Breast augmentation has extremely high satisfaction rates, but occasionally, rippling can occur following this procedure. This can occur with either saline or silicone breast implants.
Several factors have been associated with rippling following breast augmentation. These include saline implants, large implants, thin, soft tissue, and placement of implants on top of the muscle.The soft tissue characteristics of patients are extremely important. Patients with minimal breast tissue and thin subcutaneous tissue are much more likely to develop rippling than those with thicker, soft tissue. A large amount of breast tissue relative to implant size minimizes the potential for rippling. Larger implants, saline implants, and placement on top of the muscle are all associated with a higher incidence of rippling.
The potential for rippling can be decreased in several ways. It’s important in high-risk patients to avoid using implants that are large relative to the patient’s native breast tissue. Firmer implants such as silicone and adhesive gel implants can also decrease the potential for this problem. Sub muscular placement decreases rippling by increasing the soft tissue coverage over the implants. Surgeons should avoid over dissection of the pocket and avoid implants that are wider than the patient’s breast tissue. Finally, over filling the implant when using saline may help to minimize rippling.
Despite all these maneuvers, rippling occasionally may still occur. It’s important to realize that in the vast majority of patients, rippling is not a problem and even when it does occur, most patients are still very happy.
