Q: Dr. Eppley, I had saline implants placed under the muscle 12 years ago. There were fine until about three years ago when I noticed rippling on the undersides. I am a thin woman being 5’7” tall and weighing 126 lbs. Why has this rippling appeared now years after surgery? Will it get better or is it permanent? Will it get worse? What is the best way to get rid of it?I am very unhappy with the shape, size and asymmetry, along with the rippling, so am leaning towards having them redone anyway.
A: Rippling is common feature of saline breast implants and every women will develop some degree of it unless they had a fair amount of breast tissue initially. It will be felt along the bottom and sides of the implants where there is not a muscular interface underneath between the implant and the skin. While perhaps not noticeable early after surgery, it may appear months to years later as the swelling goes away and the breast tissue thins over time. This rippling issue is particularly relevant in thin women with little breast tissue. This is an important consideration to know before breast augmentation surgery so this is not a surprise when it appears later. The best correction of the rippling problem is an exchange to silicone implants where the amount of rippling is considerably reduced due to the thicker and more congealed silicone gel material. This is one of the advantages of the newer gummy bear breast implants.
Dr. Barry Eppley
Q: Hi there. I read your blog about rippling in implants. I had breast implants 10 years ago and over the last few years I have noted rippling. I am not sure if I had saline implants or silicone but I want to know if it is possible to inject more saline or silicone into the implant to rectify this problem.
A: The physical characteristic of rippling in saline breast implants is quite normal. Not every women will feel the rippling unless they had scant breast tissue prior to their augmentation. It will always be felt on the side of the breast where the tissue is the thinnest. While most plastic surgeons overfill saline breast implants to lessen rippling, it inevitably occurs over time as the containment bag relaxes a little. (just like a stretched rubber band) The manufacturers generally recommend that a saline implant can be filled up to about 20% over its base volume size. (e.g., a 500cc implant can be safely inflated to 600cc)
More saline can be added to the implant at a later date through a simple procedure. This can help decrease the amount of rippling. But one has to be careful to not place too much volume as the implant can get a very hard feel which is quite unnatural.
Silicone implants generally have little to no rippling as they do not contain a liquid filler but a gel material. This reacts with the containment bag differently as is not prone to the same amount of rippling as that of saline implants.
Dr. Barry Eppley