Ideal structured saline implant vs. Natrelle Inspira silicone gel implant?

As a FDA investigator for the IDEAL implant, I have followed my patients for more than 9 years and have published and reported nationally on the comparison of this implant to silicone gel implants. To begin with IDEAL® implants have 3-6 times less deflation rate than silicone gel implants (2% at 8 years) and significantly lower capsular contracture rate than gel implants ( 6.5% vs 11-16%) while at the same time having the feel of silicone. It is not to be compared with, nor the same, as traditional saline implants which I do not prefer due to increased rippling and unnatural feel. IDEAL Implants® look and feel like silicone in my experience. IDEAL implant® monitoring is simple; just look in the mirror to see if your implant is intact rather than worry about silent rupture and the need, expense and hassle for repeated MRI scans. As the contents are only saline, it is absorbed. Since the shell is smooth, presently there is no risk for ALCL. Although I recommend to my patients with silicone gel implants that they should consider replacing their implants after 10-12 years (as rupture rates are relatively high) or whenever they are told they have a rupture, with IDEAL® implants there is no need to monitor or replace them unless there is a problem which will result in significantly less surgeries in their lifetime. When a silicone gel implant rupture occurs a longer and more expensive capsulectomy procedure is required, vs when simply replacement if an IDEAL implant® ruptures.

hello lesadkThe Ideal Implant™ was recently FDA approved and is now being offered at our facility, Pacific Center for Plastic Surgery Newport Beach. Some women are not comfortable having silicone implants in their body and that was one of the reasons why the Ideal Implant was created. This implant gives a more natural feeling than traditional saline implants on the market. The unique structure of the Ideal Implant allows for a similar look and feel as silicone with the safety of saline.
Find a board-certified plastic surgeon that has already performed procedure with this implant and discuss realistic goals and expectations.

These are both excellent implants with similar safety. What your doctor is recommending seems reasonable, but maybe you should consider getting a second opinion if you are still quite interested in the Ideal implant.

That is a good question and it is one that I discuss with almost every patient interested in breast augmentation. Here is my take on it. 1. both are good implants that provide a 10 yr. warranty and coverage for capsular contractures. 2. In most cases, I think that either implant can provide a very pleasing result without rippling.3. The Inspira implants feel more like breast tissue, but the issue of feeling the saline implant is usually only significant in slender women with little breast or subcutaneous tissue to begin with. 4. While both implants have a good safety record, if a gel implant leaks, that rupture is often silent meaning that an MRI or other imaging study will likely be necessary to detect the leak.  The FDA recommends regular screening of silicone filled implants. 5. Although Ideal has a very good track record for complications such as leakage and capsular contracture, Allergan has certainly been in the business longer and it a much larger and more established company. 

I am not sure that "safety" is the right word, because both implants are considered safe and effective by the FDA.  Another question to ask is which implant has less of a chance of having problems for you down the road. The ideal structured saline implant has the advantage of not having to worry about a silent rupture- when it leaks you will know it without needing an MRI or and ultrasound.  The Ideal implant has not been around as long, but the 8 year data was recently released and it is impressive.  With a primary breast augmentation ( a patient that has not have breast augmentation before,ie, a first procedure and not a revision) the Allergan/ Natrelle gel implants have a reported 8 year MRI deflation/ rupture rate of 7.4% vs the Ideal Implant with an 8 year deflation/rupture rate of 2.1 %.  That means that with the gel your chance of having a deflation at 8 years is more than 3 times greater than with the Ideal structured saline implant.  Another report in the study compares the rated of a Baker III/IV capsule contracture at 8 years and shows the Allergan/Natrelle 7 year rate of 16.2 % and the Ideal structured saline implant 8 year rate being 6.6 %.  They don't have an 8 year number for the Allergan/Natrelle but it would not be lower and would typically be higher.  So with the Allergan/ Natrelle gel implant your rate of having a visible or painful capsular contracture is almost 2.5 times higher than with the Ideal structured saline implant.  
It is true that the Ideal implant company has not been around for as long.  But an interesting development is that Liberty Mutual Insurance company will offer you what is essentially a lifetime warranty on the Ideal structured saline implant.  For a primary augmentation you enroll in the Premium protection plan for $189 in the first year and this is renewable annually FOR YOUR LIFETIME for $79 a year.  So for your lifetime, an outside, independent insurance company will sell you a policy that, among other things, covers capsular contracture and deflation with a payout of up to $5000 towards uncovered costs.  It is without precedent to be able to obtain a lifetime warranty on any breast implant and a vote of confidence by the insurance actuaries at Liberty Mutual in the Ideal Structured saline implant.  
I still use silicone gel implants.  They are safe and effective and have their place.  The Ideal Structured saline implant does not feel exactly like the silicone gel implant. But it is very close, and much closer in feel than the traditional saline implants.  So understand the tradeoffs of both and see which makes the most sense in your case.

Thank you for this excellent question. I have had the opportunity to use just about about every implant that has been approved for use in the U.S. in the past 10 years. I enjoy following the technology trends and am always looking for the best. Since using the IDEAL Implants, I have been completely satisfied (as have my patients) with how they look, feel, and behave during surgery. I do think that silicone gel of all types made by the major U.S. brands (Allergan, Mentor, and Sientra) are of high-quality and are safe. But, they can rupture and that seems to lead to more surrounding tissue reaction when it does occur. The saline implants do not tend to do that. I hope that helps.

Excellent question. 
Both implants are fantastic. Ideal Implants have a very low complication rate and there was a recent study published showing how good they are. The newer generation silicone gel implants also have good data. Many of the implant manufacturers have excellent warranties. Both types of implants feel about the same and have very low rates of capsular contracture and rippling. Although Ideal implants have not been on the market as long as other manufacturers, it has an early track record of success. My personal feeling is you will not go wrong with either option. Hope this helps. 

Yours is an important question for which there is no definitive answer.  Different plastic surgeons will have different opinions.  In general I advise patients that all breast implants are temporary devices.  Saline leakage is harmless, and removal and replacement as simple as initial augmentation, if not simpler.  Silicone gel implants come with recommendation for periodic magnetic resonance imaging (MRI) monitoring for hidden leakage.  Removal and replacement can involve more extensive surgery.  Gel implants may be recommended by surgeons for all their patients or for specific patient anatomical issues.  If you seek additional information specific to you, you may consult with other board certified plastic surgeons in your area.