Why hybrid breast augmentation can be an important option for slim patients

After silicone implant breast augmentation, some patients may notice:

• Visible implant edges
• Skin waviness
• Tightness or pulling of the skin
• An unnatural “implant look”

This condition is commonly referred to as:

“Rippling.”

Many patients imagine that breast implants will automatically create a natural and beautiful result.

However, the final appearance of implant breast augmentation depends heavily on:

• Skin thickness
• Breast tissue volume
• Body frame and rib structure
• Amount of soft tissue
• Implant size
• Surgical pocket dissection

In particular, slim patients with thin skin are more likely to experience visible implant contours and rippling.

At AVAN TOKYO, breast augmentation is not designed based only on implant volume.
We carefully evaluate each patient’s anatomy and focus on creating a natural upper body silhouette.

What Is Rippling?

Rippling refers to visible waviness, folding, or pulling of the skin after silicone implant breast augmentation.

It may become more noticeable in areas such as:

• The outer breast
• The décolletage
• The cleavage
• When bending forward

Some patients describe it as:

• “The implant looks too visible”
• “The skin feels pulled”
• “The breasts don’t look natural”

Rippling is a known risk of silicone implant breast augmentation.

Why Does Rippling Occur?

Rippling usually occurs not because the implant itself is “bad,” but because the tissue covering the implant is too thin.

The following factors can increase the risk:

1. Slim Body Type and Thin Skin

One of the most common causes is being very slim.

When there is limited breast tissue or subcutaneous fat, there is less soft tissue covering the implant.

This can make implant edges and folds more visible through the skin.

Patients with:

• Low BMI
• Thin décolletage
• Visible ribs
• Narrow chest structure

are at higher risk.

2. Implant Size Too Large for the Body

If the implant is too large relative to the patient’s body frame, the risk of rippling increases.

A large implant may create:

• Excessive skin tension
• Compression of soft tissue
• More visible implant contour

Especially in slim patients, implants larger than the high 300cc to 400cc range may create a stronger “implant appearance.”

3. Inadequate Pocket Dissection

If the implant pocket is too tight or improperly dissected, the implant may create localized tension on the skin.

This may result in:

• Pulling of the skin
• Deformity
• Uneven contour

Case Example: Rippling After Motiva Mini 235cc

This patient underwent breast augmentation with:

• Motiva Mini 235cc implants
• Subglandular placement
• Inframammary fold incision

At 1 month post-operatively, mild rippling and implant visibility were observed due to the patient’s slim body type and thin skin.

However, at only 1 month after surgery, the tissues are still healing.

Over time:

• The skin gradually stretches
• The tissues soften
• The implants settle naturally

and the appearance may improve significantly.

For this reason, AVAN TOKYO usually evaluates the long-term appearance after approximately 3 months.

Treatment Options If Rippling Persists

If rippling remains after healing, several options may be considered.

1. Secondary Fat Grafting (Hybrid Breast Augmentation)

One of the most natural and less invasive solutions is adding fat grafting around the implant.

This can improve:

• Implant visibility
• Rippling
• Thin décolletage
• Hard cleavage appearance

Interestingly, even when fat retention is not perfect, the skin itself may stretch and soften, helping reduce rippling.

For this reason, secondary hybrid breast augmentation is often an effective option for slim patients.

2. Pocket Revision Surgery

If the implant pocket is too tight or improperly positioned, revising the pocket may improve the result.

However, this requires another surgery and may involve more recovery.

3. Implant Size Change

If the implant is too large for the patient’s body, downsizing may improve naturalness and reduce rippling.

This is particularly important in slim patients.

4. Changing from Subglandular to Submuscular Placement

In patients with extremely thin soft tissue coverage, changing the implant plane from subglandular to submuscular may reduce implant visibility.

The muscle provides additional coverage over the implant.

However, this method may also create other issues such as animation deformity.

Why Hybrid Breast Augmentation Is Increasingly Important

Recently, more patients at AVAN TOKYO are requesting:

“I don’t want implants alone. I want hybrid breast augmentation from the beginning.”

Especially in slim patients, implants alone may create:

• Visible implant edges
• Thin upper chest appearance
• Unnatural cleavage

By combining implants with fat grafting from the start, it becomes easier to create:

• Softer breasts
• More natural contours
• Better décolletage
• More refined cleavage
• Better overall upper body balance

What AVAN TOKYO Focuses On

At AVAN TOKYO, breast augmentation is not simply about making the breasts larger.

We carefully design:

• Overall upper body balance
• Décolletage shape
• Arm-to-breast contrast
• Cleavage contour
• Lateral breast expansion
• Natural appearance

One of our most important procedures is:

Arm liposuction × Hybrid breast augmentation.

Sharp, refined arms combined with naturally enhanced breasts can dramatically improve the overall upper body silhouette.

Conclusion

Rippling after silicone implant breast augmentation may occur in patients with:

• Thin skin
• Slim body type
• Implants too large for the body
• Inadequate pocket dissection

However, the appearance often continues to improve during the first few months after surgery.

If rippling persists, options may include:

• Secondary fat grafting (hybrid augmentation)
• Pocket revision
• Implant size change
• Conversion to submuscular placement

For slim patients especially, hybrid breast augmentation can help create a softer, more natural, and smoother result.

At AVAN TOKYO, breast augmentation is designed not only based on implant size, but also considering body structure, skin quality, breast tissue, fat distribution, and overall upper body harmony.

AVAN TOKYO GINZA

AVAN TOKYO GINZA LIPOSUCTION CLINIC

We specialize in arm liposuction, fat grafting breast augmentation, and hybrid breast augmentation to create refined upper body contours and natural breast aesthetics.

International patients welcome.
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