There has been lots of excitement about Preservé™ on social media and we are getting calls about this procedure so let’s discuss what it is and what it isn’t. I had a patient in consultation recently ask me if I could do it for her. Surgeons are posting about it on social media as being one of their favorite techniques and the buzz is spreading!
Preservé™ is described on Motiva®’s website as a “Minimally-invasive breast surgery utilizing tissue preservation, specialized technologies, and techniques to reshape the breast while conserving its intrinsic structure and function.
It is claimed to allow the patient to benefit from smaller scars and not disrupt native breast tissues which may allow for a quick recovery. They claim it to be less invasive and to allow breast stability. By using Motiva®’s SmoothSilk® implant there is a low amount of inflammation and this decreases potential complications.
The procedure is performed as follows. Local anesthesia is used to numb the area that the implant will be placed. This is often done under anesthesia sedation but can be done fully awake. After this an introducer is placed via a small incision to create a tunnel to the breast in the space above the muscle. A balloon is then used to expand the tissue to create a space for the implant. A specialized funnel like device is then used to place the implant. The following is a diagram from Motiva®’s website:
First of all balloon dissection of pockets is not new. Implants were placed via the belly button (umbilical incision) by many surgeons for years. It is funny that most board certified plastic surgeons scoffed at the idea of doing the surgery this way as it was described as blunt traumatic dissection and therefore not precise. We were taught in training to avoid blunt dissection and to use accurate precision techniques.
How can this balloon substitute for the accurate direct visualized pocket creation that we have done for years. How does one control bleeding? How does one control malposition? How does one create symmetry? Every surgery that plastic surgeons do is based on precision and control. This technique seems to fly in the face of what we have done to improve results for years. Perhaps the technology is just that good, or perhaps this is all fabulous marketing. The name Preservé™is genius in terms of marketing a device and clearly has a great appeal to patients. Patients have already been calling my office asking if I do this surgical technique and I see posts on Instagram describing patients who have traveled hundreds of miles to surgeons that do offer it.
Where is the published controlled study data? Where is the long term follow up data? I like to make data driven decisions for my patients. What are the complication rates? What are the downsides? Industry representatives have given me none of this information to date.
These implants are being placed with subglandular above the muscle or in some “new plane” in the gland itself. How does this affect breast cancer screening? There isn’t even an attempt to stay subfascial here.
I see the “smaller incision” described but my incision is already typically about 3 to 4 centimeters in length depending on the size of the implant placed. Is a 2.5 centimeter incision that much smaller? Yes it may be very slightly smaller, but not much. Surgeons shouldn’t be making 3 inch long incisions for breast augmentation. Keller Funnels solved this problem years ago.
Is the recovery easier? Subfascial muscle sparing breast augmentation already has improved upon my already quick Rapid Recovery Breast augmentation techniques. Many of my patients do not take any pain medication other than ibuprofen or Tylenol. How much of an improvement can it therefore be? Truth is I placed implants under the muscle for over 20 years with quick recoveries. Dr. John Tebbetts of blessed memory published articles on “Breast Augmentation with a 24 hour recovery” in the year 2002. Perhaps the recovery with this new technique may be slightly quicker but is this worth it for what I see as big potential tradeoffs?
Furthermore the implant that can be used needs to be a small ergonomic implant. This limits greatly who would be a candidate for the procedure. I have already discussed in a previous post my thoughts on the Ergonomic versus Round implants.
For full disclosure I am scheduled to travel to Costa Rica where Motiva®’s factory is and be trained on this technique at the end of October 2025. That being said I have many reservations about the technology. I also admit that I do not know everything about it quite yet but since patients are already asking me about it I feel compelled to express my thoughts.
I watch plastic surgeons on social media describing how great this new technique is. In truth none of them have done more than a handful of these surgeries as Motiva® tells me that no surgeon in the United States has been given more than 5 of these proprietary kits. I have trouble with their bold pronouncements about this great new technique that they simply can not have much experience with. Patients see posts about the revolutionary technology. This is very misleading to a patient with limited knowledge about breast implant surgery who is doing her research. That being said there are some surgeons with excellent reputations who have been advertising this technique so maybe there is more to it than I see.
I will continue to learn more about this technology and procedure as I feel a plastic surgeon who specializes in breast augmentation needs to have knowledge about every technique available. That being said just because something can be done doesn’t mean it should be done. Surgeons need to be critical thinkers and advocates for their patients.