CASE #1

This 48 year old woman had undergone multiple previous breast implant procedures. She presented with several problems related to her existing implants, including synmastia (loss of normal cleavage with detachment of the skin over the breastbone) and severe waviness and rippling most evident when she leans forward. The correct surgery consisted of a capsulotomy to repair the abnormal medial extent of the periprosthetic pocket, insertion of a Strattice acellular dermal matrix graft to reinforce the repair and insertion of a new pair of 375 cc Moderate Profile Plus silicone gel filled breast implants. Her postoperative result is shown six months after the corrective surgery. There has been correction of the synmastia with restoration of normal cleavage in between the breasts and almost complete resolution of all the waviness and rippling noticeable in the breast when the patient leans forward.

Waviness or Rippling of the Breast – In some patients who have had breast implants, particularly if patients who have had multiple procedures and to have had successively larger and larger implants, they may develop a problem known as “waviness” or “rippling” of the breast. Typically, in these patients, the breast is characterized by a very thin layer of tissues so that the underlying breast implant is not well camouflaged and there is a tendency for visibility or palpability of the implant edge as well as noticeable waviness and rippling of the breasts. This can be a very troublesome deformity, it is generally worse when patients lean forward and often, manifests in the cleavage area which makes it difficult for many patients to wear the types of apparel that they would like. Fortunately, a number of new techniques have been developed that enable correction of breast waviness and rippling. Dr. Handel has extensive experience in treating this deformity. He employs a variety of different strategies to help patients achieve the best result. Among the techniques that can be used to correct waviness and rippling, are conversion from saline implants to silicone gel implants or conversion of implants from the subglandular position to the submuscular position. In recent years, there has been growing interest in the use of materials known as ADM (acellular dermal matrix) to help correct waviness and rippling. ADMs are sheets of collagen (derived either from animal skin or from human cadaver donors) which are used to thicken and reinforce the patient’s weakened tissues. These materials have been proven to be safe and effective in helping to correct a number of breast implant related deformities, including waviness and rippling. Additionally, in recent years, autologous fat grafting (fat transfer) has proved to be a very effective strategy for improving the appearance of the breasts and in reducing the extent of waviness and rippling in patients who have thin tissues. There are also new breast implants on the market that include highly cohesive “form stable” implants which have less likelihood of producing waviness and rippling. Dr. Handel will evaluate your case and will help you to select a treatment plan that is suited ideally to your particular situation to help you achieve the desired cosmetic result. Waviness and Rippling of the Breast corrective surgery in Beverly Hills, California by world-renowned plastic surgeon, Dr. Neal Handel.