A) The way saline implants look when they are placed over the muscle depends on how much breast tissue and body fat you have. Saline implants have a tendency to wrinkle or ripple so if you do not have enough breast tissue or body fat to cover the implants and hide them, these ripples could be highly visible. In fact, when touched, the wrinkles or ripples might still be felt whether they are placed over or under the muscle. With time, the muscle stretches and the wrinkles or ripples show through or are felt if there is not enough breast tissue or body fat.

This tendency for wrinkles or ripples to occur is one drawback of saline implants—they aren’t as common with silicone gel implants. Nevertheless, I have many patients who love their saline implants and would never change them. Your surgeon should be able to review the pros and cons of both saline and silicone gel implants with you in relation to your unique body structure and personal preferences.

A) Generally, it is not the best choice to get plastic surgery outside of the US. It’s not a question of whether or not there’s an intensive care unit (ICU) at the clinic. (Incidentally, in the US, “quad A” certification is the gold standard of patient safety for office-based surgical suites.) There are certain standards of care here in the US that you will not find elsewhere. I’m not sure what they are in a clinic in Mexico.
Studies have shown that complication rates are high among patients who have undergone breast implant surgeries in other countries. Part of the problem is that you won’t be followed by the surgeon who performed your procedure. In the event of complications, the same studies indicate that you’ll have a hard time finding a local plastic surgeon willing to correct them.

To assure that your plastic surgeon has gone through appropriate plastic surgery training, go to an American Society of Plastic Surgeons (ASPS) member. A physician needs at least six years of surgery experience and training, with three of those years specific to plastic surgery, in order to be an active ASPS member. They follow a strict code of ethics and are required to take continuing education courses that include techniques on patient safety. If money is an issue, you may want to consider finding a resident’s clinic at a medical school. The prices there are generally considerably lower.