What is Breast Implant Rippling?
Breast implant rippling refers to the appearance of wrinkles or folds in the outer surface of breast implants that can be seen or felt through the skin. This phenomenon can occur with any type of breast implant but is more commonly associated with saline implants than silicone. Rippling is more likely to happen in certain areas of the breast, particularly the sides and bottom where the tissue coverage is less dense.
A rippled breast implant is not a medical concern and won’t cause you any physical harm. It can be emotionally significant, however, negatively impacting your confidence and self-esteem. It may make you feel self-conscious about your appearance, particularly in clothing that is more revealing or form-fitting. This might affect your choice of clothing and impact your participation in activities like swimming where the rippling might be more noticeable.
If you experience a rippled breast implant, you may feel dissatisfied with the results of your breast augmentation and start to regret undergoing the procedure. You may also have anxiety about undergoing a second corrective procedure and fear being disappointed again.
These feelings are normal and understandable, but try not to get bogged down in them. You do have options, and breast implant ripples can be corrected.
What Causes Breast Implant Rippling?
The cure for a rippled breast implant depends on the cause of the problem, so it’s important to understand why ripples happen.
Unique Personal Factors
Sometimes the cause of the ripples depends on your body and its unique features and responses to breast implants. Individuals with thinner skin or less breast tissue are more likely to experience rippling, as there is less material to cover and smooth out the edges of the implant. Weight loss after surgery can exacerbate this situation.
Capsular contraction is another potential cause of rippled breast implants. Your body will naturally form a capsule of scar tissue around a breast implant. But in some people, this scar tissue becomes unusually thick and hard. When it does, it can distort the shape of the implant and lead to rippling. Some implants are textured. In that case, scar tissue can stick to the implant and cause rippling.
Implant Factors
The type of implants you have can also play a role in rippling. Saline implants have a much higher viscosity than their silicone gel counterparts. This makes them more prone to rippling. Saline implants are also inserted empty and then filled once inside the body, and this can lead to rippling as well. As briefly mentioned above, textured implants too are more likely to ripple than their smooth counterparts.
A ripple in a breast implant can also occur if your implant is the wrong size or shape for your body. While it may serve you in other areas of your life, the go big or go home mantra doesn’t apply to breast implants. An implant that doesn’t fit your body size and shape is more likely to ripple. Larger implants have more surface area, as well, so there is a greater chance of rippling.
Implant placement matters as well. Implants placed above the muscle tend to show more rippling than those placed below the muscle. This is because there is less soft tissue to cover and mask the implant. Implant age is also a factor, with older implants being more likely to ripple.
Surgical Technique Factors
While silicone implants come in predetermined sizes, saline implants are filled after they are placed within the breast. It is possible to overfill or underfill a saline implant, both of which can cause ripples.
It’s also critical that the surgeon correctly forms the pocket or capsule the implant will sit in. The pocket must neither be too large nor too small relative to the size of the implant. A pocket that is too large allows the implant too much freedom to move, which can lead to the implant settling into an unnatural position, causing the surface to wrinkle or ripple. On the other hand, an overly tight pocket can compress the implant, distorting its shape and potentially leading to rippling as well.
The pocket should closely mirror the shape and dimensions of the implant. This conformity helps stabilize the implant, reducing the risk of shifting, folding, or rotation, all of which can contribute to rippling.
Note too that proper post-operative care is essential for ensuring a smooth recovery and optimizing the long-term results of breast implant surgery. After surgery, wearing a compression garment or a well-fitted supportive bra is crucial. This helps to stabilize the breast implants, reducing movement and minimizing the chances of rippling. Patients are advised to avoid strenuous activities and heavy lifting for several weeks post-surgery. Following your post-op instructions is critical to a good outcome.
Can Breast Implant Rippling Be Prevented/Mitigated?
Sometimes a rippled breast implant can happen even when everything goes right. There are, however, ways to minimize the risk.
Pre-Operative Considerations
The task of reducing the odds that you will experience ripples in a breast implant begins before your surgery. The first step is having an honest conversation with your surgeon or surgical coordinator about what you want and whether or not you can realistically get it. If your surgeon tells you that your plans are too ambitious for the amount of skin and tissue that you have, heed their warning. Pushing the size envelope often leads to ripples.
Although what you want is important and you shouldn’t settle, it’s equally important to let your surgeon guide you through the implant selection process. Make sure you understand what they are recommending and why. And be sure to understand all of the potential risks involved with each of your options.
It’s also helpful if you can maintain a healthy, steady weight before and after your surgery. Weight fluctuations can significantly impact the appearance and integrity of breast implants, including contributing to implant rippling. Significant weight gain or loss can alter the amount of natural breast tissue that overlays the implant.
