w220
449
5059 vs 5159
I don't think there is much practical difference between the movements in the 5059 vs 5159 - that would not bother me at all.
I had a 5059, but sold it. The 5059 is rather thick for its diameter; however the 5159 is better proportioned since it has a slightly larger diameter. The thickness is the same on both watches.
Having said that, I found the dial of the 5059 to be far superior and much better looking than on the 5159. This is purely personal preference.
And the 5059 (along with the 3970 perpetual chronograph) is probably the biggest bargain in the Patek world right now. So if the thickness/diameter ratio doesn't bother you, then I'd say the 5059 is the best choice; otherwise go for the 5159. IMHO only of course. Either way, you'll get a fantastic watch!