Ideal Implants for bony chest/little natural breast tissue?

I think the issue that gets lost in questions is understanding that for lean women, any implant will be more obvious than in a fuller figured woman.  You see, regardless of the implant content (saline or gel), a thinner woman is more likely to show the shape and borders of any implant, particularly if the implant is on the larger size.I happen to be 5'3" and about 118 lbs.  I have a boney chest and had about an AA-A cup size prior to implants.  About 14 years ago I had traditional saline implants placed.  To this day, my patients can't figure out if they are saline or gel.  Because I am thin, it is easy to feel the borders of the implant and my breast (which is 99% implant) has taken on the shape of the implant.  The key to NOT having an implant look "fake" in thin women is to choose a size that is appropriate to your body proportion.  I chose a 210cc implant filled to 225cc and it's a perfect fit for my body, therefore does not look like an overfilled balloon.The same issue applies to gel implants.  For those who think that gel implants don't show rippling, just hold a gel implant up by your hand, in the position it will be in once placed in your body.  You'll immediately note that the upper pole has significant rippling and also collapses.  And, the lower pole and borders ripple.  So the notion that gel implants are immune to this issue is entirely flawed.The reasons Ideal is a good choice for lean women are the following:1.  does not collapse in the upper pole, it holds and maintains its fullness2.  the double shell provides greater integrity to the device and reduces rippling3.  the double lumen distributes the saline in two separate compartments which stabilizes the saline 4.  the baffling/partitioning in the outer lumen evenly spreads the saline, minimizing ripplingJust to circle back, remember to choose a size that is proportional to your figure and appropriately fits your chest width and skin tightness.  If you keep these principles in mind, you will find that Ideal is a great fit for you.In good health,Ellen Mahony, MD

Good day! For your guidance, rippling usually occurs when there is not enough tissue coverage or when the implants are excessively large, relative to the patient’s breast and breast tissues, or with textured implants placed above the breast muscle. Saline implants are generally at greater risk to develop rippling than silicone. Patients with extremely thin tissues may require adjustment of the pocket size and adding support with Acellular Dermis or other tissue substitutes (biological fabrics) can help with this. The Ideal Implant™ is  created for women who are not comfortable having silicone implants in their body, but desire a more natural feeling implant 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. It is best to have an in-person examination to a board-certified plastic surgeon that has extensive experience with this kind of implant and discuss realistic goals and expectations. Best of luck! #RealSelf100

Natural feel is not the only thing women care about. The FDA approved intact silicone gel implants as safe. However, if a gel implant ruptures the implant and any gel should be removed including the surrounding capsule (capsulectomy). IDEAL® IMPLANT offers women natural feel without the risk of silent rupture. Women value the advantages of IDEAL® IMPLANT over silicone gel: Rupture Advantages
No silent rupturesSaline absorbed, free Silicone Gel remainsNo MRI needed to detect rupturesLook in the mirror to know implants are intactEasy to remove and replaced if rupturedFiller Advantages
Only saline inside for peace of mindSafety of salineNo silicone gel in the bodyClinical Advantages
Youthful shape/contourLower capsule contracture rateHigher rupture strengthLow rupture rate

Ideal implant doesn't produce the sloshy water balloon look that the first generation saline implants can.  If you are really thin you may see some implant contours but that is true of silicone implants also. It's a really good alternative for thin women. 

In my practice, I recommend the Ideal Implant particularly for patients who are super lean, with little breast or subcutaneous fatty tissue to give coverage to the implant.  In this group of lean patients, I feel that the structured design helps minimize the potential for visible rippling or caving of the implant, especially in the upper pole.
Patients with lots of native breast tissue, thick, elastic skin, and an adequate layer of subcutaneous fat, will do well with a traditional saline implant and can avoid the added cost of the Ideal Implant.
I hope that I have answered your question satisfactorily.  Good luck!