By Dr. Larry Lickstein, MD, FACS, Board-Certified Plastic Surgeon Elle Aesthetic Arts & Plastic Surgery, Ashburn, Virginia 25+ years in practice | 2,500+ breast procedures | Preservé™ Certified Surgeon
I have performed breast augmentation thousands of times over the past 25 years. It’s one of the most refined operations in plastic surgery, and I’ll admit that after that many cases, I didn’t expect anything to change how I think about it.
Preservé™ did.
Elle Aesthetic Arts is now offering Preservé™ breast augmentation with Motiva® implants, and I’ve completed certification in the technique. This post explains what Preservé™ is, how it differs from the augmentation most surgeons perform today, and why I believe it’s the most meaningful change to this procedure I’ve seen in my career.
How Breast Augmentation Has Traditionally Been Done
To appreciate what’s new, it helps to understand what has always been required. In a traditional augmentation, the surgeon creates a pocket for the implant by surgically separating tissue, typically with cautery (an instrument that cuts and seals tissue with heat). Depending on where the implant goes, that can also mean releasing or lifting part of the chest muscle.
Modern techniques have made this far gentler than it was when I started. Recovery is shorter and results are better than they were 25 years ago. But the basic principle hasn’t changed: to make room for an implant, we create a controlled injury inside the breast. That tissue disruption is a large part of why the first days after surgery feel the way they do.
What Preservé™ Changes
Preservé™ starts from a different question. Instead of asking how to make space for an implant, it asks how to make space while leaving the breast’s own architecture intact.
The difference is in how the pocket is made. After numbing the area, I make a small incision in the crease beneath the breast, called the inframammary fold. From there, a specialized instrument called the Motiva® Channel Separator creates a tunnel without cutting the tissue. Next, a Motiva® Inflatable Balloon gently and gradually moves the tissue structures aside, shaping a precise pocket matched to the size of your implant. The implant is then placed into that space.
Beyond that one small incision, no cutting or cautery is used to create the pocket. The breast’s internal support structures stay in place. The procedure is designed to preserve the function of your natural breast tissue and chest muscles, including nipple sensation.
That’s what changed my thinking. For most of my career, the implant pocket was something we created by taking tissue apart. With Preservé™, the pocket is a new plane that respects your native anatomy instead of reshaping it.
Why Less Tissue Injury Matters to You
When less tissue is disrupted, the body has less to recover from. That’s the logic behind the benefits patients care about most:
Less trauma, generally less discomfort. Because the pocket is created by gently moving tissue aside rather than cutting it, Preservé™ is a less invasive* approach. Patients can generally expect a more comfortable recovery than with traditional augmentation.
A faster return to daily life. Preservé™ is designed to be performed with minimal anesthesia and to allow a fast recovery.* Even compared with today’s techniques, the goal is less downtime and an easier first week.
Smaller incisions. The technique and the implant are designed for placement through a smaller incision tucked into the breast crease.
Preserved structure and sensation. Keeping the breast’s inner support structures intact is designed to protect nipple sensation and chest muscle function, and to keep the implant stable over time.
The Implant Designed for This Approach: Motiva® Ergonomix®
Preservé™ uses Motiva SmoothSilk® Ergonomix® implants, and the pairing matters. The gel inside is highly cohesive and viscoelastic, which means it adapts as your body moves. Lying down, the implant holds a round shape. Standing up, it settles into a natural teardrop shape, much like natural breast tissue does. The result is designed to look, feel and move like a natural breast.
The Ergonomix® implant is also designed to be inserted through a small incision, which makes it well suited to Preservé™. Motiva SmoothSilk® implants are FDA approved.
Who May Be a Candidate
Preservé™ is designed for patients having breast augmentation for the first time, including first-time augmentation combined with a breast lift. It is not a revision procedure. If you already have implants and are considering a change, my recent post on when it’s time for breast implant revision or removal is the better place to start.
Whether Preservé™ is right for you depends on your anatomy, your goals and a careful examination, which is why every plan starts with a consultation.
What Hasn’t Changed
Preservé™ is new, but the fundamentals I’ve relied on for 25 years still apply. Results depend on careful measurement, thoughtful implant selection and a surgeon’s judgment about your individual anatomy. Breast implants are not lifetime devices, and every breast surgery carries risks, which I review in detail with every patient. A new technique doesn’t replace experience. It gives experience a better tool.
Key Clinical Points
- Preservé™ is a less invasive* approach to breast augmentation in which the implant pocket is created by gently moving tissue aside with specialized instruments, not by cutting or cauterizing.
- Beyond a small incision in the breast crease, the technique is designed to preserve the breast’s internal support structures, nipple sensation and chest muscle function.
- Less tissue disruption is designed to mean a more comfortable recovery and less downtime, even compared with modern traditional augmentation.*
- Preservé™ uses Motiva SmoothSilk® Ergonomix® implants, which are round when lying down and teardrop shaped when standing, for a natural look, feel and movement.
- Preservé™ is designed for first-time breast augmentation, with or without a lift. Patients with existing implants should explore revision options instead.
Is Preservé™ Right for You?
After thousands of augmentations, I don’t say this lightly: Preservé™ has changed how I think about this operation. If you’ve been considering breast augmentation, I’d welcome the chance to talk with you about whether this approach fits your anatomy and your goals.
Request a consultation at plasticsurgerynorthernvirginia.com/contact/ or call our Ashburn office at 571.440.5005.
Dr. Larry Lickstein, MD, FACS Elle Aesthetic Arts & Plastic Surgery, Ashburn, VA
*Compared to traditional breast augmentation.
Important Safety Information: Motiva SmoothSilk® Round and SmoothSilk® Ergonomix® Silicone Gel Breast Implants are indicated for breast augmentation in women at least 22 years old, including primary augmentation and revision-augmentation. Breast implant surgery is contraindicated in women with active infection anywhere in the body, with existing cancer or pre-cancer of the breast that has not been adequately treated, or who are currently pregnant or nursing. Key complications historically associated with silicone gel breast implants include, but are not limited to, capsular contracture, implant removal, reoperation, infection and rupture. Breast implants are not lifetime devices, and patients should follow up with their surgeon as recommended. Preservé™ clinical outcome data is currently based on use outside the United States. The Motiva® Channel Separator and Motiva® Inflatable Balloon are registered and listed with the FDA for use with FDA-approved implants. For full benefit and risk information, visit motivausa.com or call 1-800-924-5072. Techniques and treatment vary based on each patient’s circumstances.
Published: November 3, 2026 | Last reviewed: November 3, 2026