One of the frustrating problems that can sometimes occur after breast implant surgery is known as "rippling" - an irregular wavy look or feel to the breast orlando breast augmentation. This is caused by a combination of factors, related to the physical properties of the implant, the patient's own soft tissue and how it may have changed over time, and the choice of implant pocket design ("over vs. under").
Plastic surgeons generally divide these problems into 2 main categories, based on why they've happened.
1. Shell rippling
2. Traction rippling
Shell rippling is the most common problem of this kind I see, and is the topic for today. (I'll discuss traction ripples in a later blog. ) The classic scenario is with a subglandular ("over") saline-filled implant in a slender woman who doesn't have very much tissue coverage over the implant. Typically, the breasts looked OK for a period of time, and then, ripples started to show up later.
The usual way to improve this situation is to operate, and get more tissue coverage over the implant, by converting it to a sub-pectoral position. This move significantly improves ripples in the upper portion of the breast - which is the area most exposed by low neckline fashions. The other solution is to change the saline implant to a silicone gel implant, which has been shown in studies to have a ripple rate of approximately 1%, as opposed to the ripple rate of saline implants, at about 10%. I usually prefer to use both methods - getting muscle coverage over a gel implant. It works well to fix this problem.
Shell ripples occur for several reasons: they have to do with the tendency of the elastomeric implant shell to want to fold in on itself, the amount of fill in the implant, the viscosity of the fill material in the implant, and the pressure applied by the surrounding soft tissue. They are disguised by the amount of soft tissue thickness over the implant. Often, with the passage of time, there is thinning out of the breast tissue adjacent to the implant, and implants that were adequately covered early post-op may become more obviously rippled over time.
