Wrong implant - silicone instead of saline. How do I question the doctor on this?

In terms of size, it is always difficult to "promise" a certain size because there are times that there is no particular size of implant that will both fit your physical measurements and provide you with the exact size you are looking for. Same is true sometimes for silicone and saline implants, although it is also possible there was a misunderstanding there. Overall, your physician should be open to discussion about the issues present. I would remain open to his explanations and solution, as he or she should remain open to your concerns. In most physician-patient relationships, open discussion is welcome and encouraged in order to ensure that you get the best outcome. If there is a reasonable solution, I am sure they would be open to it.

Go back to your surgeon and discuss your concerns, but be nice. Your surgeon was trying to get you a nice result and sometimes, saline implants have too many ripples to look good.