Rippling vs night time bra. Is wearing a tight bra at night advisable after breast augmentation?

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

Rippling is not affected by the type of bra you wear. I believe there are very few situations in which anyone has to wear a tight postoperative bra. Many of my patients wear them for comfort, but in most situations a bra is not even needed.

The type of bra you wear has nothing to do with implants rippling. One of the  long-term influences on breast augmentation outcome is gravity. As a result, I recommend patients wear a supportive bra during their recovery, and as much as possible after fully healed. Best of luck 

Thank you for your question.  One of the greatest long-term influences on breast augmentation outcome is gravity.  As a result, I recommend patients wear a supportive bra during their recovery, and as much as possible after fully healed.  Appropriately sized bras provide support for the breasts and implants, taking stress off the breast skin, while minimizing the risk of implant displacement, where the implant has a tendency of moving lower and away from the body.  Hope this helps!

Thank you for your question.The gravitational pull on the breast implants tend to try and bring the breast implants down when standing and toward the outside when laying on your back.  The combination tends to pull the breast implants down and out.  To help minimize these negative effects that gravity has on the breast implants, I advise all my patient to wear a bra as much as possible and even at night.  The bra doesn't need to have an underwire but the underwire tends to help keep the breast implants more secure by adding additional pressure to the skin around the breast implants.  In addition, I advise all my patients to wear an underwire sports bra when exercising.  Traditional sports bras tend to smash the breast implants against the chest where the underwire sports bras tend to cup and support the breast implants.I hope this helps.  Best wishes!William J. Vinyard, MD, FACSBoard Certified Plastic SurgeonPalm Beach, Florida

No, using a bra in the night to avoid rippling doesn't have any anatomical or physiological explanation.Bra is very important after Breast Augmentation Surgery for the first month only by day, to manage the edema or inflamation that is its work. 

Rippling usually occurs as a result of having thin soft tissue covering the implant.  If the implants are subglandular, then submuscular may be better. Fat grafting or ADM may help too.

Thank you for your question. I think there are as many opinions on post-op bra wear as there are plastic surgeons. I almost always place implants under the muscle layer and do not have my patients wear bras for at least a month until the implants have adequately settled. I do have my patients massage the implants starting 5 days post op, particularly in the downward and inward direction.Ripping on the implants are caused primarily by three factors: 1. thin overlying soft tissue (that's why we usually place implants under muscles), 2. capsule contracture, which causes the implants to fold on itself, and 3. material inside the implants (silicone is more viscous and therefore is less likely to cause ripples)Have a discussion with your PS about your concerns.

I am an advocate for the use of supportive bras after breast augmentation surgery.   In my opinion, the use of the supportive bra may help prevent breast implants from moving into the "paths of least resistance": down or out. Having said that, there is no “standard” when it comes to the use of specific bras or garments after breast surgery. In other words, different plastic surgeons may have different practices when it comes to postoperative dressings/bras.  

In my practice, patients wake up with a surgical bra in place. This surgical bra, although not attractive, is supportive and used for about one month after surgery (some of my patients have been known to burn the bra ASAP). Then, patients transition to a soft sports bra. Wired bras are used when breast implants have reached their “final position” and patients have full sensation along the breast skin. Generally, the longer I have been in practice, the more I appreciate the use of supportive bras for the first several months after breast augmentation and revisionary breast surgery. Best wishes.

Thank you for your question.  The type of bra you wear after surgery had nothing to do with rippling in the future.  My recommendation is to wear a supportive, comfortable, non-underwire bra after surgery so a sports bra should be fine.  Implants under the muscle have less incidence of rippling and silicone implants tend to ripple less than saline implants. Be sure to see a board certified plastic surgeon.