A mother of three sat in my consult room this summer and told me exactly what she wanted from a breast augmentation: “I want it to be almost not noticeable. Not noticeable to anyone I know.”
That is what quiet luxury sounds like in a plastic surgeon’s office. And more and more, the women who want it ask for an implant by name.
In August, Forbes put the question in a headline: Is Motiva Preservé The Rolls-Royce Of Breast Implants? In the article, by Emma Sandler, Malavika William, Motiva’s VP of global communications and marketing, says patients now ask for an implant brand by name, which historically did not happen. CEO Peter Caldini told Forbes the category had seen no real innovation since the late 1990s.
I was one of the first surgeons in the United States doing Preservé. So let me give you my read.
Quiet Luxury, Not Logo Luxury
The women asking me about Preservé are not asking for something that shows. They are asking for the opposite.
Remember my patient’s request. Not bigger. Younger, softer, and invisible to everyone she knows. It is why the brand-name question surprises people. You would expect a status implant to be a showy one. It is the reverse.
The Badge and the Engine
A Rolls-Royce is a badge and an engine. With Preservé, people talk about the badge (the implant) when most of the difference is the engine (the technique).
The implant does matter. “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.”
But what makes it feel like nothing happened is the way the pocket is made. A balloon, not a blade. The implant sits above the muscle, behind the breast tissue, and the breast’s own ligaments hold it in place. The muscle is never cut. My technique editorial goes through it in full.
This is the same idea that has changed noses and faces. “There’s certainly a preservation trend in plastic surgery, with rhinoplasties and facelifts. The whole idea is to preserve as many of the structures that are naturally there without dividing them or cutting them. This is the same idea in Preserve, or breast preservation surgery.”
Lighter Is the New Bigger
Here is the part that sounds wrong until you see it.
Because the ligaments lift the breast, a smaller implant reads as more. “So the breast is indeed lighter, but we get more out of the implant in terms of size, compared to a traditional breast augmentation.”
The gel helps too. “They’re silicone gel, they’re the gummy type, so everything’s kind of one piece. And so that also makes it so they’re a little lighter and they feel more natural.”
I wrote about the ballerina breast trend in August. Preservé is one of the ways women get there.
Built for Women Who Move
The other reason the comparison falls short: a Rolls-Royce is built for a smooth ride. Preservé is built for women who go straight back to the gym.
“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.”
And back to the gym means two weeks, in my practice. “The procedure takes thirty minutes or less. The patients recover much faster than with a traditional breast augmentation. They usually go back to work the next day, and they can return to the gym within two weeks.”
What the Headline Gets Right
Some of the Forbes piece is simply true, and worth saying plainly.
The implant has an unusually clean record on the complication patients fear most. Capsular contracture is the body building a tight shell of scar around an implant, and it is the classic reason implants used to come out. Forbes cites a rate of 0.5 percent at five years. That lines up with what I tell patients: “The Motiva implant line has shown an extremely low capsular contracture rate of less than 0.5 percent, which is well ahead of its competitors.”
I also liked a line from the founder, Juan José Chacón Quirós, who told Forbes he treats regulatory milestones as a starting point. That is the right attitude. An approval is not the end of the evidence. It is the beginning of it. The national Motiva post-approval study follows patients for ten years, and my practice is one of its sites.
And the recovery claim holds up in my hands. Days, not weeks.
My Verdict
Preservé is the best option I have for one kind of woman: she wants a natural result, a modest change, and almost no time off. “Patients who are looking for a natural result are the ideal candidates.”
It is not the best option for everyone, and I say so in consultation. “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.”
Dr. Adam Kolker said it well in the Forbes piece: placement matters more than which implant you pick, so look for a surgeon who does more than one technique. I agree. A surgeon with one operation will recommend that operation to everyone.
On cost, Forbes reported a 30 to 50 percent premium for Preservé over a traditional augmentation. That is the article’s reporting. My starting prices are on my fees page.
Why I Got There Early
“I was one of the very early adopters of this technology.”
Motiva trained me directly, as one of a select group of about 30 US surgeons, with two trips to Costa Rica. I am an investigator on that post-approval study (ClinicalTrials.gov NCT06938399), which is still ongoing. The full verdict, with who it fits, who it does not and the day-by-day recovery, is on my surgical site.
So is it the Rolls-Royce? For the right woman, it might be. For everyone else, the luxury is a surgeon who tells you the truth about which car you need.
Ready to Talk?
Call (915) 590-7900, text 1-866-814-0038, or book at agulloplasticsurgery.com. #StayBeautiful
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