Hello and thank you for your question. Although there may be some implant warranty issues, rippling, or skin stretch concerns from excessive fill in saline breast implants, I think an important question is why you are choosing saline implants to begin with. Your question brings up the overall process of ideal breast implant selection which can be quite involved, as breast augmentation involves a number of different issues. The first step would be to clearly define your desired breast outcome goals – this would include the size you would like to achieve, and your ideal breast shape. I would then select the best breast implant for you based on: (1) Volume of the implant – actual implant sizers that you try on during your consultation can help with this. I commonly used the Mentor volume sizing system for this purpose. In general, 150-200cc is necessary for an increase in a single cup size. (2) Contents of the implant – saline vs silicone, saline tends to be a little stiffer, rounder and can cause rippling of the skin as mentioned above. (3) Shape of the implant – round or anatomic; I would show you how both round and anatomic can provide a natural shape. Different profiles of an implant would also affect the projection of your breast. (4) Position of the implant – if it is over or under the pectoralis muscle; each location would provide a different shape and projection. The advantage of going “under the muscle” is that it provides a lower risk of capsular contracture, lower risk of skin rippling, and better visualization on future mammograms. Also, many patients describe the appearance as more natural, and describe the feel as more consistent with that natural breast. (5) Skin stretch of your breast – younger patients tend to have more taught skin with more… SHOW MORE resilience, and respond well to an implant; compared to an older breast with more stretch marks, which would typically requiring a larger volume to fill the breast (6) Degree of breast ptosis (sagging) – a significant sag would benefit from a breast lift (7) Breast diameter and overall chest circumference (8) Native breast tissue volume – the amount and distribution of the natural breast tissue. (9) Any history of prior surgery or trauma to the breast The next step for you is to seek out a board certified plastic surgeon who specializes in aesthetic plastic surgery. In your consultation, be sure your surgeon addresses all your concerns and discusses the surgery details including the position and size of the incision used (with actual photographs), the type of breast implants available, the risks and benefits of the procedure, recovery time, and post-operative course. Also, be sure to see plenty of before-and-after pictures in women who have a similar breast appearance to yours, and preferably at different time frames (3 weeks out, 3 months out, etc) to more accurately predict your own surgical outcome. And lastly, I think the most important component of the consultation is to establish a good connection with your plastic surgeon. It’s the connection that allows you to clearly define your desired breast outcome goals, the first step of this whole process. If you don’t feel you have a good connection with your plastic surgeon after your consultation, he/she may not be the best surgeon for you. For more information on breast augmentation, please refer to the link below. Good luck. Mark K Markarian, MD, MSPH Harvard-trained Board Certified Aesthetic Plastic Surgeon