In order to completely understand the risks of silicone gel implants and breast augmentation surgery you should consult a board-certified plastic surgeon. Some of the most important risks or adverse outcomes associated with breast implant surgery are bleeding, infection, malposition, sensory change, rippling, capsule contracture, and implant failure. Some of these may very depending upon the implant type and pocket location chosen. There are two types of silicone gel breast implants approved by the FDA - round moderately cohesive gel implants and anatomically shaped highly cohesive gel implants. One of these implants may work better than the other depending upon breast shape, tissue compliance, desired volume, desired shape, and whether a breast lift is required at the same time as the augmentation. Round silicone gel implants can be used in any patient. Anatomically shaped silicone gel implants work better in patients with average-to-tight tissue compliance of the breast-skin envelope; and the primary focus with these implants is usually shape instead of volume. The moderately cohesive gel matrix in a round implant has enough structure to prevent gross leakage should the implant fail. The amount of gel that leaks outside the show will depend upon the size of the hole and the duration of the failure. Providing the capsule is intact (which it should be in almost all cases), the gel will remain inside the capsule. In other words, the capsule serves a protective function and prevents the gel from migrating into other tissues. If the capsule at some point loses its integrity, then the moderately cohesive gel could migrate into other tissues. The highly cohesive gel matrix of the anatomic implant has form stability. If the implant fails, the structure of the gel does not allow for leakage. There have been no reported cases of extracapsular gel migration with the highly cohesive anatomic implants. During your consultation, you will be able to see and feel both of these implant types, and understand them better. Best wishes. Ken Dembny