William Mealer, MD (retired)

This is a very, very complex issue.  A midface procedure for correcting an ectropion is extreme therapy with a long recovery.  I think that if you are serious about having a midface lift to repair an eyelid retraction issue, you should see an expert like Dr Mark Codner, Atlanta, who has done more of these cases than most. Another good consult for you would be Dr.Glenn Jelks in New York City.  Both of these surgeons are masters in difficult ectropion repair world which is not for beginners.

Great question.  I would suggest that you become informed of all of your options prior to going to your next appointment. If you have tubular breast deformity, this makes your decisions more complex.  You should study treatments for tubular breast deformity.  Surgical treatment for tubular breast deformity usually involves larger incisions so I am suspecting that you have not explored that therapy in detail or the tubular deformity is being partially treated.  Saline vs. silicone is a personal choice.  There are pros and cons with both. I feel cohesive gel implants have advantages  in very thin women with small breast.  Rippling with saline implants in thin women with small breasts is more of a problem than with firmer cohesive gel implants especially in the outside part of the post operative breast.  
Again, I feel that you should get a local second opinion with a board certified surgeon in your area to explore   other procedures that may benefit a person wanting breast enlargement with a tubular breast.  Best of luck!