Visible ripples in implants

sweetie- From everything I've read there are two camps, just like with NSM, regarding fat grafting.  Those PS's who think it's great and those who think it hasn't been researched enough.  I am very torn whether or not to have it done.  My PS (who is in the anti-fat grafting camp) told me that gaining weight would help cover the ripples!  Great- my boobs will look good but I'll hate my ass.  Jeez!

My doctor is also against it.  I had alloderm placed around the lateral and medial sides to try to reduce the rippling but we didn't think to add to the top of the breast. I am ok with the small amount on the right side but not the left. If you add a larger implant it might help I am told.

My implant on the right is at 450cc and the left is 400cc and they look very symetrical in size. So if I add to the left do I  add to the right to keep on track.

I can't even believe we have to talk about this stuff! 

Kate33 thanks for the laugh. 

Post op I just had to wear a bra - nothing special, no BRAVA.  Just a bra that gives good support without squeezing the girls too much.  I opted for a sports bra that had extra room in the breast area.  You know how some sports bras really squeeze you tight?  This one didn't since it had that extra space in the cup area.  Held me nice and firm without being too tight.  Didn't have to wear one at night, but I went ahead and wore one of those super comfy cami type bras or just a cami.

Had my follow up yesterday.  It's been almost 5 weeks.  Everything looks great and Dr. K was very pleased with the results.  He gave me the all clear to exercise and sleep on my belly if I want.

I'm very happy with my breasts and the lipo was a nice bonus!

Katie33 - you are TOO funny and I agree with Sweetie2040, since when does ANY weight we gain go to the boobs (!?!) and right, since there is no tissue there.... how would that work?

Hello all

I am scheduled for fat grafting next wednesday. I have some rippling and step offs. I am going for it. I have to go under anyways because my left implant has fallen below the mammary fold. Not bad but it could get there so she is bolster stitching it to my chest wall. I am also curious for those that have had the fat grafting if you were able to notice a difference in where they take the fat from. I would love to reduce my belly a little. I am not big but have some left over fat from having my son two yrs ago. !!

Hi Ladies, I have been following this thread as I had never heard of rippling.  I am due for exchange surgery on the 16th of November.  I see my PS this afternoon for my pre-op appt and a long list of questions.  I too am now concerned with this rippling issue with silicone.  Is there anything specific I should ask him that you would have asked your PS had you known about this issue prior to your surgery?

 Thank you for any advice you can offer... Starting to get very nervous about this next step!!

Cheryl xo

Thank you for your response!  I will be getting the silicone.  He has said all along my skin looks fantastic, so hopefully that is a good sign.  Although I do have some wrinkles on the underneath on one side, which concerns me. I will ask him about the grafting.  I will keep you posted on what he says today. 

Thank you!  Cheryl xo

Wow!  This thread is getting popular!  Not sure that's a good thing, though, since it means a lot of us are having this issue!

sweetie- I haven't set up an appointment with a new PS, yet.  I think I'm dragging my feet because I feel like, after 4 surgeries this year and multiple dr. appts., that I've exceeded my quota of tolerance in being poked, prodded and flashing my foobs at yet one more stranger!  

Yeah, I thought the whole "gain weight and your boobs will get bigger" thing was pure hooey, too.  Amazing how when your docs says one stupid thing it makes you lose all confidence in them.

ibcmets- I think there would be less rippling in gummies since they are firmer.  The down side is....they are firmer.  So you'd look good but feel worse- as in not as soft and natural.  So our choices are look good in the daytime or feel good in the dark.  Not much of a choice.  Not everyone has issues with rippling, though, so hopefully you won't.  Good luck with your upcoming surgery.

determined-  I was wondering about the shelf, too.  Seems like if they just made a stronger sling to hold the implant there would be less rippling.  Even though my PS used tons of Alloderm when the TE was placed, and during exchange, I still have lots of rippling.  Wondering if the Alloderm sling itself wasn't stitched in strong enough.

sunnyhou- Good luck with your fat grafting!  Hope you get some great results!

bigdogmo2- It's hard to know what questions to ask your PS as each one seems to have their own opinion.  The lack of consensus seems to be the worse during the reconstruction phase.  Some PS say going with a bigger implant will decrease the rippling.  And others say the bigger implant will make the thin skin even tighter which will empathize the rippling even more.  This is a source of a lot of frustration for us.  It would be nice if they could all get on the same page.

