Rippling after mammoplasty — what is

Rippling – one of the complications after surgery breast augmentation. It is called «skin dimpling» or «washboard effect».

Actually it is the optic of the implant when there is insufficient amount of skin tissue covering it.


Rippling after mammoplasty is a complication, characterized by the formation of small folds and «waves» or «ripples» on the chest.

It is a visual manifestation of the implant.

When the implant is positioned vertically, the upper part, rolled at the bottom and the top are formed of folds (characteristic of saline implants). When excessive tension on the skin, these folds begin to appear.

Rippling might not show up in a relaxed position glands and detected only when the enclosure is tilted or when walking.

The defect may occur due to physiological characteristics of the organism, with insufficient volume of the skin, properly selected implants, equipment violation operation, etc.

The likelihood of rippling depends on the size of the selected implant. The more they are, the sooner there is a defect.

Why do I get

Often a similar effect occurs after surgery when the swelling subsides, but the skin still remains stretched, poorly reduced and folded. In this case, implants are not, this is a temporary phenomenon.

There are several factors that affect the risk of this complication:

  • the volume and elasticity of the skin and soft tissues;
  • the variety and size of the implant;
  • the place and technique introduction.

«Wave» is not likely to occur or be noticeable, if the skin enough to properly cover the implant.

That is why rippling often appears in petite women with a slim body fat and small Breasts.

Obese patients with a pronounced layer of subcutaneous fat and initially oversized Breasts this is missing.

It is generally considered that the larger the chosen implant, the higher the risk of rippling.

An important role to play in the place of the prosthesis. Preferably submuscular placement of the implant (i.e. under the muscle).

This arrangement gives rise to a greater volume of soft tissues over the prosthesis, and the muscles themselves have their own tone, which also helps to hide the defect.

Since muscles cover only half or 2/3 of the top of the implant, the formation of ripples in the lower folds of the glands is still possible.

But this place itself is unobtrusive, and even with a deep probing it is possible to feel something, but nothing much to see. That is why a small rippling perceived here quite well.

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The pectoral muscle is usually well developed in the center and become thinner and flat closer to the outer boundary of the thorax.

Therefore, the introduction of the prosthesis under the muscle, the outer edge of the tissue volume may not be enough, and the side ruffle is noticeable (especially when bending). If such a defect is unacceptable, you will have to make a choice in favor of implants of a smaller size.

Ideally, the width of the prosthesis must be less than the diameter of mammary glands to mammoplasty.

«The washboard effect» often arises in setting the saline implants are filled with saline.

In addition to waves at the edges of the prosthesis, where there is a lack of its own tissues, such implants give the effect of ripples across the surface of the gland.

This is the result of the free movement of fluid within the prosthesis when there is insufficient content. Especially pronounced rippling when setting the implant over the muscle pectorales.

Gel breast implants have no such shortage, so in most hospitals they now use.

As for the surface, rough implants compared to smooth, increase the risk of the formation of the ripples.

This is due to the fact that their own tissues seem to «stick» to the textured surface.

But this point is relevant only when installing the prosthesis over pectorales muscle, but not in the introduction subpectoral.

Video: overview of operations

Looks like rippling after mammoplasty

Rippling looks like gland held in the fingers and the surface have a small «furrow».

For a small amount of tissue wrinkled chest does not look very aesthetically pleasing.

«The washboard effect» is not a fixed defect. This means that he’s usually invisible but can be visualized during walking or when the enclosure is tilted.

Ripples can be small and unobtrusive to others and to be felt only during the skin by hand.

Some women ripling do not care if they consider it to be acceptable. But for others, the defect becomes a real problem that can only be solved surgically.

Where formed

If the implant is inserted under the pectoral muscle, the wave is likely to appear from the edges of the chest, since there are no muscles that would be covered by the prosthesis.

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When the enclosure is tilted forward, the rippling becomes more visible because it pulls the skin.

Rippling more likely to occur with injection of saline implants, especially if there is little fat in the mammary glands.

This effect is explained by the chemical properties of water-salt solution, which fills the prosthesis.

When setting gel implants rippling rarely bother, since the viscous gel holds its shape well.

If you use too large of bust implants may take a rectangular shape instead of a beautiful smooth outlines. And in the area where the muscle can not cover the prosthesis, there will be a severe skin wrinkling.

What to do

How to troubleshoot problems exist, but they are all surgical. Therefore it is better to try to avoid the defect initial consultation and the surgery, selecting the appropriate implant and technique of their introduction.

Earlier ripling eliminated by replacing the saline implants in the gel or by moving them under the breast, if they were installed on it (under the Breasts).

Now to solve this problem there are several solutions.

Implants can replace with gel implants with a high density, they can be placed under the chest muscle, in the area of development of this complication is to inject the dermal matrix which will hide the waves.

In some cases, the defect is impossible to rectify through the introduction of their own fat in the problem area.

If rippling caused by installation of saline implant or its introduction over the chest muscle, the best solution would be to re-operation and replacement of the saline prosthesis in the gel (in the first case) and placing the implant under the muscle (in the second).

If the skin is themselves thin, and a sufficient volume of prostate not, you can pay attention to the introduction of dermal matrix (Alloderm). This technique will help reduce wrinkling.

Alternatively, it is possible to transplant adipose tissue, which will attach its own tissues for extra volume.

Another solution is to replace the prosthesis at least. But if the size change is absolutely not desirable, it is better just to leave it as is and not pay to defect attention.

Risks and complications

It is generally considered that rippling is not a classic surgical complication.

However, focusing on the possible discontent of patients, plastic surgeons try to the extent possible, to undertake any attempt to minimize the possibility of skin ripples.

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It’s more an aesthetic problem than health, so about the serious risks and complications it usually is not.

Not every patient is ready for another operation, so I often leave everything as is.

Rippling hardly be called a complication, since the waves do not appear always, but only when bending the trunk forward or during active movements. It can be visually hardly noticeable, and only the woman herself can feel the roughness.


No special recommendations with regards to prevention of ripling no. The main thing – is competent initial consultation and high skill of the plastic surgeon.

An experienced specialist will always select a suitable implant after insertion which will not have any problems.

The task of the surgeon to tell the patient about all the types of prostheses used and the possible consequences in case dental implants are excessively large in size, not corresponding to the original parameters.

The task of women – to analyze the information and adequately assess your physique. This applies more to slender women who wish to increase the Breasts from three sizes and more.

Themselves surgeons during surgery sometimes resort to the following measures: a little «overwhelmed» the recommended volume of the implant (in the case of saline implants).

This reduces the probability of formation of waves and Marinetti, but leads to other problems: the implant becomes excessively tight and easily palpated.

Besides, a crowded prosthesis more prone to leaks and damage, which in the future may indeed lead to serious complications.

Thus, the volume and elasticity of the skin cannot be influenced, but the size and type of implant you can control. The surgeon should choose the appropriate prosthetic and, of course, to ensure correct technique of administration.