Breast Implant Rippling
July 1st, 2009
A patient emailed me today about “rippling” of her breast implants. Her surgery was done in another office some 10 years ago. This has bothered her ever since, despite a revision surgery to correct the problem. She wants to have something done to reduce the rippling. There are several factors to consider.
Women frequently notice rippling of their breast implants. This refers to the undulation of the breast surface or breast skin above the breast implant. This is a result of fluid movement within the silicone shell. Erect posture and leaning forward seems to accentuate the condition. As the fluid shifts, it changes the shape of the implant from discoid to pear shape. The change in shape results in surface distortion of the implant which show up as rippling.
Women who have minimal breast tissue of their own, may notice this rippling more. Since they have only a thin layer of breast tissue and fat between the implant and the skin, the changes in implant surface are more noticeable. Weight loss may often include reduction in breast substance to reveal rippling or make it worse.
It seems the outer surface of the breast is affected by rippling the most. This is the area where the arm and elbow touch the chest and side of the breast. This location of the implant may only be covered by a thin layer of fat and skin. Larger diameter implants and lateral positioning of the implants toward the armpit, reveal larger portions of the implant into chest areas with less or thinner coverage. Rippling can be seen in the upper inner aspect of the breast. This is the decollete area. Placement of implants beneath the Pectoralis muscle has virtually eliminated this rippling.
Both saline (salt water) and silicone gel implants available in America can show some visible rippling. It is felt less when silicone gel implants are used. However, the most coherent silicone gel products, only available outside the US, may reduce or eliminate rippling of breast implants. Unfortunately, the coherent gel implants currently available in the US do not eliminate this rippling.
Nipntucks Sooner or Later?
June 23rd, 2009
Today is injection day at my office. Botox ® and Restylane ® fillers will be injected to help reduce the effects of aging. Generally Botox ® is injected around the eyes and forehead to reduce wrinkles. The filler materials are injected into the lower face and lips to counter the aging changes. These do wonders with little or no down time, but they are temporary fixes. Eventually, surgical measures will need to be considered, to maintain a youthful appearance to the face.
Facial rejuvenation surgery will improve many of the same conditions which injections improve, but provide the patient with a more long-lasting change. Forehead lift surgery reduces the need for botox ® and face lift surgery acts to reduce the need for Restylane ®. So when is the time to consider these surgeries?
As a general guideline, patients often consider surgery when the annual expense for injections reaches 10% of what surgery would cost. Most rejuvenation surgery lasts at least 10 years before the aging process catches up. However, most surgery lasts significantly longer, before signs of aging return. If you are spending more than 10% on these quick fixes, you most like likely would benefit from the surgery.
There are certain conditions where surgery is not an adequately remedy. In fact, crows feet are very difficult to treat with surgery. Botox is best for these fine lines around the eyes. Similarly, injections are well-suited as a remedy for thin lips. It is my opinion that the surgical option for thin lips looks too artificial or “done.” Finally, the fine lines on the lips respond well to injections without the skin bleaching that is often cased by deep chemical peels or laser resurfacing. As with any cosmetic procedure, I encourage my patients to understand their choices.
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