Breast implant revision advice ...

I have had 2 breast augmentations Second was to "fix" the rippling that occured in my first implants, now 4 years down the track my second set of implants have rippled, they ache and are awful. I am 164cm tall and currently sitting on 57kg . My implants are cohesive silicone tear drops above the muscle. I've had a consult with a different but the surgeon advised to go to round high profile silicone implants and wanted to use an implant 50cc smaller, stated he couldn't guarantee until he opened me up what size he could use, wouldn't an ultra sound give some hint to what's going on? I would rather not loose size plus I'm concerned if I had a smaller implant I would be left with loose skin ? I want to go ahead with this procedure though am worried I will select the wrong surgeon again.

Butterfly September 2nd, 2016 WA

  • Answer
    Mr Mark Ashton

    Mark Ashton

    2 answers

    Plastic Surgeon
    Victoria, Australia

    Good Afternoon Butterfly,
    A MRI is a much more accurate method of measuring the volume of your implant.I would use this rather than an ultrasound.
    The rippling is a result of the implant, the capsule and your overlying soft tissue.
    Some implants are more prone to rippling. We know that saline implants are the worst, and that softer, less cohesive implants are more prone to rippling than firmer, more cohesive implants. The firmer the implant, or the more "cohesive" the silicone gel, the less likely the chance of rippling. You can check the cohesiveness of your implant on the company's website.
    Secondly, mild capsular contracture often first presents as rippling. You mention you also have some mild aching pain and hence if your implant is firmer on one side than the other, it would be worthwhile checking with your surgeon to ensure that the capsule on the affected side is normal.
    Finally, any mild rippling will be visible in very thin patients or in whom there is inadequate soft tissue cover. One option to camoflague this rippling, particularly in the cleavage area, is to swap the implant from above the muscle to a retromuscular pocket. In this way the muscle is used to augment and supplement the skin and soft tissue and may allow you to fix the rippling without changing the implant size.
    The other option we sometimes use is fat grafting.
    The implant shape and its profile will have very little, if any implact, on rippling. I have seen severe rippling in both round and anatomical implants.
    The most reliable method to correct your rippling is to swap the implant to a high cohesive gel implant, at the same time perform a capsulectomy, and swap the implant from it's subglandular position to a behind the muscle pocket.
    I hope this helpsCheers MarkProfessor Mark Ashton MD, MBBS, FRACS