Loss of fat in the breast area can thin the tissue covering the implant, making any ripples or wrinkles in the implant more apparent. Conversely, weight gain can change the shape and size of the breasts, potentially stretching the skin and affecting how your implants sit or look.
Rapid or large-scale weight fluctuations can affect skin elasticity, as well. Loss of elasticity due to weight loss may not only make rippling more noticeable but can also lead to sagging of the breast, which might distort the appearance of the implants.
Surgical Technique
Your surgeon can help reduce rippling by selecting an implant size and shape that is proportional to your body size and existing breast tissue. They should discuss this choice with you prior to surgery but, upon occasion, something they find once in the operating room may require them to pivot.
Once surgery begins, careful dissection of the implant pocket is critical. This ensures that the pocket matches the shape and size of the implant to prevent excessive movement and reduce the chance of folding or rippling. Ensuring the pocket isn’t too large is crucial, as an oversized pocket allows the implant to shift and potentially fold and ripple.
In some cases, fat grafting may be necessary. Adding fat grafts over the implant can increase soft tissue thickness, providing more padding to cover the implant and reduce the visibility of any rippling. This is particularly useful in visible areas like the cleavage or the sides of the breasts.
Fascial flaps are another surgical technique used in breast augmentation procedures to enhance the coverage and support of breast implants. Fascia is a thin yet sturdy layer of connective tissue. In the context of breast surgery, surgeons may use the fascia from the pectoral muscles to help envelop and secure the breast implant. This technique is particularly valuable in patients who have thin skin or limited breast tissue, where the implant edges might otherwise be visible.
Post-Operative Care
After surgery, the task of reducing rippling risks falls to you. Follow your after-care instructions closely. Your surgeon will direct you to wear a surgical bra or compression garment and it’s crucial that you do so. This will prevent your implants from shifting out of place as you heal, which can cause rippling and other problems.
Your plastic surgeon may also recommend massage techniques after your surgery. Massage can be a beneficial technique for managing and reducing scarring after breast implant surgery. The main goal is to promote healing, improve skin and tissue flexibility, and minimize the formation of hard scar tissue, known as capsular contracture, around the implants. It’s crucial to first talk with your surgeon before starting any massage routine, however. The timing, technique, and appropriateness will depend on individual factors.
How is Implant Rippling Diagnosed?
Diagnosing implant rippling involves both a visual examination and a physical assessment, typically performed by a plastic surgeon. Implant rippling is characterized by visible and/or palpable folds or wrinkles in the breast implant.
The initial step involves a thorough visual inspection of the breasts with the patient in various positions—standing, lying down, and sometimes bending forward. These different positions can help highlight any surface irregularities caused by rippling.
After the visual examination, the surgeon will palpate (feel) the breasts to assess the texture and integrity of the implants and the surrounding tissue. This tactile assessment helps in identifying areas where the implant may be folding or where the saline or silicone filler may be unevenly distributed.
Although not always necessary, imaging studies like ultrasound or MRI might be recommended in some cases to assess the condition of the implants more thoroughly and to rule out other issues such as implant rupture or displacement.
How Grading of Breast Implant Rippling Works
Breast implant rippling is graded based on a scale that determines how severe the problem is. Many patients have heard of the Baker scale, but this scale measures capsular contraction rather than breast rippling. Capsular contraction can cause rippling but doesn’t always. Breast rippling is measured on the following scale:
Grade 1: Mild Rippling
Visibility: Rippling is not visible when standing or in a neutral posture but might be palpable upon close examination or when the skin is manipulated.
Impact: The rippling has minimal cosmetic impact and is generally acceptable to the patient. It does not typically require corrective action unless the patient desires it.
Grade 2: Moderate Rippling
Visibility: Rippling is occasionally visible when in certain positions, such as bending over or lying down. It may also be palpable in the standing position.
Impact: This level of rippling might cause some cosmetic concerns or self-consciousness, particularly in clothing that is tight-fitting or under certain lighting conditions. Patients may seek advice on corrective procedures.
Grade 3: Severe Rippling
Visibility: Rippling is clearly visible in most positions and under most conditions. It is easily palpable and may affect larger areas of the breast.
Impact: The visibility of the ripples significantly impacts the aesthetic appearance of the breasts and can cause considerable emotional distress or dissatisfaction for the patient. Correction through surgical intervention is often considered at this stage.
Treatment Options for Breast Implant Rippling
Surgery is certainly an option for repairing ripples in breast implants, but you may be able to correct the issue without surgery.
