Breast augmentation continues to evolve with new technologies focused on improving outcomes, minimizing trauma, and optimizing long-term patient satisfaction. One of the most exciting recent advancements in this space is the Motiva Preservé system, a next-generation surgical platform designed to create a controlled, precise, and minimally traumatic implant placement experience. Although not yet available in the United States, it’s gaining traction worldwide, with anticipated U.S. availability projected for the first quarter of 2026.

In this blog, we explore how the Preservé system works, what makes it different from traditional augmentation techniques, and why it represents a significant leap forward for both surgeons and patients.

What Is the Motiva Preservé System?

The Motiva Preservé system combines a series of sterile, single-use components—including a tissue expander balloon, introducer sheath, and Motiva implant—that are used in a specific sequence to create a precise pocket and place the implant with minimal tissue trauma.

At its core, the Preservé system is designed to standardize and streamline the augmentation process while significantly reducing the manual manipulation and tissue trauma typically associated with conventional techniques.

Step-by-Step Overview: Inframammary Incision and Balloon Expansion

The procedure begins with a small inframammary incision (crease below the breast)—an approach that offers direct access, optimal control, and excellent concealment of the final scar. Unlike more traumatic techniques that involve blunt or sharp dissection to create the implant pocket, the Preservé system utilizes a temporary balloon expander.

This balloon is inserted into the surgical plane—either subfascial or subglandular, depending on the patient’s anatomy and surgical goals—and gently inflated with saline or air. As it expands, the balloon creates a uniform, bloodless pocket, reducing the need for forceful retraction or cutting through tissue.

Once the pocket is formed and the balloon is deflated and removed, the implant is placed atraumatically through a sterile introducer, further minimizing direct contact and potential contamination. This technique offers several downstream benefits in terms of patient recovery and long-term results.

Avoiding Animation Deformity

One major advantage of the Preservé technique is its ability to avoid animation deformity, a common issue with implants placed under the muscle. Because the implant is placed in a subfascial or subglandular plane, there is no distortion or movement of the implant when the chest muscles flex—making this an ideal option for athletic patients or anyone seeking a more natural, stable result.

Atraumatic Placement and the Preservation of Tissue Integrity

Traditional methods of pocket creation often involve a combination of cautery and blunt force, which can traumatize nerves, blood vessels, and surrounding soft tissue. The balloon expansion method used in the Preservé system is gentle and consistent, significantly reducing mechanical stress on the tissues.

This atraumatic approach leads to less post-operative pain, reduced swelling and bruising, and shorter recovery times. Perhaps most importantly, it enhances the likelihood of preserving nipple sensation, a major concern for many patients considering breast surgery.

Reducing Capsular Contracture and Infection Risk

Another key advantage of the Preservé system is the use of a closed, sterile environment from implant preparation to final placement. The Motiva implant is never touched by the surgeon or exposed to the surrounding surgical field, which minimizes contamination.

Additionally, the gentle balloon dissection avoids bleeding, which is a known risk factor for capsular contracture. By reducing both contamination and trauma, the Preservé system may contribute to lower rates of post-operative complications, including infection and excessive scar tissue formation.

Advanced Implant Technology with Motiva Ergonomix

The Motiva Ergonomix implant used with the Preservé system features a responsive gel-shell interface that adapts to body movement and positioning, mimicking the look and feel of natural breast tissue. Its proprietary microtextured surface reduces the risk of inflammation, rippling, and capsular contracture—further enhancing safety and aesthetic outcomes.

Optimizing Results with Motiva Implants

Motiva implants are known for their soft feel, natural shape, and durability. When paired with the Preservé system, the placement is optimized to enhance these characteristics. The precise pocket formation ensures that the implant sits exactly where intended, reducing the risk of malposition or asymmetry.

Because the Preservé system allows for exact implant placement without overstretching or tearing tissue, patients can achieve highly predictable, natural-looking results with less downtime.

What Does This Mean for Patients?

