Those are great questions and I refer you to my website where you can review videos discussing Ideal, blog and before and after pics. But let's get right to the point with some answers:Pros of Ideal Implants: 1. safest implant on the market with the the lowest rate of capsular contracture and leaks. 2. feels and looks natural as noted by every single woman in whom I have placed these implants 3. natural and safe alternative to a chemical such as silicone 4. IF there were a leak, your body will absorb the saline and you will detect a leak without either the need for an expensive MRI or the worry about a "silent (gel) leak" which could cause problems without your awareness 5. offers advantages of both moderate and high profile shapes 6. maintains great upper pole volume 6. great warranty 7. a leak in a gel implant is a straight up easy replacement- not so with a leak in gelCons of Ideal Implants: I've heard cost is greater than gel but this is not uniformly the case and varies from office to office. Regardless, the difference is not significant and I might argue well worth it...considering the awesome level of safety this device provides.Why would anyone choose Ideal over Gel or Vice Versa: Excellent question. And I put that to the test in my practice. Once I offered Ideal, in addition to traditional saline and gel, I laid out the pros and cons of each and let women just like you decide for themselves. As it turns out, women believe that safety is the most important factor when it comes to medical decisions and what they choose to put in their bodies. As I would tell any woman, a silent leak in a gel implant is no woman's friend. Most of those leaks show up as a capsular contracture requiring complex surgeries which thus far are not under full warranty with manufacturers. Some surgeries need to be staged. And, there is double the risk of another capsular contracture if you have had one. Regrettably, gel implants are not usually presented with full disclosure of all the facts. Often the "pros" are reviewed and the "cons" are glossed over and not discussed in terms that make sense for women. Bottom line, as my patients now ask me, "Why would any woman choose gel?!"Are Ideal more expensive than gel? As mentioned above, they may be but it is worth shopping around on price. And if more expensive-- they are worth it. Can any of us put a price on peace of mind??Do the Ideal still look good in slim women with minimum breast tissue? Yes, go to my web site and look at Ideal. We are just starting to create a page dedicated to them. Keep in mind, there are studies done in which plastic surgeons couldn't tell the difference between patients with anatomic and round- so why worry? All round implants assume somewhat of an anatomic shape with the help of gravity. These look terrific in a wide range of body types. Why is a silent leak dreaded? It's considered silent because it's not physically obvious, NOT because it's SAFE. That's a good question for the manufacturers. Let me ask you this: If you had a leak, which would you rather have in your body? Saline or gel?? Saline is safe, our bodies absorb it. Silicone is a foreign body. It may be one of the better foreign bodies out there but our bodies still recognize it as an outsider. For this reason, our bodies respond to it but trying to wall it off. You see, although gel is "cohesive" and is not a liquid that flows out of the implant, it still rubs against your tissue. Everytime you move or flex a chest muscle, the implant shape changes and the gel contacts your tissue. Our tissue can harden to wall off the implant (capsular contracture) which creates deformity and eventually pain. That implant has to be removed with the capsule. These are always bloody procedures. And, there is risk of bleeding and impaired circulation to the remaining tissue. Not always the best situation to immediately put in another implant. And if you put in another gel, you are at double the risk for another contracture. Between time out of work, costs, pain, stress....it's a big deal.Over the last 4 years, I had 4 women come in with gel problems. In the last 4 months I've had over 15. Textured gel implants are associated with lymphoma.I think I've given you plenty to think about. My suggestion, when talking to your surgeons, be sure to ask not just about the benefits. Always ask about the RISKS, CONS and ALTERNATIVES. It's our job to educate you, not tell you what to do or sell you on a highly marketed device. As women, we deserve the best and are capable of arriving at the right decisions for ourselves- we just need the FACTS. Ladies, ask for the facts.In good health,Ellen Mahony, MD