I have been a big fan and user of saline implants for the last 18 years.
The big advantage of saline as had it is filled with IV saline, the same a would use for hydration and intravenous medications. It is completely safe and gets absorbed of the implant ever breaks.
Fortunately, deflation and breaking of the implants is very rare, something like 1% per year.
This means that for many patients, saline implants never need to be changed. Silicone gel implants do require Replacement surgery at some point after 10-12 years.Often MRIs or ultrasounds are needed as well to detect if there is a silent rupture.
Saline implants cannot have a silent rupture, they just deflate and the shape changes obvious.
It is not an emergency to replace the deflated saline implant and it can be done at any time.
Other reasons that someone might need to change her replace implants over time could include changes in weight, changes in breast shape, hardening of the scar capsule over time,, or a persons desired to have the implant size changed or implants removed.
Some doctors encounter higher rates of rippling or visible deformities with saline versus silicone, but I have found that rare in my practice as long as we choose an appropriately sized implant.
The appearance is no different than silicone.
Underneath the breast however, one can feel the implant a little bit more than silicone as it feels more water-filled, but this is usually not bothersome to anybody.
The decision on what type and size of implant to use is very important, so going to a fully Board certified American Society of Pastic Surgeons and The Aesthetics Society member surgeon is of vital importance for your health, safety, and outcome.