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.
Cosmetic Surgery Larceny
June 2nd, 2009
Today The Orange County Register reported the surrender of the “Big Busted Bandit ” to the police. Allegedly she stole a breast enlargement surgery through identity theft. She was tracked down through her implant manufacturer serial numbers, according to the paper. It makes sense that with the advent of relatively inexpensive cosmetic medicine procedures popping up in some retail settings rather than established clinics and hospitals, this kind of thing has become more “popular.” I am sure that difficult economic times have played a role as well.
Cosmetic surgery larceny is nothing new. I first saw this occur in my practice some 20 years ago. A breast enlargement patient stopped payment on her check, on the very afternoon after having surgery. I was unable to re-collect the fee even though I tried. A difficult and expensive lesson to learn as a new plastic surgeon in practice.
All goods and services including cosmetic surgery and cosmetic medicine are at risk for theft. Most long standing plastic surgery practices have been victims at some level and recognize the risk. Measures are often taken to reduce the risk of this type of fraud. Requiring prepayment by 7-10 days if paying by check is a common practice and credit card payments may also be limited, as these charges can be contested by less than honorable patients. The last responsibility needed by a physician is chasing after a fee!
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