Capsular contracture and ripple deformity of breast implants

Our surgical understanding and preference for an implant design suggests that location of the implant in the retromuscular plane gives an aesthetically better looking clinical result, there is less rippling when the chest wall is vertical, and the implant flattens when the patient is lying supine. An implant with a textured posterior wall and smooth anterior wall assists adherence of the implant at the desired level. It also induces a pseudo-bursa over its anterior surface which, being larger than the implant surface, allows it to flatten naturally when the patient is lying or raising the arm. A gel-filled implant gives the most natural quality to an implant and the contents displace less readily and therefore do not tend to cause rippling.