Non-Surgical Options
Non-surgical options for addressing ripples in breast implants are limited because rippling fundamentally involves physical characteristics and placement of the implant itself. However, there are a few non-surgical approaches that can help improve the appearance of rippling or manage minor issues associated with it, and they may work for those with grade 1 rippling.
Wearing bras designed to provide extra support or strategic padding can help camouflage minor rippling, especially when wearing certain types of clothing. Adequate hydration and a diet rich in vitamins and minerals can also help by improving skin elasticity, which might help reduce the visibility of rippling.
Skin-firming creams and lotions can sometimes improve the appearance of the skin around the implant area. While they won’t actually fix the rippling of the implant, they can improve skin texture and firmness, potentially making rippling less noticeable.
Massage techniques can sometimes be used to manage mild breast implant rippling, especially when the implants are relatively new and the skin and surrounding tissues are still adapting. The primary goal of these massages is to help the implants settle into place more naturally, ensure proper positioning, and potentially alleviate minor rippling by promoting soft tissue flexibility and adjustment. Compression and zonal massage techniques can both be beneficial, but speaking to your doctor before attempting massage treatment is important.
Keeping regular appointments with your plastic surgeon to monitor the condition of the implants and surrounding tissue is important, as well. This can help catch any changes early. Your surgeon can provide advice on when a more invasive approach might become necessary or continue to recommend non-surgical methods to manage the situation.
Surgical Options
Surgical intervention can be an effective option for addressing significant rippling in breast implants, particularly when non-surgical methods are insufficient. Grade 2 and 3 cases typically call for a surgical approach. There are many surgical interventions to choose from.
One option is to swap out the implants. Changing from saline to silicone implants, for example, can significantly reduce rippling. Silicone implants, especially those with a cohesive gel, are less prone to rippling because they have a very low viscosity. Sometimes, using a different size or a different profile can better suit the patient’s body frame and existing tissue, reducing the likelihood of rippling.
Changing the implant’s placement may also prove beneficial. If the existing implants are placed above the muscle, moving them under the muscle or into a dual-plane position can provide more coverage over the implant, thus minimizing the visibility of any rippling. The muscle layer serves as an additional buffer that disguises the texture of the implant.
Sometimes the implant itself is fine but the pocket that holds it is not quite right. In that case, tightening the pocket that holds the implant can help reposition it and make it more stable. This adjustment can alleviate rippling, especially if it was caused by a pocket that was too large or misshaped. Modifying the dimensions or location of the implant pocket can also help ensure that the implant sits correctly within the breast, reducing the risk of rippling.
In cases where rippling is caused by severe capsular contraction, a complete capsulectomy may be in order. This procedure removes the scar tissue capsule around the implant, resetting the environment around the implant and allowing for better positioning and less tension on the implant surface.
Sometimes, surgeons can utilize fat grafting to correct rippling. This process involves acquiring donor fat through liposuction and then injecting it into the breasts to provide some extra padding around the implant. This technique is particularly useful for camouflaging rippling and for enhancing the natural look and feel of the breasts.
Surgeons can sometimes use acellular dermal matrix (ADM) or meshes to create additional soft tissue coverage over the implant, especially in patients who do not have sufficient natural breast tissue. These materials act like an internal bra, providing support and reducing the visibility of implant edges or rippling.
Surgical Recovery Timelines
It takes months for the swelling to completely abate after breast surgery, and your surgeon will likely prohibit intense physical activity and exercise for six to eight weeks. In most cases, however, patients can return to work, driving, and normal daily activities one to two weeks after surgery.
You will experience some bruising and discomfort in the first few days after any breast surgery. Your surgeon will prescribe medication to keep you comfortable during this time, and your pain should decrease a bit every day. You won’t be able to raise your hands above your head or lift anything for a few days, however, so you may need help around the house and taking care of the kids.
Additional Considerations
The cost of treating rippling in breast implants can vary widely depending on several factors, including the specific surgical approach chosen, the geographical location of the surgery, the surgeon’s expertise, and the complexity of the case. On average, fat grafting starts at about $3,000 while exchanging or repositioning implants can start at $5,000 but can easily exceed $10,000 or more.
At Mia Aesthetics, we pride ourselves on keeping costs as low as possible without compromising patient safety. We also offer flexible financing options to make it easier to fit plastic surgery into any budget. If you’re living with a rippled breast implant but fear you can’t afford to fix it, reach out to us and explore your options. Fixing the problem may be more affordable than you think.
Financial concerns aren’t the only ones to consider when facing a rippled breast implant. Make sure you lean on your family and friends or join an online support group for women with similar issues. A rippled implant can really cripple your self-esteem and be emotionally taxing, but you don’t have to go it alone.