Is Preservé the same as "over the muscle" or "above the muscle" augmentation?
No. Standard above-the-muscle placements (subglandular or subfascial) create a pocket behind the breast tissue but do not preserve the circumammary ligament or place the implant in the intralaminar space. In a traditional above-the-muscle augmentation, the implant sits behind the breast, and the breast drapes over it. In Preservé, the implant integrates into the breast tissue and is held by the ligament. The anatomical difference is significant.
What is the "nesting effect"?
When the circumammary ligament is preserved, and the implant occupies the intralaminar space, the surrounding breast tissue conforms around it and contributes to the final shape. In patients with adequate tissue, this effect contributes roughly 25% additional perceived volume beyond the implant alone and allows the implant to move with the breast naturally, rather than independently.
How is implant size chosen if there are no intraoperative sizers?
Through detailed pre-operative measurements, tissue quality assessment, four-quadrant volume distribution analysis, and 3D imaging. The implant base width, profile, and positioning vector are finalized before surgery. The base width is matched to the ligament boundary; the profile is selected based on your anatomy and aesthetic goals.
Can Preservé be performed under local anesthesia?
Yes, and for many patients, this is one of its most appealing features. Because the pectoral muscle is not involved, local anesthesia with light sedation is a viable option. We discuss anesthesia preferences during your consultation.
Will I need a lift with Preservé?
It depends on your anatomy. Patients with mild pseudoptosis, where the nipple sits at or just above the fold, can often achieve a beautiful result with Preservé alone, as superior-medial implant positioning can recruit upper-pole volume and soften mild laxity. More significant drooping requires a mastopexy, which can be combined with augmentation in select cases. We assess this carefully at your consultation.
How long has this technique been available?
Preservé has been performed internationally for several years, supported by cadaveric dissection data. In the United States, it became available following Motiva's FDA clearance. Our surgeons were trained directly with the clinical team that developed it, so our experience with the technique reflects both the science behind it and hands-on clinical training.
What implants are used with Preservé?
Preservé uses Motiva Ergonomix implants exclusively. These implants feature SmoothSilk® surface technology, designed to reduce inflammation and capsular contracture risk, and respond to gravity and body position in a way that closely mimics natural tissue movement. Their flexibility also allows deployment through a smaller incision than a conventional implant would require.
*Disclaimer: This information is provided for educational purposes only and does not replace a consultation with a board-certified plastic surgeon. Outcomes, risks, and suitability vary from patient to patient.