There are many mysteries and misconceptions around breast implants, but two of the most common questions that have been coming up lately in my practice are rippling and flipping.
Rippling
Rippling describes seeing the folds of the implant through the overlying mastectomy skin (in reconstruction) or breast tissue (in augmentation). It can happen with either saline or silicone implants, though it tends to be more pronounced with saline implants. More cohesive/”gummier” implants are less likely to ripple because they hold their shape better in the body and are firmer, so the implant folds are less prominent. Although rippling is talked about more frequently in discussions of over-the-muscle reconstruction, it can happen with either over-the-muscle or under-the-muscle reconstruction.
When rippling occurs, several different approaches may help improve it. Switching out implants to more cohesive implants can work well. Sometimes, implants may also need to be exchanged for larger ones to help fill out the skin envelope better, which can reduce the appearance of rippling. Putting in a biologic mesh that will help stabilize the implant and/or add a little thickness to the tissues can also help. And finally, fat grafting may also be an effective option for some women to help camouflage the rippling by adding volume to the tissue over the areas of rippling.
