The most important consideration in breast augmentation is naturalness. By this we mean a size appropriate for your frame and with as little appearance or feel of the implants as possible. There can certainly be a tradeoff between size and naturalness, but you should look and feel as natural as possible.
The size of an implant involves both width and volume. The implant width is chosen to fit the width of your breast and then an implant model is chosen to achieve the desired volume.
Careful placement of the implant and careful adjustment of the pocket holding the implant is important. Placement partially underneath the muscle is far superior to placement just underneath the breast in most circumstances. The result is far more likely to remain soft, and the overlying muscle pads the implant in the cleavage area giving a more natural transition to help prevent implant show with a low neckline.
The choice between saline and silicone gel implants is a personal one. There is absolutely no credible scientific evidence that silicone implants cause any autoimmune disease. You can choose based on other factors. Silicone implants feel more natural, especially in women with smaller breasts. Saline filled implants have an edge on safety if there is leakage because they just contain salt water. Saline implants can also be placed through smaller incisions in the areola or in the armpit. Silicone implants generally need to be placed through an incision in the crease underneath the breast.
The links below provide authoritative sources for additional information on breast augmentation. There is a lot of information here, and it is reliable. Please contact our office for any further information and assistance. You can email Dr. Friedenthal at drfriedenthal.com or phone him at 1-415-752-2066 for further information and assistance.