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Re: Alloderm coverage for rippling
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Glad you've found the time I spend here helpful. I've found alloderm or other similar materials helpful to create support in the lower half of the breast and if properly configured can boost things to limit upper pole rippling and shape. I don't often use it as an onlay in this area because if the pectoralis is rippling in the upper pole adding another millimeter of material over it won't affect that issue to any meaningful extent......in other words, the alloderm will ripple along with the underlying layers as they are thicker than the alloderm to begin with.
Fat injection can help soften the look of the skin over the implant but won't affect significant rippling either in the long term. I do use fat injection however to improve the look in subtle ways when I think it'll make a difference........I call it "adding a little poof" to the outcome but not good for bigger problems.
Usually reducing the spasm in the pec, improving implant shape/periphery/volume and modifying lower pole support helps the most.
Hope this helps,