What is breast implant rippling?

Breast implants are the foundation of beautiful breast augmentation results, but the illusion of ample natural cleavage can be compromised if your implants are not chosen and placed with the utmost care, or if you have a complication.

One largely avoidable problem is the appearance of visible implant edges beneath the skin, also known as breast implant rippling. The issue is most likely to be seen beside the underarm, and may be especially pronounced when leaning over. Today’s blog will explain how implant ripples happen, how to avoid the problem, and what you can do if you already have breast implants and see them wrinkling.

Why does breast implant rippling happen?

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. There are multiple possible causes of breast implant rippling, and more than one may apply when it comes to a given individual:

• There is little natural breast tissue to cover and cushion the implant. If you have relatively thin breast tissue, then you may be at greater risk for visible implant rippling.
• The capsule is too small for the implant. During breast augmentation, your surgeon creates a pocket, or capsule, that needs to be precisely sized to hold the implant in place.
• Saline implants were under-filled. Unlike silicone implants, saline implants are filled during surgery to within a recommended range. Because underfilling is strongly associated with rippling, many surgeons precisely overfill implants to prevent the issue—but this requires judgment as overfilling can also lead to rippling.
• Saline implants have lost volume. Saline implants can lose volume over time if the valve fails. If this happens, the implants should be replaced to both remedy visible rippling and to stop the implant capsule from shrinking, which makes it difficult for your surgeon to give you a good result from future revision surgery.
• Scar tissue is tethered to the skin. Scar bands can form between your skin and the capsule of scar tissue your body forms naturally around the implant. With movement of the breast, this tethering can be visible through the skin.
• The capsule is adhering to your textured implants, leading to a rippled appearance.
• The surgeon placed too large an implant in relation to your breast width and amount of natural breast tissue.
• Weight loss after surgery has exacerbated breast implant rippling.

What choices can help me avoid implant rippling in the first place?

There are three primary choices that will help you avoid implant rippling: (1) the width, profile, and size of your implants, (2) the placement of your implants, and (3) the material of your implants.

1. The width, profile, and size of your implants

When choosing an implant, many patients want to focus on cup size or volume (i.e. 400 cc), but these choices are not the only ones that a surgeon considers to achieve a beautiful result. In implant sizing, the width and the projection (profile) of the implant are equally significant factors that affect your aesthetic outcome, and they are both key in preventing rippling.

An appropriate implant width is the same or just under the diameter of your breast, and the diameter may need to be on the lower side if you have very little natural tissue to cushion the implant edges. The choice of width requires keen artistic judgement on the part of your surgeon: Too narrow and small of an implant creates no cleavage or upper pole fullness, while too wide an implant may ripple along the edges.

Further, round implants of the same width may have different degrees of projection. Lower profile implants are flatter, wider, and ultimately add more roundness to your upper pole, and higher profile implants project more in the center of your breasts. If you have a petite frame and require a somewhat narrower implant, you will typically require a higher profile implant, as well, to create the augmented breast size you want.

2. Implant placement

A fully under-the-muscle implant placement puts more natural tissues between the implant and your skin, reducing the chance of visible implant rippling (in contrast with subglandular, or above-the-muscle, placement).

However, most surgeons place implants in a partially submuscular position, which can lead to rippling in the lower and outer poles of the breast. Total submuscular and subfascial (below the tissues that surrounds the muscle) placement reduces rippling throughout the breast.

Still, this placement will not be ideal for every patient. Talk with your surgeon about the pros and cons of each implant placement before deciding which is best for you.

3. Saline vs. silicone implants

You will have a choice between saline- and silicone gel-filled implants. Silicone implants are less likely to cause rippling in most breast augmentation and reconstruction patients. And highly cohesive “gummy bear” implants will not ripple at all; however, they are textured, and therefore may cause the appearance of ripples as the surface of the implant becomes tethered to its capsule.

What can my cosmetic surgeon do to prevent breast implant ripples?

Your cosmetic surgeon should use an appropriately sized implant for your frame, and if you have little natural breast tissue, should aim to choose silicone implants and under-the-muscle placement where possible. Choose a board certified cosmetic surgeon who has extensive experience with breast augmentation and is well-versed in the intricate surgical technique required to get a sound, beautiful-looking result. For more information, read our guide to choosing a surgeon.

What can a cosmetic surgeon do to correct visible rippling?

If you are experiencing a new visible implant ripple, your surgeon may fix the problem by either using fat transfer to cushion the area of rippling or breast implant revision surgery to correct the cause of the rippling.

Fat transfer involves using liposuction to remove fat from one area of your body, such as the abdomen, purifying the fat, and carefully injecting it into the breasts as a natural dermal filler.

Breast implant revision, on the other hand, may involve different surgical techniques to improve your results. Not only can your surgeon replace your current implants with silicone implants of an appropriate size, placed under the muscle, but they may also add a dermal or synthetic matrix to the implant pocket to help to support your natural tissues and better prevent implant rippling. Breast implant revision may also involve changing the implant pocket size; or, your surgeon may instead place an implant of the appropriate size to fill the implant pocket.

Locate a trustworthy cosmetic surgeon to prevent or correct breast implant rippling

The first step in getting a gorgeous result, or improving on an unsatisfactory one, is finding a board certified cosmetic surgeon. Use our tool for locating surgeons in your area, then read our tips for selecting a surgeon who is a good match for your needs.