This is a great question as breast reconstruction has become more and more common over the past few years. The options for breast reconstruction continue to grow as technology improves.
Rippling is more common with breast reconstruction than with a breast augmentation because the majority of the breast tissue has been removed. This leaves very little buffer between the implant and the skin. So the treatment usually involves trying to increase this insulation between the implant and skin.
One of the best ways to do this is with fat transfer. Fat can be liposuctioned from various areas of the body, processed and then used to soften the breast and hide the rippling that is seen. The fat transfer can be done at the same time as nipple reconstruction or other second stage procedures. Occasionally patients will need more than one treatment with the fat transfer to improve the appearance of rippling. The fat acts as an insulation layer to decrease visible rippling and give the breast a more natural feel and appearance.
The new highly cohesive gel implants often can help with the visual appearance of rippling as well. If patients have saline implants I would remove them and replace them silicone implants. The new implants have greatly decreased the amount of visible rippling in both breast reconstruction and breast augmentation patients.
There are several options to improve the appearance of your breast reconstruction. Please discuss your options with your board certified plastic surgeon.