The fact is that all breast implants ripple.  There is only a problem with that when the patient can feel or see the ripples such as you describe.  The reason for the ripples being seen and felt is that there is not enough soft tissue over lying the implants.  The silicone gel filled implants ripple much less than the saline filled implants. If you had saline filled it would be a consideration to switch out the saline filled for gel filled.  Since that is not an option the only other solution is to increase the soft tissue over the implant either by moving the implants from under the breast and placing them under the muscle or by fat grafting the area where the ripples are felt and or seen.  It may be necessary to do both.  Fat grafting is done by harvesting your own fat from areas of excess on your body and grafting it into the soft tissue over your implants.  It works very well but may be limited by your lack of body fat.  Contact a Board Certified Plastic Surgeon with experience with both of these techniques to get your best options available to you.  

Breast Augmentation

A breast augmentation with or without a lift or a breast reduction are very frequently preformed at the same time as a tummy tuck.  Another good procedure to include if needed is liposuction of the abdomen, hips and even the legs or back.  Make sure your surgeon is a Board Certified Plastic Surgeon and has had experience with these combinations of operations and that they can be preformed in less than 6-7 hours.  These combinations are some times referred to as a Mommy Make Over and give wonderful results. 

Breast Augmentation

There are multiple levels to post operative activity.  The most important period that I care about is the first two weeks.  During that time I am very worried about post operative bleeding so I tell my patients not to do any lifting, bending or straining during this period.  It is also important that they don't raise their blood pressure or pulse. After this critical two weeks I encourage them to avoid any trauma to the area of surgery for at least two months after the surgery. This is because it takes that long for the wounds to develop a strong well healed wound.  The third phase is the maturation of the scar tissue.  This takes up to 24 months but the greatest changes are complete after 6 months.  This is why most surgeons will defer any further surgery on the previous area of surgery for at least six months when the majority of the wound maturation has been completed. 

Breast Augmentation

A tummy tuck and breast reduction is a great combination of surgeries to be done at the same time.  I frequently do these together and also do liposuction of the hips and abdomen. When appropriate I will even preform liposuction of other parts of the body such as lateral back, lateral thighs, medial thighs and knees.  If the patient is in good health without any medial problems there should be no problem with this amount of surgery as long as it can be completed in less then 6-7 hours. I ask my patients to have an evaluation by their primary care physician to clear them for surgery.  While there are more risks with the longer surgery, I believe that the risks of multiple surgeries is also a problem.  There is also the problem of multiple recovery periods with multiple different procedures.

Make sure you are in the hand of a well trained and experienced Board Certified Plastic Surgeon who has done a good number of these combined procedures.  Ask your surgeon exactly how long the combined procedures will take.  Also, ask to talk to patients who have had such surgery and ask to see before and after photos.

Tummy Tuck

Fat grafting of you own fat is one of the most exciting techniques available to Plastic Surgeons today.  Since you have had a good result with Radiesse you should be able to have a more permanent correction of your depression in your leg after liposuction.  Usually about 80% of the fat takes and persists if the appropriate technique is used.  

Liposuction