Visible Rippling Just 3 Days Post-op, Possibility of Getting Better? (photo)

I have 330cc silicone implants placed over the muscle. I had very little native breast tissue in my upper pole, and am 5'2" 115 lbs. I'm already seeing rippling 3 days post op. Help! It's in the middle of my chest, where the skin has stretched the most. Is there any chance that this will improve and that the rippling is actually due to the skin being swollen and stretched too tight? Any chance this could get better as the implants settle or will it only get worse? Thanks for your help.

Doctor Answers 16

Rippling after breast augmentation

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Notwithstanding the excellent answers of other responders, visible and/or palpable rippling on the surface of augmented breasts may result from a variety of factors, and management of the problem depends on which   factors apply in your case.  Your pre-operative skin excess (increased breast surface to volume ratio) does not appear to be completely corrected by augmentation alone.  Pocket size, if too small, may cause a fixed wrinkle or ripple.  Skin thickness, implant placement, textured vs. smooth implant surface, amount of breast gland over the implant, and implant size all influence the development of skin surface rippling.  Your result will evolve as healing progresses.  The implant-tissue interaction is dynamic.  Your surgeon is best positioned to help manage this problem at the present time.

San Diego Plastic Surgeon
4.9 out of 5 stars 50 reviews

Rippling Not Going to Get Better

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No I afraid that if you are already rippling 3 days post op it is only going to get worse not better.  Your choices are to convert to submuscular or fat grafting.

Rippling only gets worse over time

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Unfortunately, rippling virtually never gets better on its own and typically gets worse over time. There are many reasons to put implants under the muscle including less rippling.  Implants under the muscle also have lower risk of capsular contracture, less sagging over time, they are less palpable, they tend to feel more natural and the implants get in the way less for cancer screening mammograms.

James McMahan, MD
Columbus Plastic Surgeon
4.8 out of 5 stars 40 reviews

Rippling of the breast 3 days after surgery

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I am sorry that you are unhappy with your results.  They were predictable.  You don't say whether the implants are saline or silicone.  Silicone shows less ripling.  If they are textured the rippling is more visible.  As the swelling goes down you will see the rippling get worse; not better.  Your breasts are also a bit lax.  A tighter skin envelope would be better. I would have recommended a subpectoral placement of silicone implants and mastopexies.  We have undoubtedly made your disappointment far greater in agreeing that you had the wrong procedure.  While you continue to heal you might see other surgeons in your area who will have the advantage of examining you.  Make sure they are all certified by the American Board of Plastic Surgery (those exact words).

Lori H. Saltz, MD
San Diego Plastic Surgeon
4.3 out of 5 stars 29 reviews

Visible Rippling Just 3 Days Post-op, Possibility of Getting Better? (photo)Answer:

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Probably the only chance you have for this to resolve on its own is if the capsule that will form over the next few months gets a bit tight. I have seen that put enough pressure on the implant to help “iron” out some of the wrinkles, but that is rare. So I would give it time and see if you get lucky and that happens, but from your “before” pics I would say that to go under the muscle, you would have needed and would still need a lift..Implants in thin women does cont to be a challenge..

John J. Corey, MD
Phoenix Plastic Surgeon
4.7 out of 5 stars 48 reviews

Rippling 3 days postop

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Hi there:

Are you really only 3 days postop?  Your breast appearance is more consistent with a longer term result, and it would be truly remarkable for you to have the photographed appearance at 3 days postop.  I'm not saying you're wrong - but it's important for you to confirm that this detail is correct in order to properly advise you.

The good news is that the lower poles look good and the implants are appropriately positioned.  The bad news is that for a really good outcome, the pocket will need to be changed to subpectoral for better upper pole coverage.

I am an advocate for implants on top of the muscle in the subfascial plane, so I support your surgeons advice to put implants above the muscle as he/she has, especially as you have mild droop on your preop picture.  However, with the best of intention and experience, a revision is occasionally needed to optimise the result and you will need that in my opinion.

It doesn't matter if your implants are saline or gel in that event.

Good luck.

Unlikely to improve but there are options

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Time alone is unlikely to improve the rippling that you are seeing with your breasts.  It is a two part problem really with the lack of tissue thickness being #1 and the laxity of your skin #2.  You can prove this to yourself by tightening the breast around the implant.  When the implant to skin ratio is better the rippling goes away.  Unfortunately tightening the skin that is thin and has lost its elasticity is unlikely to hold for the long term and the rippling will come back.  Options for correction include going to form stable implant, gaining weight, going under the muscle.

All the best,

Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Rippling, Breast Implamts, Subglandular

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It's unfortunate your implants were put above the muscle as you have very little thickness of breast tissue to hide the ripples. The result is slightly blunted, ie better, right now because of swelling and will not get better but will probably become more obvious over timw as the swelling lessens. After a few months and healing is complete it is easy to go back and cover the upper part of the implant with the muscle. Make sure you have a surgeon that has experience with that operation. It is definitely not as easy as putting the implants beneath the muscle with the initial operation. And ask for smooth implants as opposed to the textured type.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Correcting Wrinkling of Implants

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Implant charachteristics, such as wrinkling or the edges of the shell are more visible in women with thin tissues in the overlying breast and more likely in an over the muscle placement.  These features can make your result look less natural.  Silicone implants perform better than saline when it comes to implant visibility.  Submuscualr dual plane positioning gives more cover.  Sometimes it is necessary to use a piece of acellular dermal matrix such as alloderm or strattice, to provide a little more cover and stability for the implant.  Fat transfer to the breast can also be valuable to camoflauge implant characteristics.  I agree with Dr. Rand that a lift and submuscular placement would have worked better.

Mary Lee Peters, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 117 reviews

Early Implant Rippling After Breast Augmentation

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Unfortunately, once someone has a ripplin issue with the breast/implant, it does not get better on its own.  Rippling is simply the result of the tissues being too thin to fully mask the device itself.  Because of this, you see the folds of the implant through the tissues.  This is the reason that it is nice to place the implants submuscular when possible.  Adding a little bit of extra tissue between the outside world and the implant helps.  It is not perfect, but it can improve palpability and rippling issues.  I hope this helps.

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.