November 06, 2026 | Breast Augmentation, Plastic Surgery News
Allure’s Best of Beauty 2026 Breakthrough list came out on September 17. Five winners from 358 entries: a liquid eyeliner, a foundation balm, eye shadow sticks, a face mask, and Preserve by Motiva.
One of those is an operation I perform.
This is how I describe it to a patient: “Preserve is the technique. The technique can be done just under IV sedation. So it’s a short surgery. We don’t have to put the tube in, so the recovery is a lot quicker. The incision is a lot smaller. It’s only about two and a half centimeters right underneath.”
What Allure Said
Elizabeth Siegel wrote the piece. Her judges included plastic surgeons, and the write-up reads more like a consult than a product review. Paraphrasing: the technique spares the breast’s ligaments; the pocket is made with a channel separator and a surgical balloon under ultrasound instead of cutting; most patients get mild sedation, not general anesthesia; the implant goes only where volume was lost; development took 13 years, from the first cases in Tokyo in 2019 to the US launch in spring 2025. One surgeon told Allure he could not think of a more profound technical change in breast augmentation in his career.
I was in the first group of US surgeons trained on it, so I get to say whether that holds up.
What Won
“It is called Preserve because we’re not cutting any nerves, arteries, or breast tissue. All of those structures are preserved, and the most important ones are the natural breast ligaments, which will now act like a mesh and keep the implant in that pocket.”
“Instead, we create a pocket with a dilator and a balloon. The pocket is precisely made above the muscle, behind the breast tissue.”
“And what we do, there’s actually no cutting. It’s called Preserve because we’re not cutting any nerves, any arteries, any breast tissue. What we’re doing is we’re creating a space with a balloon right behind the breast gland, over the muscle. It creates that space, and that’s where we put in the implant.”
Allure’s tool list is my tool list. The full walk-through is in the technique post and on the Preserve page.
The Implant It Needs
Allure notes the Ergonomix implant won the same award in 2025, the first implant to do so, and cites a capsular contracture rate under 1 percent at three years for its surface.
“The Motiva Ergonomix implant is really the only implant that can work with this technique with such small incisions, as other implants would easily rupture working through such a small incision and tunnel. The Motiva implant surface has been studied thoroughly and creates the least amount of inflammatory reaction with the body compared to other implants.”
“It’s ergonomic, which means the implant actually moves with you. So this implant is a gummy bear, but it’s round when you lay down, and when you stand up, it kind of turns into a teardrop. So it’s more natural. It’s pretty soft.”
Where the Volume Goes
Allure’s line about placing the implant only where tissue was lost is the one patients feel in the mirror.
“You can see it gives you the volume where you’ve lost it, which is the upper part. Gives you more projection. It lifts it up a little bit. From the top, you get a nice cleavage, but it’s still, we call it ballerina breast, because it’s not obvious that there’s an implant there.”
“The other difference is that we obtain greater volumes in the end result of the breast using smaller implants. So the breast is indeed lighter, but we get more out of the implant in terms of size, compared to a traditional breast augmentation.”
Allure’s surgeons put the implant ceiling at 315 cc. Mine is about 325. On the simulator: “With Preserve, the maximum is 315 cc’s, versus 400 with the traditional approach, but the result can look very similar because with this technique there’s no cutting of nerves or arteries, we’re just making a space and relying on the breast’s own ligaments to hold the implant, which pulls the breast up more and gives you more visible size than the same cc’s would with the traditional technique.”
More on who is asking for less in my post on smaller breast implants.
Who It Is Not For
Allure says so, and so do I.
“Patients who are looking for a natural result are the ideal candidates. It’s important to note that 325cc is the upper limit of how big the implant can be with this technique. So if a patient desires more than a two cup size increase in their breast, we need to go to a traditional breast augmentation over the muscle, or dual plane. This procedure by itself is not ideal for patients who have significant breast ptosis. They will actually require a breast lift, or a mastopexy, at the same time.”
Allure’s surgeons add two more: very thin patients, where the implant edge can show, and anyone who already had an implant placed in front of the muscle. Those patients need a different operation. I do both.
What a Panel Cannot See
“Patients notice immediately after surgery that they’re able to raise their hands above their head without any discomfort or pain.”
“So the recovery is ultra fast. You’re back to work the next day, you can go back to the gym in two weeks. So it’s definitely a lot faster than the traditional method. And the chances of numbness is way lower than with any other method, because we’re not cutting actual tissue.”
“This technique prevents animation deformity altogether. It is a procedure that is very athlete-friendly, because it does not interfere with muscle strength or range of motion.”
My own numbers, with the caveat: “After performing more than fifty Motiva Preserve procedures, I haven’t had to do any revisions, although it might be a little bit too soon to tell. Overall, my patients have been very happy. They have all returned to work the next day, and they have resumed exercise two weeks later.”
Why I Was Early
“I was one of the very early adopters of this technology. I was in the select thirty-surgeon group that launched the procedure in the United States, chosen by Motiva, and trained in Costa Rica with the surgeons who developed and invented this technique.”
I am also an investigator on the national Motiva post-approval study (ClinicalTrials.gov NCT06938399), still ongoing.
What It Costs
No prices here. Starting prices are on my fees page; the exact quote follows the consultation. “It ends up costing the same as a regular breast augmentation. Especially because we don’t have to use mesh, because we’re using your own breast ligaments as a mesh.”
Why Choose Dr. Agullo
Double board-certified, by the American Board of Plastic Surgery and the American Board of Surgery. Mayo Clinic plastic surgery fellowship. Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. Castle Connolly Top Doctor for 13 consecutive years. Trained by Motiva on Preserve, more than fifty cases done, and still doing traditional augmentation for the patients it suits.
Ready to Talk?
An award says the technique is real. A consultation says whether it is yours.
Call the office at (915) 590-7900, text us at 1-866-814-0038, or book a consultation at agulloplasticsurgery.com/appointments. #StayBeautiful
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