When seeing patients in consultation for breast augmentation, I individualize my recommendations when it comes to the type of breast implant that will most likely achieve the patient's goals, with the least risk of complications. In order to provide this type of advice, the patient's physical examination and very careful communication of her goals are necessary. In my practice, I find the use of computer imaging and goal pictures very helpful. You will find, that without posting your pictures and your goal pictures, that online consultants will not be able to be of much specific/meaningful help to you.
The type of implant used may determine the final outcome achieved after breast augmentation surgery, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue.
Each patient differs in the amount of breast tissue that they have. If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants. If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference. Patients may need an MRI to diagnose a silicone gel rupture. Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they are implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
Generally speaking, patients should be aware that more important than any technical detail (such as type of implant, placement of incisions...) will be their careful selection of plastic surgeon; I think that this selection will be the most important factor when it comes to the outcome of the procedure performed.
I hope this, and the attached link, helps.