Visible ripples in implants

Determined-I feel the same as you. I am fine about it for a while but I keep thinking about it. My husband keeps laughing at me because I'm always looking at my boobs and he thinks its funny. He thinks they look fine and says to just leave it alone, but I know it has to be my decision. I have smooth HP allergan. I thought that I read that textured can produce more rippling, although I'm not sure. If that would have solved the problem for me I think my Dr would have offered a textured implant for the revision. He also does do the gummy's and I asked him about those and he said they could still show some rippling, although I have seen many pictures now on the pic forum and I don't really see the girls with gummy's having any problems with rippling. I think the rippling may be more of a problem because of the thin skin and muscle coverage we have, that is why a bigger implant may not solve the problem much. I think 50cc's more won't make you look any bigger, but for me he said 50 to 100 and if I go with a 100cc's than he said I will be 20% bigger. My Dr didn't offer me additional Alloderm either so it's good you have that as an option. I did a little research on that and I read it can help with severe rippling.  I didn't really want to do that. I would like to meet for coffee too, but your not in CT right?. The best I can do is yahoo and webcam if you have messenger or AIM.

Orchidgal-So sorry you also having so many problems with rippling. It sounds like you do have quite a bit. The more I read the more I think that is seems that a lot of women end up having to have a revision on their reconstruction. It is very discouraging especially after already having several surgeries. I had three so this would be four me as well.  Part of me wants to just be done with all of this but like you I agree we should feel good in clothes as well as without and should get the best possible result we can. It sounds like you have a good PS who is willing to work with you and has options to solve your problems. Take time to heal from your last surgery and really think about it. Six weeks is still early and they will keep changing. I am over three months out and the Dr. told me to give it at least four months for things to really settle. Have you been to the pic forum? There are a lot of postings about revisions as well and it is encouraging to know that things can be fixed.  I also like to work out and have struggled about what type of exercises I can do with weights and have been avoiding them. I think I need to research that more. I agree with your last comment too.

Sweetie
Diagnosis: 2/25/2010, IDC, 1cm, Stage I, Grade 1, ER+/PR-, HER2-

Kate- I was going to ask Orchidgal what a neurectomy was too. Your too funny...I think your right the husbands will say what it takes if keeps us from obsessing about it...but we can't!! That's the point we just can't. I kind of feel like if I'm going to do something I want to do it sooner than later, but husband thinks I should wait and go through the summer and see how I feel. I may wait a little longer but if I start wearing summer clothes and I see ripples when I look down,that's going to make the decision for me! I don't know Kate maybe we could make a pact and do it at the same time so we both don't chicken out.

Kate-the casino analogy,too funny. I guess we are becoming boob obsessed at this point. I agree that choosing the first surgery was easier in a way because it was something we knew we had to do no matter what type of surgery so it was just a matter of choosing the surgery that we felt most peaceful about. This is so different because we are done with that and now it's more of a cosmetic thing, if you can really call it that.  I guess the thing with the options is the Dr's don't really know which way will work best. They always say if you don't like something you can a revision like it's no big deal. I think for you, you have some less invasive options like the fat grafting. If I had that choice I'd probably try that first to see if it gave me a good result. If it did you wouldn't have to think about the other options.

I too need to be looking for a job. I was laid off two years ago which worked out good because I needed last year, but like you I want to sort of wait to see if I will be doing one more surgery. Plus it's so cold here in the winter I don't even want to go out. My daughter starts college in the fall, maybe that's a better time to start looking.

Valerie- Alloderm is supposed to help with rippling so maybe I would have been even worse without it.  My PS also used the Alloderm to create a shelf at the IMF and used some on the side to prevent the implants from gravitating out.  It's weird, though, because I can feel a ridge where she used it.  It scared me when I first felt it because I thought I had a lump.

Well I sure don't think I want any nerves cut - I'll live with the "animation foob" - kind of funny actually.  And I hope my foobs will be ok without the use of Alloderm - doctor seemed to think they will be fine - I only notice a tiny bit of rippling when I lean over.

Yeah, Kate, I've seen the muscle flexing thing.  Pretty bizarre looking, certainly reminds you that you have a rebuilt boob.  BUT...I hardly ever see it because it happens when I'm clothed, cutting something in the kitchen, etc.  I have tried to stop "making" it happen when I can observe it.  It's better for me if I just don't focus on it.  I'll be interested to see what your dr. tells you about the nerve surgery.  I wonder if any strength is lost?  Keep us posted. deekaay

deekaay- Oh, I'm so sorry!  As if all this wasn't hard enough.  It must have been really scary when they first found the lump.  Thanks for sharing with us, though.  It does make me think twice about pursuing fat grafting.  It seems like none of our choices are good choices, doesn't it?  Is there anything they can do to dissolve the lump for you?  Again, so sorry this happened.  (((hugs)))

