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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?

Doctor Answers (14)

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

+4

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.

Seattle Plastic Surgeon
5.0 out of 5 stars 44 reviews

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

+4

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 smooth this out. It will usually do the trick.

If you are very thin-skinned in this area, another option is to place some more tissue between the implant and your skin to act as a bit of padding and prevent the wrinkle from being seen or felt. This tissue is usually either some of your own skin from another part of your body or a product called Alloderm (as your doc about it) which works quite nicely.

Finally, while all types of implants can have wrinkling or rippling, I find that this is less common in my patients with silicone implants. If this is something you would consider doing, talk to your plastic surgeon about it.

Hope that helps and best of luck,

Dr. S

Seattle Plastic Surgeon
5.0 out of 5 stars 85 reviews

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

+4

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 worsen over time since the constant pressure of the fold/knuckle may cause gradual, progressive atrophy of the overlying tissue. Most patients will accept this imperfection until it is quite obvious, painful, or causing excessive thinning.

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 6 reviews

Feeling a Fold in Saline Implants

+3

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
  • allograft - the placement of tissue bank skin inside the space over the implant to add tissue coverage
  • overfilling the saline implant to try to diminish folds
    • I do not advocate this option because it may make the implant unnaturally round and rubbery firm 
  • replacing the saline implant with a silicone gel-filled implant
    • silicone gel implants tend to have fewer and less folding
    • consider combining this with fat grafting or allograft (above)

I hope this helps!

Web reference: http://www.drzwiebel.com/denver-breast-augmentation-breast-implants

Denver Plastic Surgeon
4.0 out of 5 stars 5 reviews

This is not common, but....

+3

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.

Orange Plastic Surgeon
5.0 out of 5 stars 22 reviews

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

+2

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 is not a health problem, the decision to fix it can be anytime.

Web reference: http://www.zubowicz.com/subpag,13-atlanta-breast-augmentation.htm

Atlanta Plastic Surgeon
4.5 out of 5 stars 6 reviews

Palpable nodule after breast implant surgery

+2

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.

Atlanta Plastic Surgeon
4.5 out of 5 stars 16 reviews

Rippling after breast augmentation.

+2

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.

Salt Lake City Plastic Surgeon
5.0 out of 5 stars 66 reviews

Lumpiness and saline implants

+2

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.

Baltimore Plastic Surgeon

Rippling of breast implants

+2

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.

Manhattan Plastic Surgeon
4.5 out of 5 stars 14 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.

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