Here's a recent question from realself that touches on the important differences between saline and silicone implants and how to tell if there's an implant rupture. See my answer below:
It's a very good question and it is an important difference between saline and silicone. If a saline implant ruptures you know it after just a few days as the implant deflates. However there are downsides to saline implants. They tend to show more visible rippling and feel less natural and silicone. Silicone implants feel more natural, have less chance of rippling, and the latest generation cohesive gel implants do a good job of keeping fullness at the top of the breasts where most women want it. It's important to know that the latest generation of silicone implants are actually a silicone solid. They are not a silicone liquid, so when they rupture the inner silicone does not leak out into the body. This is an important safety feature. It is indeed more difficult to diagnose ruptures with silicone and it requires an MRI or high-resolution ultrasound. Taking all of these factors into account, most women are still choosing silicone implants.
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Dr. Austin Hayes is a Board-Certified Plastic Surgeon with offices in Portland, Seattle, and Hood River.