Ok. So my M5 has the ventilated seats. I have tried/test drove the ventilated and non-ventilated seats in the X5. The BMW Genius and salesreps should tell you that YES the ventilated are a bit firmer; they have about 25% less cushion thickness compared to the non-ventilated. I noticed this on the X5, our X3 m40 and my M5. There is definitely a difference in cushion. It is mild but it is there. If you live in a cooler area where it does not get super hot, I don't think you need ventilation and take the extra cushioning. If you live somewhere where you drive a lot of long distance and in temperatures above 90, then I would definitely get the ventilation. It is NOT AC as several have mentioned, but it will certainly help with that sweaty feeling on a hot day in car.
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