Are patients usually happy with saline breast implants?

The question of saline vs silicone is a common one, and there are many misunderstandings of the tradeoffs between each implant.  If the implants are placed underneath the muscle and also a the serratus fascia laterally, there is no difference in appearance except in a very thin patient with large implants there can rarely be slight rippling laterally.  In patients with moderate size implants and some breast tissue, in my experience there is very little difference in the way they feel.         The advantages of saline implants are that they are easier to follow (silicone leakage can be difficult to detect), easier to replace in many cases( silicone implant exchange often involves a partial or complete capsulectomy), and the risks of capsular contracture are significantly less in implants greater than 10 years old.  Most of my patients choose saline implants unless they are very thin, have minimal breast tissue, and desire two or more changes in cup size.  Both implant types make a very high percentage of people happy, if the surgery is done well.

Many patients do well with saline implants if they have a
good amount of breast tissue to cover them. The rippling is definitely more
pronounced with saline even when place under the muscle. If you are and A cup,
I would be concerned about how much coverage you would have. As another
colleague stated, the MRI is only recommended. Most of my breast augmentation
patient chose silicone. I am fairly certain that none of my patients have ever
had a "surveillance" MRI.Certainly you need to discuss this with your surgeon in more detail.
Best wishes for your decision!

Thank you very much for your question.  Most patients are quite satisfied with saline implants for breast augmentation if they are well informed about the pros and cons of both choices.  In patients with significant breast tissue, wrinkling and palpability is usually not a major issue and patients are usually very happy.  When you have very little breast tissue, then it becomes more of an issue. With an A cup with little breast tissue and your desires to go up 400 cc with saline implants, you will definitely have palpability and in the long term wrinkling in addition to a firmer feel than silicone.  If you accept that reality as a trade off for not having MRI's or concerns about undetected rupture associated with silicone, then saline would be an ok choice.  If those issues are going to be  a concern, then silicone would be a better choice.   You can also switch from saline to silicone in the future if you have issues with wrinkling and palpability, which is improved with silicone. Best wishes.