MONTREAL - After years of yo-yo dieting, Kerry McCarthy had seen her breasts become a "deflated D."

In 2004, the Montreal hairstylist's own insecurities led her to a plastic surgeon who fitted her with a pair of implants that, for four years, restored her sagging chest and her confidence.

But it wasn't long before the saline filled bags began rippling at the sides -- a common side-effect that could be seen through her skin.

Last year the now 33-year-old exchanged them for cohesive silicone gel implants, previously available only with special permission from Health Canada.

"I feel like they're actually mine," McCarthy said of her new implants, adding her husband recently confessed he was a little "disturbed" by the fact he could actually feel her previous ones.

While they cost her $9,000 -- $3,000 more than the saline implants -- she said they're "completely worth it," and that she's recommended them to fellow Montrealers, many of whom never even knew the option existed.

Doctors say that with bathing-suit season approaching, spring is traditionally the time of year many women consider implants as a means of filling out their bikini tops, but McCarthy's plastic surgeon is cautioning Quebecers in particular to do their homework before going under the knife.

Dr. William Papanastasiou, a practitioner for 22 years, said he's alarmed by anecdotal industry figures that suggest more than half of all implants in Quebec are saline compared with just 10 per cent in the rest of Canada.

A proponent of the cohesive silicone gel variety which is the predominant choice among Europeans and increasingly Canadians outside Quebec, Papanastasiou fears many of his Quebec colleagues aren't properly informing their patients of the options.

Noting gel implants are about $1,500 more expensive and somewhat more complicated to insert, Papanastasiou suspects many doctors have grown comfortable with the saline variety and haven't bothered to update their training so they can offer the new product.

"I just wanted to put it out there to inform the public a little better because I feel that a lot of the Quebec population is not as well informed as the rest of the country or the world for that matter," he said.

Papanastasiou offers both options but argues silicone gel implants, particularly the textured pear-shaped ones, look and feel more like a real breast compared to the inflatable round bags of salt water that sum up the saline variety.

Saline implants have about a 10-year shelf life before they must be replaced, he said, adding gel implants are believed to last up to 25 years though it's impossible to say for sure as they've only existed for 17 years.

Saline implants, he added, are also more prone to ripple at the sides or become hard.

Dr. Richard Lapointe, another Montreal plastic surgeon who's embraced the gel implant, suggested Quebecers in particular tend to shy away from silicone because they equate the new model with the controversial liquid version popular in the 1980s.

Liquid silicone implants were banned in 1992 due to a variety of health concerns. Lapointe said about 12,000 of the 14,000 Canadians who had the old "Meme" implants were from Quebec.

"Those implants were the first to be condemned and removed from the market so there's still a historic memory," he said.

"People here were more prudent when the new silicone gel came on the market."

While the liquid version may have been banned, the more viscous "gummy-bear"-like ones have long prevailed in Europe.

North America, however, was more reluctant to embrace the technology and it wasn't until 2006 that Health Canada approved cohesive silicone gel implants for widespread use. Prior to that they were available only by special request.

A study published in last month's Aesthetic Surgery Journal found 60 per cent of plastic surgeons in the United States still favour saline.

Still, an editorial published in the most recent issue of the American Journal of Cosmetic Surgery seeks to refute the growing belief that gel is better.

Dr. Nabil Fanous, another Montreal-based practitioner, favours neither option more than the other and believes it comes down to what is most important to the patient.

The gel-saline split is about 50-50 in his clinic and the biggest factors tend to be price, scarring and the aesthetic look and feel.

Larger women with lots of breast tissue to camouflage the implant may prefer to avoid a large scar and go for the saline, he said, whereas petite women who wish to jump two cup sizes may opt for the more natural gel variety since it will be more visible through her skin.

Still, regional differences are evident. Dr. Richard Warren, a Vancouver-based plastic surgeon and spokesman for the Canadian Society of Plastic Surgeons, said about 80 per cent of his patients choose cohesive gel implants.

Meanwhile, Dr. Yvan Larocque, president of the Canadian Society for Aesthetic Plastic Surgery said the opposite is true at his Montreal practice where 80 per cent of patients choose saline implants.