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Saline Breast Implants - Palpable Nodule on Breast Normal 9 Weeks Post-op?

I'm 9 weeks post-op after my saline breast implants. I noticed a nodule like projection on the lower pole of one breast which felt exactly like pressing on the resilient scalloped edges of sides of the implant shell, as early as 2 weeks post-op.

My PS told me my skin was much thinner along this area. When I wear a sheer bra, this lump is noticeable and palpable. When touched, it's extremely weird like touching a breast with 'cysts' except that these lumps can be pressed and bounce back.

Is this a common occurence? Is it normal to have palpable linear nodule-like projection arising from the rippling effects of saline implants? Will it get worse? If yes, what are remedial options?

Asked 41 months ago by Leeza in Fresno USA

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saline implants side effects

Leeza, Unfortunately this is not an uncommon occurence...

Leeza, Unfortunately this is not an uncommon occurence when saline implants are used for breast augmentation in very thin women with very little overlying breast tissue or fat. In most cases, as long as it is not painful or is not visible, it is tolerated by the patient. But there are a few options that can be considered: Sometimes, there is just a small wrinkle ot fold in the implant, and the surgeon can go back in, rotate the implant a bit, and even fill it with a bit more saline to help... more

Shahram Salemy, MD

Seattle Plastic Surgeon

ASPS

If there is not enough soft tissue cover over the...

If there is not enough soft tissue cover over the implant, you may be able to palpate folds or knuckles of the implant's bag. Sometimes these are also visible. If an implant is unfilled, your surgeon may be able to add more saline although this may not solve the problem completely. Down-sizing is another possibility so that the size of the implant lies within the dimensions of your normal breast tissue, although this might be unsatisfactory due to the smaller final size. This situation may... more

Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon

ASPS

Feeling a Fold in Saline Implants

Leeza, You are most likely feeling a fold in the surface of the saline implant in an area of relatively tin tissue coverage. This can occur and is not an indication of a problem with the surgery or your implant. Options: accept this as an imperfection of your surgery and monitor the area if it seems to be getting worse or the tissue seems to be thinning over time, consider a revision fat injection to improve tissue coverage over the area... more

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Paul C. Zwiebel, MD

Denver Plastic Surgeon

ASAPS ASPS

This is not common, but....

Hello, Feeling saline implants is more common in thinner patients and those who have them placed "over the muscle." Options include changing to silicone gel implants and/or placing the implants in the "under the muscle" position. You could also remove them. The good news is that this isn't common. The bad news is that it has.

John P. Di Saia, MD

Orange Plastic Surgeon

While all patients with saline implants can feel the...

While all patients with saline implants can feel the implant edges in the lower and outer poles of the breast if they try, what you are describing I would say isn't "normal." Preferrably, your implants were placed submuscular for more tissue cover of the saline. Sometimes patients will be feeling the implant valve mechanism. You might well need to consider switching to gel or just having to live with this imperfection. Perhaps ask another local plastic surgeon to check this out. more

Richard P. Rand, MD, FACS

Seattle Plastic Surgeon

ASAPS ASPS

A palpable nodule after saline breast augmentation is due to a fold in the shell of the prosthesis.

What you have is not common but also not rare. Sometimes a fold can occur in the shell of the implant and generate a lump. I have never been able to adjust the implant to make it disappear in the office, so an operation to reposition the implant would be necessary. However, unless it is a major aesthetic problem (visible through clothes), I would suggest you leave it alone. The call is your's however. Also, you have the luxury of time. Because it... more

Vincent N. Zubowicz, MD

Atlanta Plastic Surgeon

ASAPS ASPS

Palpable nodule after breast implant surgery

The photo you included is very helpful. It looks like you are feeling the actual implant, as you have already guessed. You are quite thin. You may benefit from switching to silicone implants or even having ADM (acellular dermal matrix )placed to thicken the coverage over the implant in this area. Ask your surgeon about this option.

Carmen Kavali, MD

Atlanta Plastic Surgeon

ASPS

Rippling after breast augmentation.

From your description it sounds most like rippling of the implant. If this bothers you then you can replace the saline implants with silicone. That is usually all that needs to be done.

Richard H. Fryer, MD

Salt Lake City Plastic Surgeon

ASPS

Lumpiness and saline implants

Saline implants can be felt and the edges can be felt as hard fold, rippling is very common with saline implant. In your case and from the picture it seems you have a fold in the implant and that need to be corrected, probably by surgery. If your skin is that thin then you need to reconsider the type of implant, the position of the implant or the use of AlloDerm to cover the implant.

Samir Shureih, MD

Baltimore Plastic Surgeon

ASAPS ASPS

Rippling of breast implants

Unfortunately, rippling can occur with patients that do not have alot of soft tissue coverage. If the implants are overfilled, they can camouflage this a bit. Also silicone implants may provide less rippling. In addition, sometimes alloderm may help to give more soft tissue coverage and mask the rippling.

Steven Wallach, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Implant nodule

Thanks for including a picture!! As you probably know, this is probably an implant ripple. I forewarn my saline implant patients that they will likely feel small ripples, but should not see them (unless they have a small implant and large breasts). I encourage very thin women to consider silicone implants to reduce the risk of rippling. In very thin women, it is also possible to palpate the fill valve area of the saline implant, which is more firm than the remainder of... more

Jason R. Hess, MD

San Diego Plastic Surgeon

ASPS

Palpable nodule after breast augmentation

From what you are describing, this does sound like you are feeling a ripple or fold in the implant. Based on the photo you provided, the incision appears to be inframammary. If the closure of the incision did not adequately pull the soft tissue (breast capsule) closed, the implant will be palpable in the lower pole. Although overfilling and silicone implants would lead to less palpability, the problem is essentially not enough soft tissue between the implant and the skin. My... more

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David Bogue, MD

Boca Raton Plastic Surgeon

Underfilled saline breast implants occasionally develop knuckles.

Hi, You are probably feeling a fold in your implant. Unfortunately this does not get better with time. You need a revision, best with silicone breast implants, or at least with OVERFILLED saline implants, which are les prone to rippling.