Hi ladies, took a break for awhile but always thinking of you.  I was recently at my general surgeons for the one year visit. Previous to this I had only been visiting with my PS. I mentioned to him how pleased I was with the nipple and skin sparing he had done. Showed him the indentation I was considering having fat transferred to for his opinion.  He commented it was the pec muscle pulling and that it was noticeable because of his having to remove subcutaneous fat from a misfired titanium marker from the biopsy which was in the fat and not the breast tissue.  I commented that I was very pleased that I did not have ripples and raised your concerns. At first he was talking generally about saline vs gels.  In mx, he said that the ripples come from too thin of skin with too much subcutaneous fat removed during the mx. The muscle then becomes more noticeable.  He said its a fine line between the subcut. and the breast tissue and thats where the experience of the surgeon comes in.  Seems to make sense because I did not have the nipples turn blue or fall off like alot of the girls on the other thread mentioned.  He said some surgeons go real close to the nipple and take too much of the fat.  Both Kate and Sweetie are thin to begin with, perhaps you started with less subcutaneous fat than I did.  Perhaps if a woman starts out in this process as being very thin with not alot of subcutaneious fat, it could predict possibly a problem with ripples??? or is it all skill of the surgeon.??? Something to think about, learn from.

Hmm...this brings up an interesting question.  We've all heard the thin skin, thin muscle coverage as being a possible cause of ripples, but is it being thin to begin with that is at the heart of the problem?  I know there are a number of women on the picture forum that are thin without ripples.  But are we a subset of thin women who get ripples? 

Without being offensive, can you ladies weigh in on whether you'd describe yourself as thin, average, or fluffy?  If this is offensive, let me apologize in advance.  No judgment here, I'm just trying to get a clue to see if we have a pattern here. I would say overall I am on the thin side with a little extra fluff in the middle. I was also small breasted previously.

At my DX I was 5'4" and weighed 102 lbs.  (Now I'm more like 115.)  The little weight I did have was more in the thigh region.  I was a 34B before surgery with a very small ribcage.

PB22- You're right.  I would have done the same thing.  I told my PS that I was upset with her because she had never even warned me of the possibility.  I have to say, though, that had I learned about Dr. Khouri's procedure ahead of time I would have been tempted to go that route.  My BS was a 2 hour drive from my house to have a NSM.  What's a 6 hour flight? 

Interesting....so far, looks like most of us are on the thin side.  I wonder if that contributes to thinner muscle in addition to thin skin.  But I know I've seen thin women on the pic forum that don't have ripple problems that are visible.  I have also wondered if over expansion of TEs contributed to my problem, making the skin/muscle too loose the tuck the implants in tight, thus pushing ripples out.

Here's what I keep going back to--if I pull my skin tight at the bottom of my breasts, everything tightens up and ALL ripples disappear.  That would be a way to fix this w/o going larger.  But I've asked my PS several times about doing this and he just shakes his head.  I should have asked him why not. 

Well, like PB22 said, I still would have done this even knowing what I know now.  That's a good way to look at it..

Deekay-I have been doing some research on the internet about rippling and it seems like a lot of women who have augmentations have it. When they have it their doc's recommend silicone and under the muscle (which most of  us have both). Also their Dr's said that if the woman was thin and had very small breasts to begin with it was more likely she'd have some problems with rippling. So for us ladies who had a MX, we are dealing with NO breast tissue and thin skin. I'm beginning to think it's the way it is. I am however considering a larger implant 50-100cc's more. I'm thinking it won't look much bigger and my Dr said it will either improve the ripples a little or a lot, but they won't be worse. I have noticed now that three months have passed and everything has settled in my body that these don't feel very large anymore. In fact I'm wearing all the same clothes and I look pretty much like I used to a small B (even though I must buy a larger bra size now)

Deekay I understand what your saying about pulling the skin tighter. Mine is the same way. If my shoulders are pulled back and I stand real straight all the rippling goes away. I wonder if some Drs when they do the exchange pull in the skin. My friend who had her exchange last month had a lot of stitching and the Dr told her he tightened certain areas.  I was expanded to 400 and changed out to 450.

Kate-good point. Maybe it is all how each person's body responds to things and number of factors. There certainly is no cut and dry fix for this.

Just a little update re revision surgery, etc. Was at my dermatologist's office today, an established "celebrity" and non-celebrity guy who has been around and seen everything. He asked me the status of my recon, and I told him the PS said I needed a revision, that he would put a larger size in to take care of the ripples. I told him I didn't feel good about it, didn't want anything larger, and wasn't sure if I should go through with it or not. He said that a larger size, especially on my petite frame would make matters worse, and possibly impact (distort) my ribcage, plus create a larger capsule and require more surgeries to make it right. He referred me to another PS who specailizes in revision, and said he doesn't know him, as he does my current PS, whom he respects and likes, but that this other PS is a breast recon specialist, and did a great job on another patient of his who had a similar problem as I do. So my appt. with the new PS is on Thursday. Will  let you know what comes of it! So hard to know the best thing to do and expect, under these circumstances...feeling you all on tis issue!

I was expanded to 270 and have Mentor Silicone high profile 375s. Still fit in my clothes, but a little tighter than before. I was a 32-C/D, now a def 32-D.