Breast Implant Rippling: Smoothing Out the Rough Edges

What exactly is implant rippling?

You know what you’re seeing in the mirror, but what exactly is it? Implant rippling happens when the edges, folds, and wrinkles of the breast implants can be seen through the skin, often around the cleavage and the sides of the implant. Implant rippling is most common with saline implants, but silicone-gel implants can also have this problem. The implants that have the least chance of rippling are the gummy bear implants because they are “form stable.”

What causes implant rippling?

Almost all implants ripple, but not all ripples are visible. Many different factors can contribute to this effect.

• Tissue and body fat. Women who have very little body fat and thin breast tissue have a greater propensity for implant rippling. Generally, women that have plenty of breast tissue will never have a problem with rippling regardless of any of the following reasons.
• Large pocket. If the pocket for the implant was too large when it was originally made, the implant is able to shift, and the edges can show through more easily. Even the capsule, which is made up of scar tissue, can form too large for the implant, allowing unwanted movement and the rippling effect.
• Sub-glandular placement. When the implant is placed over the pectoral muscle rather than below the muscle, implant rippling is more likely to happen, especially in women without enough breast tissue.
• Implant shape. Round implants tend to create implant rippling more than tear-drop shaped implants.

How can implant rippling be treated?

If your implants are creating a rippling effect in your breasts, you don’t have to accept it as a side effect of the augmentation. A number of different treatment options are available today.

• Fat transfer. For women who have little breast tissue, one option might be a fat transfer, moving fat from the abdomen or thighs to the breast. Fat transfers last a lifetime. The procedure involves liposuction to remove your fat from one of the above areas. The fat is then purified, put into a liquid form, and injected into the breast tissue. Dr. Tolson will transfer more fat than is necessary as about thirty percent of the fat transfer will not take. Once the blood supply is established to the new fat, the breasts will have a natural, fuller appearance. For a fat transfer to work, you must have the body fat available for a fat transfer.
• Pocket reduction. If the implant is shifting within the original pocket, either because the pocket was created too large for the implant or because the capsule that formed was too large, a pocket reduction is an option. This is a surgical procedure where Dr. Tolson enters through the original incision to reduce the pocket size, shifting breast tissue and using sutures to support the pocket.
• Implant replacement. Another option for correcting the mis-match of the implant pocket with the implant is to exchange the incorrect implant for the correct size.
• Implant repositioning. If the implant rippling is caused by the implant being placed above the pectoral muscle, repositioning the implant to sit below the muscle or under the covering of the muscle known as fascia is a possibility. This is a surgical procedure where Dr. Tolson goes in through the original incision, removes the implant, and replaces it underneath the pectoral muscle or underneath the covering of the muscle. Placing the implant under the muscles or covering of the muscle allows for more tissue to cover the implant, reducing the chances of rippling.
• Implant change. Sometimes the best solution to implant rippling is to change the type of implant being used. Gummy bear implants have the least tendency to ripple and the lowest chances of capsular contracture. Of silicone-gel implants, smooth implants have less of a tendency to ripple. Saline implants have the highest tendency to ripple of all the implants. The teardrop, textured saline implants will ripple less than the textured, round implants. Another thing to keep in mind is that teardrop implants ripple less than round implants.
• Acellular dermal matrix insert. For thin women that don’t have a lot of breast tissue, inserting a sheet of acellular dermal matrix along the bottom of the breast implant creates a “wall” to separate the implant from the breast tissue, effectively hiding ripples from the surface of the skin.

What does implant rippling surgery involve?

Consultation

The first step in addressing your breast implant rippling is to make an appointment with Dr. Tolson for a consultation. Dr. Tolson is certified by the American Board of Plastic Surgeons and is a member of the American Society for Plastic Surgeons and the American Society for Aesthetic Plastic Surgery. He has 29 years of experience in the cosmetic surgery field and will take the time figure out what is the best solution to your rippling. During the consultation he will

• Examine, measure, and photograph your breasts for your medical record.
• Look at your current size, shape, and rippling.
• Discuss your current implants.
• Examine the quality and quantity of your breast tissue.
• Examine your skin quality.
• Discuss your medical history, including current conditions and medications.
• Discuss your previous augmentation.
• Discuss your family’s history of breast cancer.
• Go over your current mammogram.

Preparation

Once the consultation is complete, you will need to schedule your procedure. When the day arrives, you will want to

• Wear soft, comfortable clothing that opens in the front.
• Wear slip-on shoes so you don’t have to bend over.
• Arrange to have someone drive you home from the procedure and stay with you the first night.
• Stop taking aspirin, anti-inflammatories, and any herbs that may thin the blood well before the surgery date.

Your implant rippling surgery will be performed in Dr. Tolson’s state-of-the-art, AAAASF-certified operating room in Cumming, Georgia, ensuring your comfort throughout the procedure. Depending on what exactly is being done, Dr. Tolson will use either intravenous sedation or general anesthesia. Once he is finished, you will go to recovery where one of his staff will observe you to ensure that all is well.

Recovery

You will go home with either gauze and an elastic bandage or a surgical bra on to aid in the healing process. If a drain has been inserted, one of Dr. Tolson’s staff will go over the care instructions with you. Some of the side effects you can expect to see are

• Swelling and discoloration at the surgery site. This should subside with time.
• Limited range of motion. As the swelling and discomfort subsides, your range of motion should return.
• Feelings of tightness around the implants. As healing progresses, the feelings of tightness will disappear, and they will begin to feel natural.

Regain the excitement you once had about your augmentation. Implant rippling doesn’t have to be what you settle for. Dr. Tolson can help restore a natural, beautiful look to your breasts once again.