The IDEAL implant: Any opinions?

I have changed my mind on getting silicone and would like any input/info that anyone may have on the new, FDA approved IDEAL saline implant. I am very interested due to rhe claims that it has a more 'natural' look than traditional saline, without the worry of possible silicone bleed with the silicone implpants.

Doctor Answers 14


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I am an FDA investigator for the IDEAL Implant and have followed my patients annually since first placing them in 2009. In general my patients are extremely happy with their choice. The IDEAL implant is now FDA approved and available in the USA and Canada. It is indeed more natural than traditional saline implants, softer and do not "bounce" as much as your own or silicone implants. Because there is no silicone gel inside there is no chance of silicone bleed. The internal structure controls movement of the saline and its design reduces folding and wrinkling which is thought to be a key cause of implant rupture/deflation. The outer edges are lowered for better contouring to the chest wall. 

The #IDEALIMPLANT contains no silicone gel,has a natural feel because of its unique design with an internal structure  for optimal shape. The 5 year data indicates a lower capsular contracture rate than most saline or silicone implants available. The peace of mind factor concerning  a silent rupture with silicone implants is significant for many of my patients. Instead of a MRI scan they just need to look in the mirror to know that their implant is intact. 

Ideal Structured Saline Implants - the closest we have to the "perfect" breast implant

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I have been using mostly IDEAL structured saline implants since they became available approximately a year ago (Sept 2015). I have been augmenting breasts since 1991 and have seen every possible long term problem with breast implants over my career. I had always stated that the perfect breast implant does not exist, however the IDEAL implants are as close as it gets to the perfect breast implant. As a female plastic surgeon, I understand the connection of my patients with their breasts at a different level. Patients have always stated that they want the look and feel of their augmented breasts to be natural. The natural looking augmented breast can be achieved with any brand of implant regardless of what the implant is filled with. The dimensions of the patient's breast and the diameter of the implant are the important factors in achieving a natural look. The natural feel is dependent on the amount of "padding" the patient has, ie patient's own natural tissue, as well as, the feel of the implant. In the past, silicone implants felt softer and more natural compared to saline implants, provided the capsule around the implant did not contract. However, there are some negatives with silicone implants: silent rupture requiring MRIs of the implants every 2 years to look for a leak, and increased capsular contracture. Single lumen saline implants feel firmer compared to silicone and have the issue of rippling, particularly in a patient with very little breast tissue.The IDEAL implants have the advantages of both implants of the past without the disadvantages! The structuring has improved the feel of the implant and minimized the rippling! They are filled with saline, so if there is a leak, the patient knows by noticing the decrease in volume of the leaking implant. MRIs are not necessary to check the integrity of the the implant. The replacement of the implant is easy because there isn't any free silicone to clean out.My patients love the feel and look of the IDEAL implants!We finally have a breast implant that fits all my criteria for my patients.I strongly believe that any woman desiring breast augmentation should consult with multiple surgeons. Be sure to pick surgeons who have different preferences in implants so you can hear all different sides and make your own informed choice. Definitely consult a surgeon who has experience with the IDEAL implant as part of your research. These implants, in my personal opinion, are the closest we have to the perfect breast implant!

Aysel Sanderson, MD
Kirkland Plastic Surgeon

Ideal implant avoids silicone problems

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The Ideal implant is saline filled so it doesn't have the baggage that silicone implants, including Gummy Bears, have.  It feels better and doesn't have ripples like some first generation salines do.  I think it is going to be very popular.

