While skin expanders are used in breast reconstruction to stretch a flattened chest wall after mastectomy, they are almost never used for routine
augmentation. Silicone gel implants avoid the rippling commonly seen with saline implants, and do feel more natural. I have extensive experience removing the older leaking gel implants, which are more difficult to remove than the current, more cohesive implants. I never "redo" an augmentation on a routine basis.