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This is because saline implants are slightly firmer and less malleable than silicone implants and so with less of the patient’s breast tissue to surround the new insertion, the less natural the final result may be.
Of course, as some do, if a patient wants to achieve an obviously fake look then that is up to them! It’s definitely down to aesthetics that it’s better rather than it being medically preferable. There is an added concern that the implant can reduce in time oversize and will be more likely to need replacing.