PB22- Aww, you're so sweet for the offer!  I had thought that if I were to do fat grafting I would want to go to Dr. Khouri as he seems to have the most experience with the procedure.  It would be a long way for you to drive but I might take you up on that just so I can finally meet you!  

Reading all these posts with interest. I am going for my exchange Nov.. 22nd. I decided on the silicone over the gummies because feel gummies might be to hard but I know silicone does create ripples. When I asked my PS about them he said if I get them he will to injection of fat to control it. Is that the same as fat grafting?

I have no idea how big I am going to big. I was there 2 hours the other day and he said he would just fit me to my body type.  Is that the normal course? I just want this finalized so I can be better by xmas.  I was also told that I could not lift for 6 weeks. Did you all get that same restriction?

Dear NJ-there are lots of threads on BCO about implant sizing. You may also want to PM whippetmom about sizing. She predicted my sizing by taking my measurements and was 100% accurate with what I ended up with.  I too was placed under strict no lifing/pushing/pulling for 6 wks after. It was tough but now that I understand more about the pectoral muscles & their effect on implant placement and (heaven forbid) implant migration, I am glad I obeyed the restrictions.  Best of luck!

Glad to have found you all over here.  I am 4 mos. out from exchange and 2 mos. out from nipple/areola grafting. I had one round of fat grafting during my last surgery for step off which it helped and one area with a wrinkle in the implant which the fat softened a little.

Had my final visit with PS this week and thought he'd rec another round of fat grafting--he didn't.  Since I have some ripples, I am disappointed.  I am going to wait and see how things look in 3-4 mos.  My ripples don't show at all if I stand up straight, but emerge with rounded shoulders. PS says it's due to thin skin, thin muscle coverage.  He said some rippling with implants is to be expected.  He added the only way to really avoid ripples is to not use implants and do flap surgery.  I'll try to post my updated pix on the forum this weekend. Generally, I think I look good in clothes with and without a bra. It's the naked self that bugs me.  deekaay 

Hi Everyone -- Great thread!  I too have ripples, one big one going all the way from 2 o'clock to the nipple which shows when I wear a V-neck top or a bathing suit.  After getting second opinions and Whipptemom's suggestions, I've decided to go in for a revision on Dec. 4th with a new PS.  The goal is to fill the pocket with the correct size implant.... moving up from a 475 cc to 600 or maybe even 650.... would prefer the smaller size, but want that pocket filled.  I'll let you all know if it helps the rippling!  Was happy about the decision yet I'm definitely apprehensive because I don't want to be let down again.  Pam

deekaay- Like you and sweetie it's the "naked effect" that bothers me, too.  It's probably why so many PS's blow us off thinking, "Hey, you look good in clothes!  Why are you bitching?"  I pretty much wear a bra 24/7 (even in, ahem, intimate situations) because I'm so self conscious about it.  So to me it comes down to a quality of life thing and PS's should be more sympathetic to our displeasure.

vanderlady- I will be very curious how your revision comes out in regards to the rippling.  Will you keep us posted here?  There is so much controversy among PS's about resolving things with bigger implants.  I'm wondering if the issue is the pocket is too big, and if I don't want to go with a bigger implant, whether they can just go in and make the pocket smaller?  Just wondering- when was your original exchange surgery done?  My PS said she didn't want to do anything until at least spring and my exchange was done the end of June!

sweetie- There is a member on here named swastew who had something called a Stacked DIEP flap.  It's a flap they can do on thinner women.  She had it done at the Center for Restorative Breast Surgery in New Orleans.  (breastcenter.com)  She is very thin so I was impressed they could do it on her.  But, and it's a big but in my mind, she had massive scars than ran from hip to hip.  (She lives near me and showed me her results.)  Personally, for me, I'd rather have rippling than such a large scar. 

