Yes, silicone-filled implants are still an option. In fact, our doc said that they do produce a more natural look and feel, but my wife does not mind that her tits look a little "porn star". Come on, she is 5'5" tall, 105 lbs, with a set of D's - that's big for her frame!
Our doc also made note of the fact that some people want a "natural" look, whereas others desire a more "in your face" set. My wife opted for the latter since she was going from FLAT to a D. It was a huge difference and we both love them. It does not, however, look "cartoon-ish", just HOT!
In terms of rippling, hardening, etc., that all comes down to the doctor's ability - both medical and artistic.
And, might I add: HOW the doc implants them is of great importance. I have dated women who have had them inserted through their navels, armpits, and under the breast. They all were not perfect. I spoke to our doc about this and he said that the only certain way to perfectly place the implants is to insert them very close to where they will finally reside. So, in his opinion, under the nipple is the best way. Otherwise, the doc is forced to "place" the implant from a greater distance and that results in reduced ability to "pocket" the implant. "Pocketing" the implant is the process by which the doctor creates a cavity in which the implant will stay. The formation of scar tissue will then keep the implant in place and no further "tweaking" should be necessary to achieve a perfect look.
Here's my experience:
Under the breast - Even in the natural fold of the breast the scar never blends well. I've dated several girls who've had this method. Bad choice - looked like Frankenstein did their boob jobs! B A D !
Navel - I dated two girls (different docs) who used this method. In both cases the implants shifted dramatically. This caused the "which way did he go?" look, with the nipples facing different directions and very poor symmetry. Also, intense post-surgical pain since the doc must cut through 1 foot of abdominal muscle to reach the chest.
Armpit - Same problem as above in terms of symmetry and nipple placement. Also, doc must cut through the thick, muscular wall of the chest cavity - painful procedure w/ less-than-great results.
UNDER THE NIPPLE - A well-qualified plastic surgeon should attain perfect placement using this method. He's working right where the implant will be placed. It's a no-brainer. As for scaring - he should give up his license if he cannot create a scarless incision where the areola meets the breast. My wife's scar was gone, GONE! within 3 months of the surgery.
Hope this info helps...