Rippling:  Ugh !

Rippling, although not a common complaint with breast implants, can occur. The rippling that is of concern is visible rippling not palpable (what we feel).

To explain this you must understand that a Breast implant is a balloon. The implant is a malleable bag. With gravity, the weight of the filler (whether saline or silicone) will pull the contents of the bag to the bottom with gravity distorting or rippling the bag itself. As you fill the bag more (higher profiles) the bag containing the fill gets more tense and will ripple less as the bag expands. Although filled more the bag will still ripple as gravity exerts forces upon the contents of the bag and with gravity the badge adjusts shape.  Increasing the fill volume (ultra high profile) makes the bag more tense and less ripple but a firmer and more of a ball shaped bag. The amount of covering you have (fat, breast tissue , muscle, skin) also determines if you see ripples. We must understand that All implants ripple. The question is whether or not we SEE A ripple.

Not only does the amount of “fill” play a role in rippling but also the type of fill also determines how much rippling can occur. Liquids move. The more cohesive of a liquid the slower it moves or forms a ripple. Slowing down the movement of a liquid (Ideal implants) or increasing cohesion can decrease the rate of forming a ripple. If a ripple is slower to form when you move, then if you move again it may undo the ripple before it forms. Gels move slower than water. Therefore, Silicone and more cohesive fills (the less it moves) ripple less.

Solids do not ripple but the problem is that solids are hard! Solids are not malleable. The more solid the fill the less likely to ripple.  The more cohesive or gummy the less rippling can occur.

Anatomy also plays s role in the possibility of rippling.  The side of the breast is where  there is the least to cover the implant. Feeling a ripple is not the main issue, the issue is seeing the ripple. Over time the body is always changing. As the breasts age the tissue atrophy’s (breast tissue goes away as you get older as the body is not likely to need milk for a child) and as you lose weight (fat cells) the breast thins in most people and ripples may or may not become apparent.  Having less breast tissue and fat does not mean rippling. The tightness of the skin plays a major roll and the space available for an implant as well. The less space means less movement with gravity. Under the muscle can minimize ripples at the top of the breast. The muscle only covers approximately 15-20 % of the implant at the top. The bottom and sides are covered by the breast. Hence the term Dual Plane ). Dual Plane is the same as under (as that’s exactly what it really is) and subfascial is the same as Over. These are terms made up to make “YOU” think a surgeon has something unique to offer. The truth is they do not. In summary, rippling is not as much an issue but visible rippling can be upsetting. The amount of space you have around and in the implant  determines firmness, rippling, shape and outcome.  The type of fill, how much is filled and cohesiveness if the fill play a role as well. The anatomy of your body with skin, fat muscle and breast tissue  plays a role as well.

For more information call Dr. Gray at 248-538-3333 or visit