Traction rippling with textured anatomicals?

For thin women with little breast tissue, do the chances of traction rippling increase with the size of the implant? If I were to choose a significantly smaller implant than the max for my bwd, would that decrease the risk?

Doctor Answers 3

Traction rippling should be minimal with shaped textured implants

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if you heal ideally... with no excess space around your pocket and the implant snugly 'attached' to your chest.  But the larger the implant, the more stretching of your tissue and presumably, the greater the risk for traction rippling.  But no one can tell you exactly where the rippling will begin so my advice would be to get the look you want and if you happen to get traction rippling, so be it.  At least you will look great except when bent over at the waist.

Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Traction rippling with textured anatomicals?

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Thank you for the thoughtful question.  Although I cannot provide you with specific advice here, I would say that generally the use of larger breast implants (that "push" the patient's breasts anatomic limitations), are more prone to implant rippling/palpability, compared to smaller breast implants.  In other words, the use of smaller breast implants tends to allow for  better coverage of the breast implants by the patient's soft tissue coverage.   There are no hard and fast rules when it comes to diameter of breast implant versus diameter of breast (band width). In other words, these measurements are useful but are only one of the many factors come into play when it comes to selection of appropriate breast implant size/profile.

Patients undergoing breast augmentation surgery should remember, that even with careful execution of the procedure (such as pocket dissection…) and careful selection of breast implants type/size/profile, that some breast implant  rippling/probability can occur.  Even with breast implants in the sub muscular (dual plane) position (which I think is a preferred position for breast implant positioning for most patients, including athletes), there are certain areas (such as the sides and the lower aspects of each breast) that are more prone to breast implant rippling/palpability. Furthermore, patients may feel or see the breast implants more so in certain positions, such as bending forwardr of twisting their torsos, when the overlying soft tissues move  more so than the underlying breast implants.   Therefore,  communicating the need for realistic expectations prior to proceeding with the breast surgery is important when it comes to  breast augmentation surgery.  If I get the sense that a specific patient does not understand that breast implants are, after all, a foreign body that  very rarely "behave" as we wish (precisely simulate breast tissue), then I do not offer the operation to the patient.

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 saline implants will also increase the rippling/palpability of the implants.

Also, generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of know words such as “natural” or "C or D cup” etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.

3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers. I hope this (and the attached link/video, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

Rippling in anatomical breast implants.

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Hi and thanks for your question. Without seeing you I cannot predict what the risks would be in your case, However, the form stable breast gel reduces the risks of rippling when compared to the softer round breast implant gel that is used in a textured round breast implant. I have placed about 200 Mentor anatomicals and see very little rippling even in "thin patients". Hope this helps, Dr. ALDO

Aldo Guerra, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 215 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.