Breast Implant Rippling: A Complete Guide

After a boob job, one of the most common complaints is breast implant rippling (and capsular contracture). It is reported that anywhere between 0-35% of the patients experience this complication. However, you need to understand that implants may ripple because of the way they’re made. 

Keep in mind that being able to feel the implant is not the same as rippling. You’ll almost always feel the presence of the implant, especially at the bottom of the breast, where it is not covered by muscle. Rippling, as the name indicates, creates ripples. However, it becomes problematic when the ripples become visible beneath the skin and cause significant deformation of the breasts. 

What Is Breast Implant Rippling? 

Breast implant rippling refers to the wrinkling and folding of the surface of the implant that is visible through the skin. Rippling can more commonly be seen on the outer and inner edges of the breasts, where either the breast tissue or muscle is thin. 

When lying flat on a surface, you won’t see any wrinkles or folds on the implant surface. However, when the implant’s upright, you can see creases forming on its surface. Skinny patients might also experience rippling when they’re bending over or stretching. But keep in mind that not all patients experience this complication. That’s because it depends on certain factors, and patients can experience varying degrees of rippling. 

These ripples may be palpable but not visible to the eyes. In that case, it’s not much of a problem. However, they can cause significant cosmetic concerns when they end up creating folds in the skin above. 

Grades of Rippling 

A study published in the peer-reviewed journal of Aesthetic Plastic Surgery outlined three grades of implant rippling. These are as follows: 

  • Grade 1: It is the mild rippling, which is only  (meaning it can be felt) and not visible to the eye. It is further classified into 1a and 1b. In the former, the rippling is confined to the outer portion of the breasts. In the latter, the ripples can be felt in the inner portion of the breasts (towards the cleavage). 
  • Grade 2: Ripples are visible when you bend forward. 
  • Grade 3: The skin of the breasts is visibly creased even when you’re standing up straight. This is the most severe case. 

If it’s grade 1, you will be advised against any surgical intervention. Grade 2 is also normal, especially if you have a low body mass index (BMI). However, if it’s grade 3, you’ll probably have to get in touch with your doctor to fix the problem through different treatment options. 

What Causes Ripples In Breast Implants?

Breast implant rippling can result from one or more of the following: 

Thin Breast Tissue 

Having thin breast tissue is one of the most common reasons why the rippling of the implants becomes visible. Breast tissue drapes over the implant. When it is thin, the folds and creases in the implants will show through the skin and become visible. There’s a higher risk of rippling in women who naturally have smaller breasts. That’s because they have limited tissue and cushion of fat underneath to camouflage the ripples. 

Those who have had a mastectomy often experience breast implant rippling because they don’t have enough breast tissue. This is even if the implant is placed below the pectoralis muscle in the chest. In this case, patients are usually recommended an adjunct treatment option, so the ripples are not visible. Keep in mind that the quality of the breast tissue isn’t something that your surgeon has control over. 

Choice Of Implant 

Some types of implants are more prone to rippling than others. This is a common complaint with saline implants, which can ripple if under or over-filled. Although saline implants come pre-filled, they may also be filled with saline during the surgery after the empty silicone shell is inserted into the body. 

If the implant ends up being under or over-filled, it will end up rippling. Implant rupture, too, can create ripples later on. Other than that, it is possible for textured implants to ripple more than smooth ones. Their thick and stiff surface can make the ripples more noticeable. It is also possible for the implant to ripple if it is so large that your breasts cannot adequately support it. Therefore, the choice of implant matters. And it is something that your surgeon should guide you through. 

Weight Loss 

The ripples in your implants can become noticeable if you lose significant weight. It’s because of the limited cushion of fat between the skin and the implant. For this reason, some doctors even recommend their patients gain weight as a solution for rippling. However, understandably, not many patients go for this treatment option. 

How To Treat Breast Implant Rippling? 

Your surgeon may recommend the following for the treatment of visible rippling in your implants: 

Fat Injections 

Increasing the thickness of breast tissue is one way to solve the problem of rippling. Through liposuction, fat is harvested from different areas of the body, such as the abdomen, thighs or back. It is then purified and then injected into the breasts. The presence of fat will help hide the ripples on the surface of the implant. Keep in mind that some fat injected into the breasts will be absorbed by the body; its results may only be temporary. 

However, it should be noted that usually skinny women experience rippling. Therefore, they may not have enough fat in the body that can be harvested and injected into the breasts. So, it may not always be a treatment option. 

Implant Replacement 

You can consider undergoing an implant replacement surgery to deal with the problem of rippling. You can switch from saline to silicone implants and opt for smooth implants instead of textured ones. You should further consult your surgeon about the type of implant that will best suit you. 

Acellular Dermal Matrix 

According to the FDA, an acellular dermal matrix is a “surgical mesh” that’s either made from the skin of humans or animals. Breast tissue is supported by these scaffolds. These dermal matrices are commonly used in breast reconstruction surgery. However, they’ve also been shown to treat rippling. 

According to a study published in the Aesthetic Surgery Journal, an allograft dermis (made from donated human skin) can help correct rippling in patients who are “soft-tissue deficient.” It was used in both reconstructive and cosmetic breast surgery. 

How To Prevent Implants From Rippling? 

There are different things that can be done so that you don’t experience this problem in the first place. 

Placing Implant Beneath The Muscle 

One of the most commonly suggested ways to prevent implant rippling is placing the implant underneath the chest muscle (an implant can also be placed on top of it). It can be placed in two different ways: 

  1. Dual Plane 
  2. Sub-muscular 

In the dual plane, the upper portion of the implant is under the pectoralis muscle, but the lower part is still exposed. So, if any wrinkles form there and you have thin breast tissue, it might show through. 

However, in sub-muscular placement, the whole implant is placed beneath the muscle. But you should know that muscle thickness gradually decreases down the implant. With thin breast tissue, rippling is more likely in the lower part of the breast. Still, this type of placement can help prevent the implant ripples from being visible. 

Choice Of Surgeon 

One of the best things that you can do to prevent breast implant rippling is to find a surgeon that’s experienced and board-certified. Your surgeon should discuss the pros and cons of a particular implant type with you before you make your decision. For instance, if you have limited breast tissue and you get very large implants, the chance of rippling will increase. It is something that your surgeon needs to warn you about beforehand. 

The choice of implant should be determined according to your breast anatomy. And an experienced surgeon can best guide you about it so that you can prevent visible rippling from occurring in the first place. 

Similarly, since the improper filling of a saline implant is another factor that causes this complication, an experienced surgeon is unlikely to overfill or underfill it. Even before that, when the surgeon makes the pocket for the insertion of the implant, they need to make sure that it’s not too small as that, too, can cause visible rippling. 

Concluding Remarks 

Rippling of the implant is not problematic as long as it’s not visible to the eyes. But if the ripples show through the skin, it can deform the appearance of the breasts, which can affect the overall aesthetics. 

In that case, there are some treatment options that you can consider. For instance, fat injections are popular for fixing rippling. Other than that, you can get your implants replaced for those that are less prone to rippling. But keep in mind that this alone may not be enough as the best choice of implant depends on your breast anatomy. And an experienced surgeon can guide you about that. So, make sure to do your research before getting a boob job. 

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