Rippling, possibly bottom out? Why does this happen and how can it be fixed? (Photos)

All implants will ripple when leaning forward. in most cases they are covered with adequate tissue to hide this. Your implants are under the muscle, but it appears that the areas where the rippling is visible is beyond the lower edge of the muscles. The appearance after pregnancy is likely related to a loss of tissue coverage. You may have less breast tissue or fat after the pregnancy. Sometimes implants will show rippling after time just due to natural stretching and thinning of the overlying tissue. This is more common with larger implants. There are not many options to treat this. Fat grafting may improve the appearance but will not likely hide this completely.

Rippling is typically a consequence of inadequate tissue camouflage. Implants will typically all show some evidence of rippling on imaging however, this is not easily appreciated by the naked eye because of soft tissue coverage. Leaning forward tends to accentuate rippling by pulling the soft tissue coverage away. The goal in sizing is to select a device which can be comfortably hidden by your anatomy.

With regards to your specific question, your degree of ripple is minimal and only visible when leaning forward and allowing the device to hang. This can be addressed via fat grafting to accentuate coverage by soft tissue.

As always discuss your concerns with a board certified plastic surgeon (ABPS).

Thank you for the inquiry! We would love to sit down with you to discuss your concerns. Typically, when you have thin skin, you can see some rippling. A little fat transfer can hide the rippling. As long as you are wearing a good compression bra when running, it should be fine. Schedule a consultation with a Board Certified Plastic Surgeon to help you reach your goals.

Thank you for sharing your concerns and photos. As a plastic surgeon, I tell all of my augmentation patients that the key to having a natural result is to make sure that the implant is hidden by your existing anatomy. I anticipate that your surgeon was thinking the same thing, That's why your implants were placed under the muscle (at least in part) and they chose a Natrelle soft touch implants (somewhat cohesive but still soft). I would have done the same things. The great unknown was your pregnancy. During and after pregnancy, many women experience some loss of breast tissue and fat. That reduces the tissue covering the implants (which don't change with pregnancy). Your running is great for your health but it can cause strain on the breast tissue. The implants can become more visible and obvious.
There are several things which can help. That includes shifting to highly cohesive gel implants, using mesh to reinforce the capsule, or fat transfer. Each option has advantage as well as risks. See what your surgeon suggests. The decision is based on how much this bothers you. Best of luck.

Thank you for your question. I have been in practice over 30 years and breast implant revision surgery is a large portion of my practice. It appears that your wrinkling is significant. This usually represents implants on top of the muscle. I would replace your implants underneath the muscle and reposition your nipples to more central location as well. You should be able to have an excellent result. Best wishes to you.

Thanks for sharing your experience and photo. It looks like you're experiencing upper pole rippling, which can become more visible over time, especially in lean individuals, post-pregnancy, or with high physical activity like distance running.

Your implants (Natrelle Inspira Soft Touch, submuscular) are a good choice, but even cohesive gel implants can ripple when there’s reduced tissue coverage, particularly after breastfeeding or body composition changes.

Common options to improve this include:

-Fat grafting to the upper pole for better coverage.

-Implant exchange to a firmer (more cohesive) implant.

-ADM (acellular dermal matrix) if the tissue is very thin.

Running isn’t harmful to implants, but a low body fat percentage can make rippling more noticeable.

You're doing the right thing by using supportive bras and following up with your original surgeon. If you’d like another perspective, I’d be happy to see you for a consultation.

Rippling and wrinkling can be seen when there is inadequate tissue to camouflage the implant. It can be more frequent in those with loose or thin skin as well as those with smaller amounts of native breast tissue. It is also more common in those with larger implants.

You have lost soft tissue coverage over the implants. Your options are
Fat grafting to provide soft tissue coverage
Use firmer implants and fat grafting
The other question is if your implants are truly submuscular or subfascial?
If you have animation, then they are submuscular.

Based on your post photos, the option that should be suggested is micro fact, grafting under ultrasound or the new ALLOCLAE injections to stimulate fat growth and thickness in those areas. Expect these to range from $5000-$20,000. Best of virtual consult with.

Ideally, we should have access to proper before and after pictures to make a quality assessment.
If you don’t have before, and after pictures, then ask your surgeon to forward the pictures they took.
Your implant should have fairly good muscle coverage at the area where you have ripples.
Ripples typically form when there is very little soft tissue covering the implant.
Silicone implants tend to ripple less than saline implants. High profile implants tend to ripple more than low profile implants.
The bigger, the implant the more likely it is that the patient will have undesirable side effects, complications or the need for revision surgery.
Bigger implants will always equal more problems.
It may be challenging to get rid of the ripping.
Follow up with your provider or schedule a few in person second opinion consultations.
Best,
Mats Hagstrom MD