The ideal option to prevent rippling is to decide preoperatively what type of implant you need and whether it should be placed above or below the muscle. The optimal way to prevent rippling, or at least minimize rippling, is to place the implant below the muscle, make sure there is adequate breast tissue and not oversize or underinflate an implant if you are using saline or silicone implants. Sometimes the use of silicone implants may be better, especially in patients with no breast tissue as well as placement below the pectoralis major muscle. If you are using saline implants make sure you maximally fill it and not overfill or underfill, as that can cause more scalping or rippling. If you underfill, it can cause more deflation in saline implants. Remember, one can almost always feel any implant in the lower outside quadrant of your breast. Your surgeon will be the best person to advise you after examination.