August 18, 2026 | Uncategorized
The question I hear most often after describing the Preservé technique in consultation is some version of “wait, go back, nothing gets cut?”
Correct. Nothing gets cut. That single fact reorganizes the entire operation, from the anesthesia to the recovery timeline, and it is why I have added Preservé alongside my traditional breast augmentation practice. Here is the full picture, including who it is for and who it is not.
What Stays the Same
Preservé still shares fundamentals with a traditional augmentation. We use an implant, and a pocket is created. I use Exparel on all my patients, injecting this local anesthetic between the ribs to numb the breast for up to three days for a better recovery.
What Changes
The incision still sits in the inframammary fold, but it is much smaller, about two and a half centimeters, roughly an inch. The patient can be under a light sedation rather than full general anesthesia.
And the pocket is made without a blade: there is no cutting involved, and no electrocautery. Instead, we create the pocket with a dilator and a balloon, precisely made above the muscle, behind the breast tissue. Once the pockets are made, the Motiva Ergonomix implants, a gummy bear type of implant, are placed through a Keller funnel.
The procedure takes thirty minutes or less.
Why It Is Called Preservé
We’re not cutting any nerves, arteries, or breast tissue. All of those structures are preserved. The most important ones are the natural breast ligaments, which now act like a mesh and keep the implant in the pocket.
Two practical consequences follow. By using these ligaments, we get a lot more of a lift from the breast with just the implants. And we obtain greater volumes in the end result using smaller implants: the breast is lighter, but we get more out of the implant in terms of size compared to a traditional breast augmentation.
No Muscle Release, Explained
The implant goes above the muscle, behind the breast gland, so the muscle does not need to be released as in a dual plane augmentation.
When patients exercise, flex their pectoralis muscles, or lift upper body weights, the implant does not animate. There is no motion, which looks far more like a natural breast, and the technique prevents animation deformity altogether. Muscle function is not jeopardized and strength is not affected, which makes this very athlete-friendly. Patients notice immediately after surgery that they can raise their hands above their head without discomfort or pain.
Recovery, Side by Side
| Preservé | Traditional augmentation | |
|---|---|---|
| Procedure time | 30 minutes or less | Longer |
| Anesthesia | Light sedation possible | General |
| Incision | About 2.5 cm | Larger |
| Back to work | Next day | About a week |
| Back to the gym | Within 2 weeks | About 4 weeks |
| Animation with exercise | None | Possible with submuscular placement |
Who Is (and Is Not) a Candidate
Patients looking for a natural result are the ideal candidates, and most who seek Preservé are specifically interested in the ultrafast recovery.
The honest limits: 325cc is the upper limit of implant size with this technique. A patient who desires more than a two cup size increase needs a traditional breast augmentation over the muscle, or dual plane. And significant breast ptosis is not corrected by this procedure alone; those patients require a breast lift at the same time.
Why the Implant Is Non-Negotiable
The Motiva Ergonomix is really the only implant that can work through such a small incision and tunnel; other implants would easily rupture. Its surface has been studied thoroughly and creates the least amount of inflammatory reaction compared to other implants. The Motiva line has shown a capsular contracture rate of less than 0.5 percent and a rupture rate of less than 0.5 percent, well ahead of competitors. More detail is on my Motiva breast implants page.
My Training and My Numbers
I was one of the very early adopters of this technology: part of 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 the technique.
I have performed more than fifty Preservé procedures. I have not had to do any revisions, though it may be a little too soon to tell. All of my patients have returned to work the next day and resumed exercise two weeks later.
Why Choose Dr. Agullo
Double board certified. Mayo Clinic fellowship trained. Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. Castle Connolly Top Doctor thirteen consecutive years. And one of thirty surgeons nationally trained by the inventors of this technique.
Ready to Talk?
If a natural result with a next-day return to work is what you want from an augmentation, ask about the Motiva Preserve technique. Call (915) 590-7900, text 1-866-814-0038, or book a consultation online. #StayBeautiful
@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
Companion reads: the preservation-era editorial on drworldwide.com, and the practice overview at swplasticsurgery.com.
