and it can add up very quickly, even close to an amount for a surgical revision. You dont say where the rippling is, whether it is near the cleavage or on the sides. Saline implants have a higher incidence of rippling than silicone, but even silicone can get rippling when there is thin soft tissue coverage and/or the implants are large and extend beyond the boundaries of your natural breasts.  Behind the muscle placement helps, but the outer third of the implant is not covered by muscle, and this is where most rippling occurs.  Without seeing you, it is difficult to comment, but often changing to silicone and doing a capsulorraphy (tightening the capsule around the implant) can alleviate the rippling.  If the rippling is severe, and the soft tissue coverage is very thin, then adding strattice or alloderm may be necessary.  Sculptra is another option, or fat transfer, but the fat would be dependant on whether you have sufficient amount for harvesting and transfer.  I realize these are all options for surgical revision, but that is really the only thing that is going to make a difference. Estimated cost is difficult to say because it will depend on what you end up having done.  Good luck!

Gerald Minniti, MD, FACS · Answer

Hello Firefly 2,

	I am sorry you now have rippling of your breast implants.  I wish there was a way to lose weight only in the areas that you wanted!  Unfortunately, there are no non-surgical options to eliminate rippling except to regain the weight, which I assume is something you don't want to do.

	If this is something that you absolutely need to take care of, then you will have to undergo some surgical procedure. The causes of rippling are many, and so therefore how yours should be fixed is uncertain. A physical exam will help determine what is the best approach, possibly including changing the implant to a smaller implant, changing to a silicone gel implant, and/or adding strips of acellular dermal matrices like Alloderm or Strattice.

	I hope you can resolve this issue.

	Best of luck!

Richard H. Tholen, MD, FACS · Answer

I'm sorry to hear that losing weight has caused an unsightly change in your breast appearance. Unless both implants were to miraculously and simultaneously leak equal amounts, you can be sure the implants have not changed, it is your weight loss that has exposed what has been present all along. Thank heavens you were submuscular, or this would be an even worse concern!

	Other than a good push-up bra, there is NO non-surgical way to "fix" this issue.

	Surgical options include fat grafting to "fill" the rippled areas, but this rarely works well, and involves more than one session in many cases. Not advised.

	Additional saline can be put into the implants IF they were underfilled at surgery. For moderate size implants, 10% more saline than the stated implant volume is about right, but that decision is made at surgery with the tissue conditions seen at that time. That is the problem when you lose weight. If you had 350cc implants filled to 350cc, then filling to 380-390cc may help the rippling, but in my experience even this will not eliminate rippling, only improve it, making for one unhappy patient who was expecting her ripples to "go away completely."

	Switching to silicone gel implants is the best of all options, and ALWAYS improves (but may not completely eliminate) visible rippling. Doing the surgery sooner rather than later may improve the results, as implant ripples can become capsule ripples over time, making improvement less dramatic in these patients.

	Costs are up to your surgeon. I charge for implants, OR, and anesthesia (no surgeon's fee) for my own patients. Unless capsule work needs to be done (for longer-term rippling, contracture, position change, or for placement of larger implants), this may be done under local anesthesia. Otherwise, going to sleep will be recommended. Cost will be less than your original augmentation, but it will still be a couple thousand dollars to more, especially on the coasts. Good luck and best wishes!

Is There a Way to Camouflage Rippling from Breast Implants? What (If Any) Are my Non-surgical Options?

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Is There a Way to Camouflage Rippling from Breast Implants? What (If Any) Are my Non-surgical Options?

Answers (8)

Answer: Breast Implant Rippling

Answer: Breast Implant Rippling

Answer: Rippling with saline breast implants. What to do.

Answer: Rippling with saline breast implants. What to do.

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Recommended reading

Everything you need to know about Breast Implants

Our mission is to create a world where every investment in modern beauty is Worth It.