Can saline breast implants feel more natural? What can I do to avoid rippling in saline?

Good question. Much of the final “look” and ""feel" achieved after breast augmentation surgery depends on several factors:

1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the preoperative breast appearance the more likely the breast augmentation “look” and "feel" will be optimal, regardless of the type of breast implant utilized.  

2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing long-term well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone) or model (low/moderate/high profile) of implant.

3. The type of implant used may determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue.  In other words, if a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants. If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.

4. The size and model of breast implant used may make a significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C or D cup” or "fake look" etc. means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
I use intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible. I hope this, and the attached link (dedicate to larger breast augmentation concerns), helps. Best wishes.

Saline implants are very natural feeling and in some
cases can feel just as natural as silicone implants.However, in very thin patients the implant
feels watery and can show more ripples.In patients with a fair amount of breast tissue, it is difficult to tell
in the look and feel the difference between the two implants.Therefore, saline implants are good for
patients with more breast tissue.

Thank you for the question.  It's not uncommon to have patients desire certain characteristics of a Breast augmentation that are actually provided by different implants.  In your case, the smaller incision is consistent with the benefit of a saline implant while the natural look and feel would be better provided by a silicone implant.  A good plastic surgeon may be able to approach the incision length of a saline implant and still place a silicone implant using a Keller funnel.  Your best path forward is to have several consultations with well trained board certified plastic surgeons that have great before and after photos and great online reviews.  They will be able to provide you with recommendations about the best path forward.All the best,Dr. Remus Repta