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

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

Breast
augmentation has extremely high satisfaction rates, but occasionally rippling
can occur following this procedure.This
can occur with either saline or silicone breast implants.Several factors have been associated with
rippling following breast augmentation.These include saline implants, large implants, thin soft tissue, and
placement of implants on top of the muscle.The
potential for rippling can be decreased in several ways.It’s important in high risk patients to avoid
using implants that are large relative to the patient’s native breast
tissue.Firmer implants, such as
silicone and cohesive gel implants, can also decrease the potential for this
problem.Submuscular placement decreases
rippling by increasing the soft tissue coverage over the implants.Surgeons should avoid over-dissection of the
pocket and avoid implants that are wider than the patient’s breast tissue.Finally, overfilling the implant when using
saline may help to minimize rippling.Despite these maneuvers, rippling
occasionally may still occur.It’s
important to realize that in the vast majority of patients, rippling isn’t a
problem and even when it does occur, most patients are still very happy.If you’re concerned about rippling
following breast augmentation, consultation with your plastic surgeon is
appropriate.Depending upon the
specifics of your previous procedure, your surgeon should be able to formulate
a treatment plan that addresses your concerns.

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 the implant.  It may be wise to monitor this issue unless you are considering another surgery.  If this crease is horribly bothersome, your best bet may be to switch to silicone.  Also, make sure that your implant is in a submuscular plane.  This maximizes tissue coverage and minimizes implant palpability.

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.

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.

This is not an uncommon problem with saline filled implants.  You are feeling the lower edge of the implant.  With time it could get better or it could get worse.  If it does not get better then it is possible that an fold suture may be needed to cover the lower pole with more soft tissue.  

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.

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 recommendation would be a revision with a change to a sub-muscular pocket (if your implants are subglandular), and/or a switch to silicone implants if you are amenable.

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.

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.