Why Does my Saline Implant Appear (And Feel) Lumpy?

Reasons for a lumpy breast saline breast implant:

1) thin skin with visibility of normal wrinkles

2) capsular contracture with "scrunching" of implant causing folds

3) textured surface causing folds and knuckles

4) partial deflation of implant with collapse and folding

5) underfilling of implants

6) flipping of implant

7) seroma

8) heterotopic calcification

There may be a slow deflation of the saline implant or there is less tissue coverage making the feel of the bag much more obvious. Seek attention of specialist with revision surgery.

Anytime a patient has saline implants and they feel folds or what may be described as "air pockets", it generally is the folds of the saline implant.  Depending on the fill volume of the implant, there may be a few bigger folds or a number of smaller folds, and if you have thin tissues, it is not unusual to feel them over time.  I would meet with your surgeon for an examination, but from what you are describing, you are probably feeling the implant imperfections.

Rippling can happen because the sof tissue coverage is too  thin. This can sometimes be corrected with silicone implants , under the muscle, or alloderm.

It is difficult to see from your photo. However, given your description, it is possible that you have a recurrent capsular contracture or some scarring of the breast capsule.  You should see your PS and consider a revision.  If you are unhappy with your options always seek a second opinion.

It is difficult to give a good answer without an examination.  The "bumps" may be due to scar tissue (capsule).  It may also be that the saline implant has lost volume (leak?), or under filled.  You should see your plastic surgeon, or if not satisfied, obtain a second consult.

I agree that it is difficult to know the reason for your lumpiness from your photo and description.  You may still have some element of capsular contracture as well as rippling.  I feel that both are more likely to occur with saline implants places above the muscle and least likely to be seen with silicone implants beneath the muscle.  I also agree that you should seek a second opinion if you are unsatisfied with your original surgeon's explanation and solution.