Daryl K. Hoffman, MD
San Jose Plastic Surgeon
4.6 out of 5 stars 17 reviews

Love them so far

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I have been in practice 18 years and have placed 6 or so pair of Ideal implants in the last month.  I think they are a great alternative to silicone, in fact I think these implants could make traditional saline implants obsolete. Jane

IDEAL implant

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The IDEAL saline implant is manufactured a little differently than a traditional implant by adding in several layers within the shell that are perforated.  The manufacturers claim that this internal "movement" within the implant will help create a more natural look and feel to the implant.  That is the claim.  The results, however, are going to depend on your body type as well as what your desired outcome is. If you desire a larger, more voluminous breast, than an overfilled saline implant will always feel firmer than its silicone counterpart despite the different shell structure.  Saline has a firmer feel than gel does.  If, however, you desire a smaller augmentation, than saline may be a good option for you.  In my practice, most women choose a gel implant because of their longevity and because of their natural feel.  Silicone has been found not to be harmful - it makes up our makeup, deodorants, body lotions, as well as many medical devices.  That being said, some women feel more comfortable with saline.  Both saline and gel are good choices.  However, there are hundreds of different sizes of implants, and it is imperative that you speak to your surgeon to understand what you are looking for and what your anatomy will accommodate.  Your result will depend more on correctly sizing your chest wall to achieve your desired look than it will be on the manufacture of the implant.

Emese Kalnoki, MD
Rochester Physician
5.0 out of 5 stars 2 reviews

Opinions on the IDEAL structured saline breast implant

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It indeed has a more natural feel than the traditional saline, although not quite as soft as most silicone gel implants.

The ideal implant may be “ideal” for you, if you are concerned about silent rupture of silicone gel implants, but did not like the less natural feel of traditional saline implants.  They are more natural in feel than saline but still not quite as soft as silicone.


The Ideal implant was approved by the FDA in November of 2014, but has only had limited availability until recently.  Initially only the 120 plastic surgeons who were investors in the company had access. They are now starting to release it to more board certified plastic surgeons.  It has a profile similar to a high profile implant.  I would say that it is much more natural in feel than a saline implant, but still not quite as soft and natural as a silicone gel implant.  So my patients that want the most natural feel are still choosing silicone.  The most common implant used in the country is a round smooth silicone gel implant.  And the FDA has shown silicone to be safe and effective.  The FDA recommends in their labeling instructions that you get an MRI 3 years after surgery and every 2 years thereafter to check for a rupture. One analysis in 2014 in the Archives of Plastic Surgery found that

silent ruptures occurred in 9-12 percent of cases eight years after implantation. In a silent rupture, the outer shell of the implant can rupture, but the cohesive gel stays inside the scar

tissue capsule that has formed around the implant. SO there may be no visible or palpable change in the

breast- the rupture is silent. Is it harmful-


- in the short run not much is seen. Over years the silicone

can cause some irritation of the local capsule and thickening. But if we

know the implant is ruptured we generally like to replace it.


A saline implant had the advantage of being much easier to tell if it has leaked.  You can “look in the mirror” and tell if it is intact.  When it leaks, the saline is absorbed and the shell goes flat.  The American Society for Aesthetic plastic surgery, in 2014, reported that 20% of breast augmentations used saline implants.  But they do not feel as natural-some patients describe them as being like a water balloon, and they are prone to palpable and visible rippling and wrinkles. A recent survey of 300 patients by Allergan showed that 52% of patients were fearful of silent ruptures, with 45% being concerned that despite the science and FDA saying silicone gel is safe and effective it is still a foreign substance, and 34% of patients having a fear of silicone all together. 

So the Ideal structure saline implant will be a good option for some patients that like the idea of a more natural feel than saline with the advantages of being easier to detect a rupture.  The Ideal implant has two chambers and if one leaks it will lose volume that is harmlessly absorbed by the body.  If I had to predict I would guess that the majority of patients will still use silicone gel implants prioritizing the natural feel, but an increasing number of ideal structured implants will be used in patients that are concerned about silent rupture but didn’t like the feel of the traditional saline implant.


It is a small company, and warranty concerns are valid- but I would be surprised if they are not purchased by one of the larger main implant companies in the future. The 6 year data shows a lower failure rate that the other silicone and saline implants currently on the market, including the highly cohesive “gummy bear” implants. No 10 year data yet- the study will not be completed until 2019.  But the 6 year data looks good so far. 



