Breast implants are a common choice for cosmetic or reconstructive breast augmentation, but they carry a risk of certain aesthetic complications. One phenomenon patients often research is implant rippling, where the surface of the implant creates visible or palpable folds beneath the skin. Understanding the nature of rippling, its causes, and its implications is the first step toward addressing concerns about the long-term outcome.
Understanding Implant Rippling
Implant rippling refers to the appearance of folds, wrinkles, or waves on the implant shell that can be seen or felt through the skin of the breast. This phenomenon results from the implant’s soft shell folding upon itself, becoming noticeable when the overlying tissue is not thick enough to mask the irregularity. The ripples are often most apparent along the sides or bottom of the breast, or when the pectoral muscles are flexed. Rippling must be distinguished from other complications, such as capsular contracture (hardening of scar tissue) or implant rupture (a break in the shell). Rippling involves an intact implant and is primarily an issue of the implant’s physical form showing through the tissue.
Assessing the Health Risk
The core concern for many patients is whether implant rippling poses a danger to their health. Overwhelmingly, implant rippling is considered a cosmetic or aesthetic concern, and not a threat to systemic health. This condition does not typically lead to long-term physical illness or compromise the integrity of the implant over time. While not medically dangerous, rippling can, in rare instances, be associated with localized discomfort or mild pain due to the folded implant edge pressing against surrounding nerves or tissue.
Primary Causes and Contributing Factors
The primary cause of implant rippling is insufficient soft tissue coverage over the implant surface. When the layer of skin, fat, and native breast tissue is thin, the folds are not adequately cushioned or concealed, placing individuals with low body fat or minimal native breast tissue at higher risk. The type of implant filler material also plays a significant role, as saline-filled implants are more prone to rippling than cohesive silicone gel implants. Saline is a free-flowing liquid that allows the shell to fold more easily, especially if the implant is slightly underfilled. Additionally, subglandular placement (above the pectoral muscle) offers less natural tissue coverage and increases the visibility of rippling compared to submuscular placement.
Management and Corrective Options
Addressing implant rippling begins with preventive surgical planning, including selecting the appropriate implant size, type, and placement plane. For women with thin tissue, choosing a cohesive silicone implant over saline, or placing the implant in the submuscular plane, significantly reduces the risk. When rippling has already occurred, several corrective procedures are available to mitigate the cosmetic effect. One common method is fat grafting, which involves injecting the patient’s own fat into the breast tissue overlying the rippled areas to thicken the soft tissue envelope. For more pronounced rippling, revision surgery may be necessary, involving exchanging the implants or changing the implant’s position to utilize the muscle for additional coverage.