Rippling

Rippling is one of the most frustrating breast implant issues to deal with, whether it’s the result of a poor augmentation or natural changes to the breast. Dr. Teitelbaum takes an honest, individualized approach to rippling revisions to help you achieve results that look natural and align with your curves.

What Is Rippling?

Rippling refers to visible or palpable folds in the breast implant that create a rippled or uneven appearance through the skin. While implants are designed to feel soft and natural in the body, these qualities can sometimes allow folds to form long after healing, especially in patients with thinner breast tissue.

These folds can occur anywhere around the breast, including in the lower outer breast, in the upper breast, along the inner cleavage, and across the entire breast. This can affect the appearance and feel of the breast, altering how clothing fits and your confidence in daily life.

breast rippling illustration

_{This illustration from one of Dr. Teitelbaum’s book chapters demonstrates the difference between three closely related problems: fold malposition, stretch, and rippling.}

What Causes Rippling?

While rippling can happen in any patient after a breast augmentation, the three main causes of rippling are the following:

Thin Breast Tissue: Naturally thin tissue or significant weight loss can reduce breast volume and create visible rippling along the implant.
Implant Issues: Implants are manufactured to be soft and pliable, meaning they all have the potential to develop folds after healing.
Under-Filled Breast Envelope: If the implant is too small or your skin is thin, damaged, or stretched out, the implant can drop, settle, and fold at the bottom of the breast.

Textured implants are more prone to rippling than smooth implants, and saline implants typically develop rippling more often than silicone implants, simply because of the natural properties of the implant material.

How to Know If You’re Experiencing Rippling

Because every patient’s body is different, no two will experience rippling the same way. Some patients only notice rippling when in certain positions, while others see it clearly through clothing. You may be experiencing rippling implants if you notice the following:

Visible lines or folds on the breast surface
Uneven texture in the upper or inner breast
Abnormal wrinkling
Feeling folds when palpating around the breast
More visible lines or folds when bending forward

A consultation with Dr. Teitelbaum will help determine whether the rippling is normal for your breast implants or if you’d benefit from a breast revision surgery.

View Article

_{Dr. Teitelbaum has co-authored a chapter which includes a description of how to fix breasts with implants that have stretched.}

_{This important article presented for the first time a description of the destruction a large implant can do to the breast tissue, which can lead to thinning, stretch, rippling, and drooping.}

Why Choose Dr. Teitelbaum?

As one of the world’s leading breast plastic surgeons, Dr. Teitelbaum’s treatments for rippling focus on restoring the breast with precision and balance. He’s written multiple textbook chapters and articles on the subject, cementing him as an expert in his field.

Academic and Clinical Excellence

Dr. Teitelbaum received his doctorate from the UCLA School of Medicine, where he now serves as an Associate Clinical Professor of Plastic Surgery, and then completed his residency at Harvard University. Before opening his private practice in 1995, he earned two board certifications in General Surgery and Plastic Surgery, and worked in the plastic surgery wards at LA County Hospital, reflecting his commitment to high-quality, evidence-based care. Over his 30+ years in practice, Dr. Teitelbaum has worked directly with the FDA on breast implant research and has given lectures to industry peers and students on five continents. His work has been published in peer-reviewed journals like Aesthetic Plastic Surgery and Plastic and Reconstructive Surgery, and he’s earned leadership positions and memberships in the following professional organizations:

Aesthetic Surgery Education and Research Foundation, 2016-2017 President
California Society of Plastic Surgeons, Treasurer and Legislative Committee Chair
Aesthetic Surgery Education and Research Foundation, Board Member

A Patient-First Philosophy

As a patient, you’ll feel Dr. Teitelbaum’s passion for plastic surgery and thoughtful patient care from your first consultation to your final follow-up. He and his highly trained team lead with integrity, transparency, and trust, and their goal is to deliver results without gimmicks or trendy treatments. Every procedure is done with the utmost care, ensuring your experience is safe, effective, and completely tailored to your body.

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Your Confidential Consultation

Every patient’s journey with Dr. Teitelbaum begins with a one-on-one consultation at his Los Angeles office. There, you’ll discuss your aesthetic concerns, rippling symptoms, and surgical history, and Dr. Teitelbaum will perform an in-depth physical evaluation to determine the root cause of your rippling. From there, he’ll begin building a personalized breast revision surgical plan or suggest a non-surgical treatment to address your concerns.

How Dr. Teitelbaum Treats Rippling

Your breast revision surgery to address rippling will depend on the root cause of the issue and the placement of your implant. If the implant is in front of the muscle and the tissue is thin, Dr. Teitelbaum may suggest moving the implant behind the muscle. If the implant is behind the muscle or the muscle is damaged, then he may inject fat to thicken the implant coverage or use an acellular dermal matrix to support the tissue.

Sometimes, a modest, natural weight gain can provide coverage to the implant and resolve rippling. If the breast tissue is very loose, Dr. Teitelbaum may suggest a breast lift or a slightly larger implant to help raise and support the breast.

Patient-Centered Recovery in Los Angeles

When done to address rippling, recovery after breast revision surgery in Los Angeles typically involves mild swelling and soreness for up to one week following your procedure. Most patients can return to light activity, including desk work, walking, and social gatherings, within a few days, but you’ll need to wait at least two months to resume strenuous exercise. Both implant adjustment revisions and fat transfer revisions follow this general recovery timeline. After your procedure, Dr. Teitelbaum will share a personalized recovery plan to support your healing. This list will include the following:

Incision site care and cleaning protocols, if applicable
Hygiene recommendations
Activity limitations
Sleep position restrictions
Swelling and pain management strategies

You’ll need to return to Dr. Teitelbaum’s Los Angeles office several times over the coming months for follow-ups with his team. There, Dr. Teitelbaum will monitor your healing progress, ensure the tissues have settled properly and that the implant is secure, and remove any remaining sutures, if applicable. He’ll approve your resuming impactful activities when appropriate.

FAQs

Is minor rippling normal after a breast augmentation?

Yes. Mild rippling, especially in patients with a low body weight or thin breast tissue, is to be expected in certain positions. Highly visible or widespread rippling requires evaluation by Dr. Teitelbaum.

Can weight gain after surgery reduce rippling?

In some cases, a modest increase in body weight after your primary breast augmentation can help add coverage to the breast and prevent rippling. This will depend on your individual anatomy and is not a guarantee.

Will rippling get worse over time?

Rippling can worsen over time if caused by thin or stretched tissue. Changes in weight and aging can also affect the appearance of breast implants, making rippling more visible.

References

Teitelbaum, Steven M.D. Strattice™ Reconstructive Tissue Matrix Used In the Repair of Rippling. LifeCell. 2010.
Bengtson, Bradley P., M.D., Teitelbaum, Steven, M.D. Revision Breast Augmentation. Breast Augmentation Video Atlas, Chapter 9, 72-98. 2019.
Tebbetts, John B., M.D.; Teitelbaum, Steven, M.D. High- and Extra-High-Projection Breast Implants: Potential Consequences for Patients. Plastic and Reconstructive Surgery 126(6):p 2150-2159, December 2010.