Rippling of the breast is a complication which may occur following breast augmentation. This is more likely to occur with saline implants and when the implants are placed above the muscle so that there is only skin and breast tissue covering the implant. Rippling is actually very common in women with very little breast tissue who have their implants placed above the muscle. Any patient considering saline implants should be counseled about the risk of rippling.
Rippling may also be affected by the texture of the implant. Some implants have a smooth surface and others have a textured surface. Textured implants can have a thicker surface which may be more likely to cause rippling. If rippling does occur, switching to a smooth implant may be the solution. Also, because silicone implants are much less likely to cause rippling, switching from saline to silicone implants can help. Another solution may be to change the location of the implant from the subglandular position (above the chest muscle) to the subpectoral position (under the muscle). In this position there is more soft tissue as well as the muscle covering the implant so therefore rippling is insignificant and not noticeable.
Dr. Alain Polynice MD of the Williams Center for Plastic Surgery performs breast revision surgery to correct breast implant rippling at the New England Laser & Cosmetic Surgery Center in Latham, New York. General or MAC anesthesia may be used and surgical times average one to four hours. During surgery, the old incision may be opened or a new incision may be made around the areola or under the breast. The implant is then removed and exchanged, typically in a new pocket under the muscle. Dr. Polynice may use acellular dermal matrix products like Strattice which have proven very effective in treating implant rippling. Made form pigskin, this product has been used extensively in breast reconstruction, hernia repair and in burn patients. It is a very effective tool in breast revision for providing extra coverage and support for the implant and for treating rippling.
Recovery following breast revision for implant rippling takes approximately seven to ten days. The stitches do not need to be removed because they are dissolvable. Patients are typically able to return to work and other normal activities after one to two weeks.