Rippling is a very difficult problem for all thin women. As you downsize the rippling is likely to increase similar to underfilling a saline implant. As for the differences in fill volume of the gel implants it may help a little but your tissue coverage is the most important element. You need to be under the muscle and ideally the more weight you gain the better the rippling will get. Finally there are products that are like tissue substitutes like Strattice and Alloderm that can be placed into the pocket and will help as well.
Hope that helps and good luck
Rippling is the result of thin tissue coverage. It is unlikely that changing to a different implant will correct this,. You might need an ADM or fat grafting.
It is my opinion that the more highly cohesive gel in the HSC plus Sientra implants do wrinkle less than the older responsive gel implants. these implants, temporarily are on hold in the United States. I've had good success using the Natrelle Inspira silicone gel breast implants in that they are more highly filled with a cohesive gel and a smooth shell leading to less wrinkles. I hope your surgery goes well, good luck.
You are correct that a higher percent fill and a more cohesive gel will help rippling. But if you have MORE rippling with the gel than you did with the saline, it almost certainly is due to capsulotomies or capsulectomy done at the time of implant exchange. You should consider the addition of ADM at the time of your next procedure.
Thank you for your question. The Inspira and Sientra HSC+ implants do contain a stiffer gel with a higher silicone fill that can help reduce your rippling, in addition to the downsizing you want to perform. Currently there is a hold on using Sientra implants in the US and Europe, but the Inspira are excellent implants.
Switching to Natrelle Inspira silicone gel breast implants will certainly help reduce your wrinkling issue. The HSC+ implants are temporarily (I hope) unavailable right now.
Remember that downsizing may require additional pocket work to better fit your new implant. You may also need fat grafting.