Textured Silicone Breast Implants & Implant Rippling

Oct 19, 2011 by

Did you know textured silicone implants have a higher amount of rippling and wrinkling than smooth silicone implants? I won’t even discuss saline implants- of course they wrinkle and ripple more due to the nature of saline.

This is a good post and discussion about breast implant rippling, this is taken from the Real Self website, please click here to read in full.

The patient asks the following:

I am 5’4″, 140 lbs and currently a deflated, mildly sagging 34C. My base width is 14.5cm. I’m scheduled to get 469cc textured silicone implants (14.1cm) in a few days. My PS and I have decided on dual plane, inframammary. I am wondering if there is any way to determine the likelihood of rippling… especially since my weight tends to fluctuate within about 10 lbs (breasts usually don’t fluc. a lot as far as I can tell). Should I go with less cc’s/smaller diameter to reduce this chance? Thx.

Some of the answers:

I agree that you have adequate breast tissue (tissue cover) to have a ver low likelyhood of visible rippling.  I agree with a dual-plane subpectoral approach in terms of the pocket created for the implant; however, I disagree with the use of textured silicone implants because i find that the “grow” into the capsular tissue and are more prone to “fold flaws” and creating visible or palpable rippling/wrinkles.  The truth is that almost all saline or silicone implants have “ripples” around their perimeter when they are placed, the difference is whether they can be seen or felt through the skin.  So I think the most important criteria is adequate tissue cover and I think you have that, even though personally I would have selected smooth instead of textured implants.

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The best way to avoid implant rippling is to avoid breast implants completely. Since all breast implants ripple (saline more than silicone and textured and anatomical more than smooth), the worst rippling implant would be an over sized, textured shell saline implant placed under the gland while the least rippling or better, least conspicuous would be a properly sized smooth high profile silicone gel implant placed under the muscle.

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Although it is impossible to absolutely determine the likelihood of rippling, there are several factors that come in to play. One is the type of implant and the other is the placement and the amount of breast tissue that overlies the prosthesis. That being said, a submuscular or predominantly submuscular placement of a smooth silicone prosthesis, is least likely to result in either visible or palpable rippling. I no longer use textured implants since there is a higher incidence of folds and no true improvement on capsular contracture rates. In your case a slightly smaller implant would also be of some benefit, and because you do not show a great deal of glandular ptosis on your photo, then you do not really need a full biplanar augmentation, just a little inferior release which would maintain more complete coverage of the prosthesis.

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Ripple is caused by thin cover over an implant allowing the implant to ‘show through’ after augmentation. Both a saline and a silicone gel implant can ripple. The saline implant has less cohesive fill and therefore will tend to ripple more. Submuscular coverage will substantially reduce visible ripple in all implants. A large implant will tend to ripple more because of the weight and traction forces. Finally a textured implant will ripple more than a smooth implant because of shear and traction forces on the implant. My advice would be a smaller implant in a silicone gel, moderate profile, without texturing.

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It seems that your surgeons plan to put silicon gel implants partially under the muscle is the best was to avoid rippling of the breast. When I look at your breast photos it looks like you have enough breast tissue to cover the implants whether they are under the breast or partly under the muscle. Saline implants have a much higher chance of rippling. It is thought by many that textured implants are less likely to get hard but may tend to ripple a little more. Regardless it seems you and your surgeon have a good plan.

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You have adequate breast tissue to minimize the visibility of rippling. Dual plane will also diminish this tendency. Use of high profile implants are also associated with less tendency for rippling. The use of textured silicone implants in the USA is not as popular and once a fold or ripple develops with these implants, the texturing may make the rippling more prominent.

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So what do you do? You want to reduce capsular contracture and hear that textured silicone implants are better than smooth silicone implants to reduce capsular contracture. But then you learn that textured silicone implants ripple more.Please continue to read and research your implant surface type, the more you do the more you will learn that polyurethane foam covered silicone gel breast implants have the lowest rate of capsular contracture, rippling, wrinkling and malposition of any implant type.

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