Complications Requiring Breast Revision Surgery
“Breast Implant Rippling”
All breast implants have some degree of rippling including saline or silicone, and round, teardrop, textured or smooth. Different implants have different amounts of rippling depending on the materials used. Below is a chart starting from the least rippling to most.
- Smooth Silicone
- Textured Silicone
- Smooth Saline
- Textured Saline Teardrop
- Textured Saline Round
The implants that have the lowest risk of rippling also have the highest rates of capsular contacture. Smooth silicone has the highest rate of capsular contracture and textured saline implants the lowest. Capsular contracture is the most common complication from any breast implant operation. It is always wise to choose the implant with the lowest risk of capsular contracture even though it may have a higher risk of rippling. To this end, textured implants are usually also more expensive for the surgeon to buy than smooth implants, even though the textured implants have a much lower contracture rate.
Implant rippling is a much bigger problem in women with very thin overlying skin and breast tissue. A very thin patient will have rippling no matter which implant is used. Very heavy women will never have rippling that can be seen no matter which implant is used. There is more rippling when implants are placed on top of the muscle rather than underneath it, since the muscle tends to hide most of the rippling at the top of the breast. Even under the muscle implant rippling can be seen out to the side or past the edge of the muscle where there is no muscle covering the implant.
Serious consideration should be given, when changing implants, for complaints of rippling to moving the implants underneath the muscle if they are already on top. Also switching to a smooth, rather than textured implant, will certainly help, but will definitely increase the risk of capsular contracture. Each patient is different and a thorough discussion with your revision surgeon must be undertaken in detail to provide the best solution for this sometimes aggravating problem.
Please contact our office if you are from outside the Southern California area for a preliminary telephone conversation with Dr. Moser personally to ascertain if an in-person consultation would be helpful to you.