Dr. Payne discusses this in detail with all his breast augmentation patients. In general, silicone implants are more expensive than saline implants. Saline and silicone implants tend to look the same when placed into patients so you cannot look at most women with breast implants and figure out who has saline and who has silicone. Dr. Payne believes the main difference between the two types of implants is that silicone feels softer and more natural than saline. If women compare breasts after surgery often the women who chose saline will feel that they like silicone better. However, when silicone implants were mostly banned between 1992 and 2007 Dr. Payne found that his saline implant patients were mostly happy and he had very few of them complaining about the feel of the saline implants.
If a saline implant leaks it simply has the saline (salt water) in the implant leak into the surrounding body tissue without any harm or injury. If a silicone implant breaks or leaks the silicone usually stays inside the scar capsule that surrounds the implant and does not mix in with the breast tissue. In this case there is very little danger to the patient because of a broken implant. In some cases, however, the silicone can mix in with the breast tissue and this could cause lumps, pain, and changes in the mammograms making cancer detection more difficult. The vast majority of silicone implant patients however do not develop complicated problems because of a broken silicone implant and most of these patients can simply have their old implants taken out and a new one placed.
Finally, implants now come in a variety of styles both saline and silicone. They can be round or shaped. They can have different profiles. The surface of the implant can be smooth or textured. The degree of stiffness to the silicone gel which fills the implant can vary as well as other differences. Dr. Payne talks to patients about this when he sees them for a breast implant consultation. He also shows them different examples of implants so patients understand how these differences can impact their surgical results.