Rippling!

[swansway]

Hi Dr Mele,

Hope that you are well!

I was wondering whether or not rippling is inevitable in certain situations. I recently had a breat lift and re-do augmentation. My original implants (textured silicone) were 400cc (L) and 450cc (R), these were exchanged for 575cc (L) and 625 (R) , these are also textured silicone, and I had a minimal lift. Prior to my re-do I had no rippling and I am unsure why there would be such a noticeable difference due to, what I consider to be , not such a huge upgrade in size of implant. I had substantial breast tissue before my surgery and so I would like to know if this is particulary common and whether or not there is anything that can be done to conceal this?

Thank you in advance for taking the time to read this.

Kindest regards.

[Dr. Mele]

Dear Swansway:

I believe all breast implants ripple to some extent. It is more pronounced in textured breast implants, and it is more frequently noticed with saline filled breast implants.

If rippling can be felt, but not seen, it is best to ignore it. If rippling can be seen, it is most often seen on the outer breasts when leaning forwards. This type of rippling is also not usually treated. Large natural breast tend to get similar folds.

When rippling is on the inner breast, or becomes obvious no matter what the position, then surgery may be the best option. Often, if the implant is in front of the muscle, the rippling can be decreased by placing the implant behind the muscle. Changing to smooth implants can also help. Higher profile implants tend to behave a little better too. Sometimes this is caused by a tight capsule, and a capsultomy my help. Sometimes the capsule can be folded on itself to thicken the implant coverage. If this is not an option, sometimes a sheet of Alloderm or the equivalent can be used used, but this tends to be expensive.

Whenever you see an entire list of ways to treat a problem it usually means there is no perfect way to fix the problem. If there were, there would be one way.

If you are less than a year after your surgery, there may be some more conservative options. I would discuss it with your plastic surgeon and see what is available in your situation.

Thanks for the question.