Jonathan Hall, MD
Boston Plastic Surgeon
4.9 out of 5 stars 38 reviews

The IDEAL implant

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I believe that the IDEAL implant provides a good option for women considering breast augmentation.  Traditional saline implants have the problem of being too firm, or having visible wrinkling along the edges of the implant.  I think that both of these problems are significantly reduced, or even eliminated in some cases with the IDEAL implant.  I think that when you compare the IDEAL implant to a silicone implant under the skin you would have a very difficult time determining which is which.  Additionally, patients with saline filled implants do not need to get MRI screenings every several years to check for possible rupture.  For a patient that is concerned about silicone implants (even though these devices have been proven to be very safe), the IDEAL implant offers a great option.  I would recommend talking to a Board Certified Plastic Surgeon who offers several different kinds of implants so you can compare the pros and cons for yourself.  Best of luck!

Ideal Implants offer many advantages

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The Ideal Implant is a new class of implants called Structured Saline Implants.   Compared to traditional saline implants, which have a single layered outer shell, the structured saline ideal implants, have multiple shells or layers providing a more natural structure to the traditional saline implant.

This is a game changer in many ways.    The layered shells eliminate the wrinkling or rippling that is so problematic with traditional saline.   In addition, the implants look and feel the same as a silicone cohesive gel implant that we commonly use today.    I often place both implants under a cloth towel and ask the patients to differentiate the silicone from the structured saline ideal implant.   Unanimously, patients cannot feel or see a difference.   Hence, in clothing, the look and feel of these ideal implants replicates silicone implants, and it does not wrinkle or ripple, as traditional saline implants do.

Lastly, many women will find comfort in not having to worry if their silicone implant is ruptured, or having to spend money every 2 years to obtain an MRI to test their implants.  With saline implants, the deflation is immediate and obvious to the patient, making it easier to address the rupture and lessen patient anxiety.   Plus, the saline fluid that constitutes your implant is the same saline fluid used when a patient gets iv fluids.   Hence, your body absorbs it quickly and immediately.   

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 94 reviews

IDEAL Implant

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The IDEAL implant is a very nice and well-studied saline implant.  Yes, it has a much better feel than traditional saline implants.    Find a board certified plastic surgeon with expertise in cosmetic breast surgery to give you all the options for your breast augmentation - know before you go!

Rod J. Rohrich, MD
Dallas Plastic Surgeon

A Viable Alternative to Silicone Gel Implants

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Ideal Implants have been available to the general public for some time now.  Although I was not one of the original investigators, I have been intrigued with the idea of a new breast implant that can satisfy the need for a very natural looking and feeling breast, without the significant drawbacks of silicone gel implants.  What drawbacks?  Silent (asymptomatic) rupture is the biggest problem with silicone breast implants.  The FDA states that an intact silicone breast implant is safe and effective, but a ruptured silicone implant should be promptly removed from the body.  Unfortunately, there is no definite way to determine if your silicone implant is ruptured, since the size remains essentially the same following rupture.  Because rupture rates of silicone implants rise according to the length of time they are inside of the body, the FDA has recommended that all women undergoing silicone breast augmentation, undergo an MRI exam after 3 years and then every 2 years after that for as long as they have silicone implants in.  Even MRI can miss over 10% of ruptured silicone breast implants, and  a positive MRI for a ruptured implant can be wrong up to 10% of the time.   

The Ideal Implant is specially constructed to perform similar to a silicone gel implant, with a soft, consistent natural feel, and less likelihood of visible or palpable rippling.  The major advantage over silicone is that the Ideal Implant is filled with natural saline solution, which will simply be safely absorbed by your body if the implant should rupture.  

In conclusion, I think that you are wise to consider the Ideal Implant as a viable and actually better alternative to silicone gel breast implants.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.