Preservé™: The Minimally Invasive Breast Augmentation Technique

Preservé™ is something different. It’s a newer, less invasive breast augmentation technique developed by Establishment Labs (the company behind Motiva implants) that prioritizes tissue preservation over sharp dissection.

Preservé requires specific training and certification, and not all surgeons in the United States are currently trained in this technique. Both Dr. Roider and Dr. Slenkovich have completed this training and are pleased to offer Preservé Breast Augmentation at Colorado Plastic Surgery Center. We want you to understand exactly what it is, how it works, and whether it fits what you’re looking for.

What is Preservé, and how is it different from traditional breast augmentation?

Breast augmentation is a procedure focused on increasing breast size typically using an implant. It is the only procedure that allows us to create upper pole volume and cleavage. Both Preservé and traditional augmentation share this goal. They differ in how the implant pocket is created.

Preservé takes a tissue-sparing approach. Rather than cutting, specialized instruments are used to gradually separate natural tissue planes and create a pocket while maintaining the ligamentous support structures of the breast. The implant is placed above the muscle but below the breast tissue and incorporates into the breast’s existing anatomy.

Traditional augmentation relies on dissection: the surgeon cuts through breast tissue to form a pocket in either a submuscular or subfascial plane. This approach is very effective but comes with meaningful trade-offs: increased post-operative pain, longer activity restrictions, possibility of animation deformity (the breast distorting when the chest muscle contracts) and higher likelihood of implant displacement over time (bottoming out).

How exactly is the pocket created?

Preservé breast procedures begin by numbing the region, followed by a small 2.5–3.0 cm incision made in the breast crease. A blunt-tipped instrument is used to gently push tissue aside through a controlled, twisting motion. A small inflatable balloon device is then inserted through the same tunnel and expanded, displacing tissue, not cutting, to form a precise implant pocket.

Most importantly, the circummammary ligaments, the internal suspension system of the breast, remain intact throughout this process.When these structures are preserved, the implant is supported by existing anatomy. That structural integrity reduces the likelihood of bottoming out — the gradual downward implant drift that can occur when ligamentous support has been compromised by dissection. Clinical studies show 0% inferior implant malposition at three years, ensuring long term satisfaction and confidence.

What incision is used, and where is the scar?

Preservé allows for a smaller incision than traditional breast augmentation.

The incision is approximately 2.5–3.0 cm, placed in the inframammary fold, the natural crease underneath the breast. It is one of the most discreet incision locations available in breast surgery, positioned where the breast meets the chest wall and where natural shadowing obscures it.

What implants are used?

Preservé uses Motiva Ergonomix® silicone implants exclusively. Round implants, saline implants, and other brands are not compatible with this technique.

Motiva SmoothSilk Ergonomix® implants are unique as they adapt their shape as a patient’s body changes position, showcasing a round shape when lying down and a soft teardrop shape when standing. Combined with a tissue-preserved pocket, this produces results that move and feel closer to natural breast tissue.

Available sizes range from 150 cc to 315 cc - roughly one to two cup sizes of volume increase.

What anesthesia is required?

Preservé can be performed under twilight anesthesia rather than general anesthesia. You remain comfortable throughout the procedure and breathe on your own, without a breathing tube. Recovery from sedation is faster and generally involves less grogginess than waking from general anesthesia.

At Colorado Plastic Surgery Center, we have been performing breast augmentations under twilight anesthesia for years with great success, so this approach is well-established in our practice.

What is recovery like?

Significantly faster than traditional submuscular augmentation. Because Preservé is a minimally invasive technique and the breast support structures and chest muscles are not compromised, most patients return to light daily activities the same day as surgery. Moderate upper body exercise can typically be resumed approximately two weeks after surgery. Bruising and swelling are usually mild and resolve within the first week.

For comparison, traditional submuscular augmentation typically requires six or more weeks before full activity is allowed, and final results can take up to a year to settle.

Will I lose nipple sensation?

No technique eliminates this risk entirely. Preservé reduces disruption to the nerves and supporting structures, which may lower the likelihood of sensory changes compared to more invasive approaches. That said, there is no guarantee that nipple or breast sensation won’t change. This is a risk we discuss with every patient during consultation.

Can Preservé be combined with a breast lift?

Yes. Preservé can be performed alongside a breast lift (mastopexy). While it does not eliminate the scars associated with a mastopexy, we still gain the advantage of maintaining the natural ligamentous support structures of the breast.

Who is a good candidate?

Preservé is well-suited for patients whose goals align with what the technique was designed to deliver: subtle to moderate enhancement with a natural look and feel, faster recovery, minimal scarring, and long-term structural stability. If your target size falls within the 150–315 cc range, Preservé is worth a serious conversation.

Preservé tends to be a good fit if you:

• • Are seeking your first breast augmentation
• • Want a subtle to moderate volume increase (roughly one to two cup sizes)
• • Have adequate natural breast tissue and good skin elasticity
• • Want to preserve chest muscle function and avoid animation distortion
• • Prefer minimal scarring
• • Prioritize a fast recovery

Is Preservé better than traditional augmentation?

No. Both techniques have clear benefits, and each patient’s candidacy is evaluated during consultation. Traditional augmentation remains an excellent choice for patients seeking larger implants, greater customization, or revision procedures. Preservé is well-suited for patients seeking subtle to moderate enhancement with faster recovery, minimal scarring, and long-term structural stability. The right choice depends on your anatomy and what you are asking the surgery to accomplish.

The table below outlines where the two approaches differ across the factors that matter most.

	Preservé™	Traditional Augmentation
Implant pocket creation	Blunt tissue separation — no cutting	Sharp dissection through breast tissue
Muscle involvement	None; implant placed above muscle	Sometimes
Incision size	~2.5–3.0 cm in the breast crease	4–5 cm in the breast crease
Return to exercise	~2 weeks	~6 weeks
Animation deformity risk	Eliminated	Possible with submuscular placement
Ligament preservation	Yes	No
Bottoming out risk	None to Minimal	Higher; relies on capsule formation
Implant options	Motiva Ergonomix® only (150–315 cc)	Silicone or saline; multiple brands and size options
Compatible with breast lift	Yes	Yes
Suitable for revision surgery	No	Yes

Ready to learn if Preservé is right for you?

Schedule a consultation with Dr. Slenkovich or Dr. Roider at Colorado Plastic Surgery Center. We’ll evaluate your anatomy, discuss your goals, and help you determine whether Preservé or traditional augmentation is the right approach for you.