Both have risks and both have benefits.
HRT - Blood clots (potential death), liver damage, kidney damage, and deep vein thrombosis. This is especially true if taken in pill form. Loss of erection and sterility as well as shrinking of the penis and testicles.
Silicone Implants - Eventual degridation as the silicone settles. Nerve damage that can result in loss of movement, constant pain, and/or itching. Cosmetic issues from uneven implants and scarring. The risk of the silicone sack bursting particularly for active women. Will not help with baldness or body hair or the eventual masculinization of the face.
HRT - easily monitored for problems with regular blood tests and a change in dose will alleviate most problems if caught early. Results are life long and will stop hair loss and eventually body hair (except face and pubes).
Implants - Quicker results for a feminine form and usually more "curvy" results than hormones wll give. No change to sexual function.
HRT probably costs more long-term, but it is usually easier for people to buy something now, than it is to save for something next year.
It is all a matter of risk vs. reward and what makes the woman comfortable. Most gals opt for a combination of the two. Breast augmentation is so common as to be almost standard. Facial Feminization Surgery s also commonly used to allow women to "pass".
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