Kate33- I've been pretty  much wearing a bra 24/7 too. They just feel better and look better in a bra. I don't buy the "you look good in clothes line" They are plastic surgeons they are supposed to be able to make us look beautiful in and out of clothes! I feel the same was as you and Deekaay in intimate settings. I feel like I have to have something on all the time. To add to the ripples, I have one side that rolls to the side and it doesn't look good when I'm laying down flat! The best position for my foobs looking good is me standing up with my shoulders pulled tightly back so the ripples are pulled back. Not a very natural pose.

I would not want that other procedure. I have always been the type of person who wanted the "less invasive" procedure when I had a choice. I wouldn't want a huge scar on my stomach or  back. It's bad enough I have 5 inch scars on each foob. Talk about not wanting to look at yourself naked.

Deekaay-interesting point about size and larger implants. I really like the shape and size I am now and am afraid a bigger implant wouldn't fit my body. I am just like you when I push them up the ripples disappear. It seems like there is a lot of room in there but then I think not really because the implant can't be solid or it would be a hard ball and there has to be some give. It's good that you have had some success with fat grafting. Why wouldn't your insurance cover another round if your still having issues?

Kate - My exchange was June 4th.  I saw 4 other PS from original who all said to wait 6 months... and I'm at 5 months now.  Really not much drop and fluff with me b/c I was low to begin with.... never had that hamburger bun shape many women describe.  My original PS is an artist and likes the natural look, therefore he overstretches with the TE so they have the droop effect.  He never took into consideration size of TE (14 cm) and size of implant (12.6 cm).  I asked to have it done before the end of the year so I can get it covered under the same deductible.  As for making the pocket smaller, of the 2 PS I asked about this, 1 said "maybe" but that would take away from the fullness that matches the natural side and the 2nd said "no," that if the implant wants to move somewhere, it will find a way... which I took as he is not comfortable with that .... although that was the one doc who "fits the pocket" ... I didn't choose him in the end.

Sweetie -- My first PS didn't have much to say about the rippling, he referred me to his 75 year old partner who said ....ooooh.. we need to go larger, that will show out an evening dress.  No, wasn't very happy with them from the start.... went in crying on 1 week postop visit.  Felt they were too low, my natural side was not augmented to my preference as it has a moderate profile and there is no upper pole fullness plus it is about 75 cc smaller than foob side.  Foob side I'm okay with size and like the HP but it feels low and I have pain in the pec muscle often which I never had with TE.  Plus the ripples.  From straight on perspective, they look great but from the top down view, lots of bagginess.  You know, I'm not sure that any of the docs would say going larger would take away the rippling.... so will have to see.  I mainly want the upper pole fullness and am hoping the pain will go away.... thinking there is imbalance of pressure on the pec muscle... just my thoughts.  I am 5' 6" and weigh about 135 pounds.... broad shoulders and narrow hips.  Pocket is 14 and implant is 12.6.... Whippetmom said I needed 600 to fill the pocket... my new PS thinks maybe even 650.... he'll bring in both but I'd prefer the smaller, just enough to fill the pocket.

I had fat grafting at time of exchange.... 40 cc. I'd need a lot more fat grafting to fill this area as to me if feels like there is a big void.  Also, this is in the area where I have my pain.....I don't think it is caused from the fat grafting but then again, who knows.  I wouldn't do it again any time soon.... perhaps 2-3 years down the road.   Feel free to ask any other questions.  There is one other lady who said she had a revision with about 50 cc larger and that took away her rippling. I'll have to check to see who it was.  Pam

Sweetie -- I posted to your picture forum.    Pam