Will Smaller Breast Implants Be Less Visible Through the Skin?

I have very little breast tissue and went from a nearly A cup to a C cup. I am trying to weigh my options as my implants are not only very visible with rippling, you can feel every part of the implant through the skin. I am very fearful of Silicone implants, and I'd like to know, will getting my current implants replaced with smaller Saline implants make a noticeable difference?

Doctor Answers 16

Discuss your concerns with your plastic surgeon!

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Your question is actually very difficult because I do not have the opportunity to examine you or have photographs to review. Rippling and visible edges of the implant are potential problems with breast augmentation and may be due to several causes. You are correct in noting that decreasing the size of the implant may help. Typically placing the implants in a subpectoral position--beneath the chest wall muscle--softens the outline of the implant.

Other factors that need to be considered are your body size and shape, the size and shape of the implant, and whether the presence and degree of scar capsular contraction has formed around the implant. Bottom line is you should return to your plastic surgeon for a thorough examination and discuss your options. If another opinion is desired, then obtain a consultation with a board certified plastic surgeon experienced in breast augmentation.

I hope this helps you understand your problem.

Englewood Plastic Surgeon

Smaller implants placed under the muscle may help

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Using smaller implants placed under the muscle may help the problem, but it may be that the best option is changing to a silicone implant.  Talk to your surgeon about what is the right answer for your particular case.

Scott Tucker, MD
Winston Salem Plastic Surgeon
5.0 out of 5 stars 32 reviews

Smaller breast implants

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It  would sound as if you do not have much "cover" over your prostheses. Although there are many different variables in your situation, in my experience, using smaller, round, smooth silicone implants placed behind the muscle could improve the situation

Barry H. Dolich, MD (Retired)
Bronx Plastic Surgeon

Not likely

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Hi there,

The causes of implant visibility and rippling are usually related to thin tissues, stretched skin, and the thin nature of saline. While these problems can be minimized by placing implants currently on top of the chest muscle under it, the most effective way to improve rippling and the ability to feel the implant is to replace them with silicone.

I certainly understand your apprehension about this, and would refer you to the Institute of Medicine's Report on Silicone Breast Implants. It includes more information than you probably want but should help you be comfortable that silicone is safe and does not cause illness or other problems it was previously implicated of.

I hope that helps.

Rippling in saline vs. silicone gel implants

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Unfortunately, saline implants have a higher risk of potential rippling and palpation. They are not recommended for women who have very little breast tissue to begin with and/or low percentage of body fat. Basically, if you do not have enough coverage, you would be a better candidate for silicone gel. Silicone is FDA approved now since it is a cohesive gel, meaning it does not enter the bloodstream or cause any side effects if there is a malfunction or defect in the implant. It is definitely recommended for women of your body type to prevent riplling and palpation. However, depending on your body type, you may still be able to see slight rippling with silicone as well. The implants should be placed submuscularly as well to provide a more natural look and feel. Regarding size, even if you wanted to remove your current implants and replaced them with smaller saline implants, you would still have rippling. I recommend consulting with a board certifiedd plastic surgeon to discuss the best possible options for you. The use of alloderm may provide more coverage and address your concerns of rippling. Alloderm is processed skin from a cadaver which can help provide more coverage since your skin is thin. Discuss this with your surgeon for more information. Good luck!

Silicone gel implants are as safe as saline implants and are less likely to show rippling.

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I think your fears about silicone gel are unfounded and they probably are the best solution to your problem.  Many women who were required to have saline implants in the 90's have changed over to silicone gel.  Going above or below the muscle is of no importance with silicone gel although it clearly is with saline.

Rippling and chest wall

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Rippling develops because the soft tissue coverage over the implant is too thin. If you have rippling, there are several things that can be done. First, if they are above the muscle they should probably go under. Silicone tends to ripple less than saline. You may also want AlloDerm placed to enhance the soft tissue coverage. Remember that the lower pole is the area where all implants are usually most palpable.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Silicone implants may be your best option

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For very thin women, the risk of noticeble rippling exists regardless of what type of implant is used or where it is placed. However, I have found that this risk can be reduced with silicone implants which are modest in size placed behind the muscle. These implants are FDA approved and are used extensively for breast augmentation and breast reconstruction. I stress to all of my patients that the risk of rippling still does exist, but this is the best way to reduce that risk and it is usually successful in the majority of patients.

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
4.9 out of 5 stars 155 reviews

Size is relative

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Size is relative when it comes to breast implants. What may be small for one woman's breast tissue may be large for another woman's breast tissue. Also, you need to distinguish between size and volume. If you get a smaller size (diameter), then it may not be he correct dimensions for your chest/breast shape and will be very visible. If you go with too small or to large of volume, then the implant may be visible due to the effect on the overlying tissue. All of these factors play a part in the resultant appearance of your breasts.

New saline filled implant begining clinical trials in US

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Thin skin and saline implants do not do well together. Silicone gel implants are one good alternative but these implants may also be visible through the skin. If you are truly fearful of the gel filled implants, despite the overwhelming evidence you may be interested in a new saline implant that is undergoing clinical testing: The ideal implant. This is an interesting device, it is a saline filled implant with baffles. This is intended to diminish the negative effects of a saline filled implant. I have not yet seen this implant in use but it may eventually be an interesting alternative for women who do not want a gel implant.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 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.