ABC7’s The More in the Morning team spoke with Dr. Michael K. Kim, Board-Certified Plastic Surgeon, to discuss a largely avoidable problem and common side affect of breast augmentation. This is the appearance of visible implant edges beneath the skin, also known as breast implant rippling. 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. Breast implants are made to mimic the look and feel of natural breast tissue, but this soft texture also means that, in certain circumstances, implants can visibly ripple or wrinkle beneath the skin.
Main Causes of "Rippling."
- 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 If the pocket for the implant was too large when it was originally made, the implant is able to shift, and the edges can show through more easily.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.
I have rippling. Now what?
If you are unhappy with rippling after breast augmentation, discuss it with a board certified plastic surgeon (such as Dr. Michael K. Kim). There are several options to reduce rippling that include:
- Fat grafting: This is a great option for women who have thin breast tissue. By grafting fat over the implants, the rippling is less noticeable. Fat grafting may take a few sessions to correct the rippling.
- Changing the location of the implants: If the implants are under the skin (known as a “subglandular placement”) they can be repositioned under the chest muscle. Placement of implants below the muscle will increase tissue coverage of the implants and make rippling less noticeable. Creation of a “neo” pocket in a new submuscular position may help as well.
- Reducing the size of your implant: Rippling is less likely to occur in smaller implants. If rippling is bothersome, reducing the size of the implants might be the answer.
- Changing the profile of the implant: A higher profile implant may reduce rippling due to a higher fill volume of the implant.
- Overfilling saline implants: If you think of an implant as a water balloon, you know that a fuller balloon is less “sloshy” than an emptier balloon. Overfilling saline implants is like tightly filling the balloon and leaves less space for ripples.
- Switching from saline to gel implants: Gel implants tend to be denser and patients find them less prone to rippling. Gel implants are a safe and a good choice for women who are experiencing rippling with their saline implants.
- The use of ADM: The use of ADM (acellular dermal matrix) such as strattise, or a surgical scaffold such as SERI can help increase the thickness of the tissues between the skin and implants and reduce visibility and palpability of the implants.