Implant Rippling and Visibility
Implant rippling refers to the creases that develop in breast implants that are sometimes palpable through the skin. All breast implants will ripple to some degree; saline ripple more than silicone. Submuscular implants ripple less than subglandular implants because the muscle provides an additional layer of implant coverage.
Rippling is usually seen along the bottom and sides of the breast because the tissue coverage is thinnest in these areas. Rippling between the breasts is less common, but if present, can be quite distressing as it is a highly visible area.
Traction rippling refers to creases seen on the breast, when a patient changes position and the weight of the implant pulls on the skin (seen when bending over). When a patient describes that she can “feel the bag,” this means that the tissue coverage on top of the implant is so thin that you are basically feeling and seeing the breast implant under a thin layer of skin only.
An excessively “round,” or “stuck on,” appearance of an augmented breast is usually the result from an excessively large or overinflated saline implant or from subglandular implant placement. This can also result from an implant contracture, as well as the use of a high profile implant in a very thin patient.
Treatment options vary, depending on the specific issues (implant size and type, implant location – above or below the muscle, and tissue characteristics, not to mention patient goals). A saline implant can be exchanged for a silicone variety. Relocation of the implant below the muscle can also help. Elimination of a contracture will soften the breast and treat the rippled, unnatural appearance. ADM, or Acellular Dermal Matrix (human or pig dermis), can also be used in revision breast surgery to minimize some of these issues.
