Silicone Implant Feels Lumpy and Heavy

You concerns require evaluation by your plastic surgeon, not an expensive test that frequently provides incorrect information and does nothing to resolve the issue! If you have malposition, capsular contracture, or muscle tear with implant herniation you require surgical advice and the properly-planned operation to improve or correct the problem. Since you are 1 and 1/2 years post-op implant placement, you have the latest generation of cohesive silicone gel implants (either manufacturer), and these implants do not leak or rupture. Invariably, when one of my patients with the newest generation of silicone gel implants has an MRI that states "Rupture" and I operate to replace the implant, I find a perfectly intact and normal implant. EVERY TIME! Older silicone implants CAN leak, ooze, and rupture, and those are entirely different. Still, an MRI doesn't tell me I need to re-operate on these patients--I already know that by examining them!

So see your plastic surgeon, or get the opinion of several ABPS-certified plastic surgeons. You have issues for which a surgical evaluation is needed, a plan formulated, and correction or improvement of your concern carried out. If your surgeon needs a scan to help him or her decide what to do, perhaps they are ill-equipped to deal with whatever issues you have. I would humbly submit that any experienced breast surgeon who does large numbers of BA cases and revisions (usually from other surgeons) is fully equipped and able to deal with whatever is found at surgery. I just find that a scan with the newest generation of silicone gel implants is unnecessary, not helpful, expensive, and occasionally misleading!

BTW, conversion to submammary is one solution, but one that may increase your risk of capsular contracture (from ductal bacteria causing a biofilm that can stimulate your tissues to form a contracture, whereas the submuscular position reduces those risks). I do utilize the submammary position in some cases of revision breast surgery, but usually when the implant is already in that position. Consider the pros and cons carefully if this is the recommended "solution."

Physical exam goes a long way to help determine the issue with your implant.  MRI would be very helpful to look at the integrity of the implant (or lack there of).

Dr. ES

The best advice would be to have your PS examine you to determine what could be going on with your implant

after that follow his/her advice for recommended treatment options

At a year and a half  from surgery a ruptured implant is possible, but unusual. A degree of capsular contracture could also produce some of the symptoms you describe. An examination is the only way to know exactly what the issue may be and it would be best to make an appointment with your plastic surgeon for an evaluation.

What you are describing iscapsular contracture. Your breast feels lumpy and firmer than the other side. As the scar tissue surrounding your implant tightens around it, the implant is being compressed which causes a fold or a notch in the shell. This is what you see and feel. You need to see your plastic surgeon to discuss your options to correct this condition. Good luck.