Breast implant wrinkling – What causes it and how to reduce risk?

All breast implants used in the Breast augmentation procedure have a risk of creating some amount of wrinkling. Wrinkling is the effect which can make the skin look like it has ripples. This occurs in a small percentage of cases, and the risk can be reduced if the surgery is planned well.

There are several factors which contribute to  visible breast implant rippling. The most common factors are:

  1. Consistency of  the implant: saline, gel silicon, or gummy bear silicone
  2. Your own soft tissue cover (skin, breast gland, fatty tissues)
  3. how much of the implant is placed under the muscle

In terms of potential to wrinkle, saline implants are the most likely to show wrinkling, because they are the most flexible. Gummy bear implants are firm and are the least docile, so they are least likely to show wrinkling. Pick up an implant by the edge and you can see that the implant will make lots of folds. Silicon implants are less likely to ripple compared to saline implants due to the thicker density and viscosity of the silicon. However, they too, can create wrinkles. Gummy bear implants are very dense and thus the least likely to create visible ripples. There is to be a price paid because they may feel stiff. In cases with thin soft tissue cover, such as very thin patients or post mastectomy reconstruction, gummy bear implants are the best solution to prevent visible wrinkling.

The skin, breast tissue, and  fat surrounding the implant is your soft tissue coverage. That also plays a role in the potential for visible wrinkles. The thinner your skin and the less fat you have, in general the greater chance there is for the implant wrinkles to show through the soft tissue cover.

Placement of the implant below the muscle is an important factor to control visible implant rippling. The technique of  ‘below the muscle’ as is commonly referred to, is actually a partial insertion under muscle (pectoralis major) of the top part of the implant. Over the years I have modified that technique so that the implant is covered by muscle at the top AND lower lateral half of the implant. This requires a little more dissection and time, but I have found it to reduce rippling.

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By Dr. Ricardo L. Rodriguez MD Board Certified Plastic Surgeon Cosmeticsurg Baltimore, Maryland Ricardo L. Rodriguez on American Society of Plastic Surgeons.