Silicone implants under the muscle will minimize implant detection
Thanks for your question. The average American stands 5’ 4” and weighs 140 lbs. From your dimensions, you are petite! Obviously, your tissue ‘padding’ is thin; thus you are more likely to see and feel the edges of the breast implant. Efforts to minimize this are using silicone implants placed under the muscle in the sub-pectoral plane.
Additionally, I have observed less rippling using silicone implants, especially with a moderate plus type profile. Your concerns regarding temperature and saline implants are invalid. Rest assured that both saline and silicone implants will warm up to your core body temperature.
I hope you find this helpful!
Saline Rippling a real problem
Hi there- I think it is very important to understand the relative risk involved here. You should make an honest assessment of how severe your asymmetry is, and how much it bothers you, and how much you would like this corrected. Most importantly, you need to understand whether improving (and I say improving because it is unlikely you will end up perfectly symmetric) this asymmetry is worth compromising the feel of your breast and risking visible rippling, which happen quite often in thin women with small breasts.
Only you can make the decisions that are going to be best for you in the long term, but think about this- if your breasts end up perfectly symmetric but you have visible rippling or wrinkling that is easily felt through your skin, would you be happy? Conversely, if your breasts are still a tiny bit uneven in size, but they look great and feel like breasts, would you be happy? Good luck- I hope that helped you.
It would be harder to feel the edges of silicone implants
With saline implants, after the swelling goes down, there is always a chance of feeling some rippling, but if everything heals well, it should be minimal.
The silicone gel is much smoother, and if not feeling the edge of the implant is very important to you, then you should go with silicone.
Both Saline and Silicone Gel can give you a nice result
Both Saline and Silicone gel breast implants can give you a nice, natural result if you have the breast tissue to go on top. If you are worried about "feeling" the implant and you don't have much body fat, then definitely go with silicone gel implants. It's difficult to say because of the asymmetry that you are asking about. Have an open discussion with your surgeon and make sure he can address your concerns.
Saline or silicone gel filled both work well
Tx.momof4: As a surgeon who has used both kinds, I share with patients the relative advantages and disadvantages of both types of implants. I notice many other surgeons on RealSelf recommend silicone gel filled, but I do not think the decision is so easily in favor of gel.
You mention one specific concern (rippling). First let me mention being able to feel implants (palpability). You will be able to feel either type, gel or saline. Under very thin tissues, one can more easily feel a saline implant. The relative advantage may not be much.
Rippling is a slightly different issue. This refers to a wavy feel or texture, or if very prominent, a wavy appearance, noticible through your tissues. As others have mentioned, this is more common in patients with thin body fat or breast tissue, older designed implants (both gel or saline), texture surface implants, or with subglandular placement of the implant (above the muscle). It is also more common in patients with large implants that stretch their tissues over many years time. Some patients only notice rippling when they lean or push their breast a certain way. I agree that gel implants are somewhat better in the most difficult thin patients. I think saline implants are preferable in many other patients.
You should weigh other factors in choosing gel or saline. You should expect any implant to eventually leak, and removal treatment varies greatly. Talk to your surgeon. The internet is also a good source for information about risks with either type implant.
Implant palpability more common with saline implants
I prefer to use either moderate-plus or high-profile silicone implants for a majority of my patients undergoing a breast lift. I feel these implants will help give a much nicer result and feel of the breasts compared with saline implants. I also prefer to put the implants partially under the muscle as opposed to entirely submuscular. I feel this helps provide a much more aesthetically pleasing result.
They feel more natural. It's better to accept a little asymmetry (major asymmetry can be corrected with different sized silicone implants).
Also make sure you don't use "moderate" profile silicone implants, because these are underfilled and can give you rippling also. I use Mentor round smooth walled moderate PLUS profile or high profile implants, depending on the width of the chest.
I also recommend using disposable implant SIZERS DURING surgery to determine ideal size, before opening the permanent implants. This takes the guess work out.
Quite likely to feel edges of saline implants
There are several issues here.
The rippling isn't unique to saline implants, but it is much more common and more pronounced in them vs. silicone.
Edge palpability is a separate issue. Again, saline tends to be more palpable, especially in women with little body fat, little breast tissue, thin skin, implants placed above the muscle, and textured surface, saline implants. Silicone may also be palpable, but much less likely.
The breast asymmetry is a non-issue in this situation, as it can be easily corrected with the breast lift part of the procedure. Besides, all women have some asymmetry if you look closely enough- even post-op.
Finally, I am not familiar with the fact that saline implants don't warm up to body temp?
That is my take on it anyway.
Depends on relative size of the implant
I suspect that most of your breast will be comprised of the implant and that the width of the implant will be at, or exceed, the width of your natural breast. In this situation, you will probably be able to feel, if not also see, the edges of the saline implant, particularly on the bottom and side.
You will always feel the edges of saline implants
I agree with the previous doctors that, in a thin patient, you will always feel the edge of a saline implant. Even when implants are placed "under the muscle" there are parts of the implant that are not covered by muscle. These areas are more readily palpated. The look is not affected, it is just the feel. Thousands of saline implant patients would confirm that they are thrilled, even if you can feel the edge.
Beware of "correcting" asymmetry with saline implants. What we can do as surgeons is add more volume on one side and less on the other. That corrects volume disparity but we are unable to fully correct asymmetry. Asymmetry is a much more complex problem.
For example, your smaller breast has a smaller skin envelope around it and it needs more saline than the opposite side. An example I sometimes use is that if you have a size 7 shoe on one side and a size 8 shoe on the other side, you can fill both shoes to the same volume but they will still look different. The size 7 shoe will need more volume and be tight and the size 8 shoe will need less volume because it was already bigger.
Good luck with your surgery!