Implant Rippling

Rippling of breast implants refers to the creases that can occur with all breast implants. It is more frequently seen with the use of saline implants than the silicone variety. Rippling can be visible on the breast or it can be noticeable only when the breast is examined. It is usually most easily seen on examination of the bottom and the sides of the breasts where the tissues are the thinnest. Rippling is not a dangerous condition. It bothers patients because it takes away from their breast augmentation result.

Treatment for rippling often involves exchange of implants and possibly a pocket change. Rippling is generally effectively managed with a revision procedure. The use of ADM, or Acellular Dermal Matrix, may help obtain the best result in some patients.

What is the biggest risk factor for developing implant rippling?

If you have thin tissues and you choose a large-size saline implant and place it over the muscle, you are most at risk for rippling.

Why do saline implants ripple more than the silicone variety? 

It has to do with the mechanical properties of the implants and the difference between water fill and silicone fill inside the implant.

What is the best breast implant to use to avoid rippling? 

The newer, highly cohesive (thick gel) implants have the lowest incidence of rippling, but not by much compared to currently used implants. Textured breast implants are associated with a higher rate of rippling than the smooth-walled implant.

Why is rippling more noticeable along the bottom outside of the breast? 

This is an area with the thinnest tissue coverage, so it is easier to feel the implant ripples.

Is breast implant rippling different when the implant is above or under the muscle? 

It is believed that the added muscle coverage when the implant is below the muscle reduces the incidence of implant rippling.

Why do I have breast implant rippling in my cleavage area? 

This typically occurs with larger saline implants placed above the muscle. The skin becomes stretched and the ripples become visible.

Why do my breasts have more implant rippling when I bend over? 

This is called “traction type” rippling. The implant capsule is pulled by gravity and it adheres to the overlying skin, causing this crease.

Is there a difference in rippling between the smooth-walled implants and the textured implants? 

It is generally believed that the incidence of rippling is higher when textured implants are used.

Why is breast implant contracture associated with rippling?

This is probably because the contracted scar tissue around the breast implant (implant capsule) squeezes the implant and causes buckles in the implant.

Is breast implant rippling dangerous or abnormal? 

No. In many cases, it is actually predictable. This is why your surgeon needs to educate you on the risks of a breast augmentation in those who choose overly large saline implants when they have very little breast tissue.

Is breast implant rippling associated with breast implant rupture?

It is believed that the ripples or buckles in the implant may predispose the implant to a rupture.

Will breast implant ripples go away by themselves without treatment? 

Not really. The only case of “disappearing” implant ripples happened in a patient of mine who gained weight and her skin got thicker, so her ripples were more difficult to see.

What’s the problem with breast implant rippling?

It’s embarrassing.

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