I had cohesive gels done and I'm so glad I went with them and not saline. Because they're gel, they really can't rupture. Even if somehow the casing was compromised, it wouldn't matter because it's a gel-like a gummy bear.
I also had to have a lift, so I have lollipop scars. All of my complications came from that-gels + lift =12000. Yes, 12000. Under the muscle. It f*cking HURTS, lol. I had 650cc gels.
I was so, so swollen for so long the skin and tissue ended up dropping and a year later I had to have the lift revised, which I would have had anyways since I had major, major issues with scarring-my invisible sutures split in various places on my right boob (dubbed frankenboob) and I had a hole you could place your pinky finger into at the bottom where my new crease was that leaked plasma for weeks. When it finally healed the scar tissue attached itself to the muscle wall and I had a visible dent.
After my revision, all that was fixed. I had the first procedure done in 2006. After the first, I lost all feeling in my left nipple, and the right was very sensitive.
After the second procedure, it came back. Nerve endings...can be weird!! My plastic surgeon didn't take any chances second time around and my nipples are now pretty high on the actual boob.
Even so I'm glad I had them done. They look good now, even with scars. Am I 100 percent happy? Nope. But they're better than they were before by a thousand.