For patients, the Preservé system represents a meaningful improvement in the breast augmentation experience. Key benefits may include:

• Better preservation of nipple sensation
• Less post-operative pain and faster recovery
• Lower risk of capsular contracture
• Reduced swelling, bruising, and scarring
• Highly precise, natural-looking results
• No animation deformity with subfascial or subglandular placement

Although this technology is not yet FDA-approved in the U.S., it is being used successfully throughout Europe, Latin America, and Asia. Surgeons and patients in the U.S. are eagerly awaiting its arrival, expected as early as Q1 2026.

Looking Ahead

As a plastic surgeon, my goal is always to provide patients with the safest, most effective, and most advanced techniques available. The Motiva Preservé system represents the convergence of science, engineering, and surgical artistry. By minimizing trauma and maximizing precision, it promises a better experience for patients from consultation to final results.

We’re closely watching developments and preparing for the opportunity to bring this technology to our Dallas practice as soon as it becomes available. If you’re considering breast augmentation and want to learn more about future options like the Preservé system, schedule a consultation—we’d love to share what’s on the horizon.

For patients seeking breast augmentation, today’s technology offers more advanced and refined options than ever before. At the forefront of this innovation are Motiva® breast implants, which are sixth generation cohesive silicone gel implants (gummy bear implants). Motiva silicone breast implants are known for their excellent safety profile, natural look and feel, and significantly reduced risk of capsular contracture. When paired with biosynthetic internal bras, especially in certain clinical scenarios, these implants can help deliver long-term, beautiful results.

What Is Capsular Contracture—and Why Does Motiva Matter?

After any breast implant surgery, the body naturally forms a layer of scar tissue around the implant. This is called the capsule, and it’s part of the body’s normal healing response. In some cases, however, the capsule can become too thick or tight, causing the implant to feel firm, appear distorted, or even become painful—a condition known as capsular contracture.

One of the standout benefits of Motiva® implants is their extremely low rate of capsular contracture. This is largely due to their scientifically engineered nano-textured surface. Unlike traditional textured implants (macrotextured)—which have larger, more irregular surface topographies—Motiva’s implants are uniquely designed with 4-micron uniform nano-texturing. This specific surface architecture helps modulate the body’s immune response and reduces excessive inflammation, which is a key factor in capsule formation.

Several studies suggest that this nano-surface promotes more favorable integration with surrounding tissue, thereby decreasing the likelihood of the body forming a problematic capsule. In practice, this means fewer complications (specifically capsular contracture and rupture), fewer reoperations, and longer-lasting results for patients.

The Trade-Off: Malposition Risk

While Motiva’s smooth nano-texture provides a significant advantage when it comes to capsular contracture, it also brings one important consideration: malposition. Because these implants don’t “stick” to surrounding tissue in the same way that more heavily textured or smooth implants  do, they can be more mobile within the pocket—especially in the early post-operative period or in patients with thinner tissue coverage.

Implant malposition can include a variety of issues:

• Bottoming out – when the implant drops too low

• Lateral displacement – when the implant shifts too far to the sides

• Symmastia – when implants drift too close to the midline

• High-riding implants – when implants sit unnaturally high on the chest

To mitigate this risk and create better long-term support, many surgeons—including myself—are increasingly turning to the use of biosynthetic meshes, often referred to as internal bras.

What Is an Internal Bra?

An internal bra is a supportive scaffold placed within the breast pocket during surgery. It acts like an invisible hammock, reinforcing the lower pole of the breast and helping maintain optimal implant position over time. This is especially important in patients who choose larger implants, have weaker tissue support, or are undergoing subfascial augmentation, where the implant sits just under the breast fascia rather than under the pectoral muscle.

Internal bras are no longer reserved for complex revisions—they’re now commonly used in primary breast augmentations when added support is needed.

Biosynthetic Meshes: TIGR® vs. GalaFLEX®

Two of the most widely used biosynthetic meshes are TIGR® Matrix and GalaFLEX®, each with their own distinct properties:

• TIGR® Matrix is a long-term resorbable mesh made of synthetic polymers that gradually dissolve over about 3 years. It provides initial strength and support, while slowly transferring the mechanical load to the body’s natural tissues as they regenerate and remodel.

• GalaFLEX® is a scaffold made from poly-4-hydroxybutyrate (P4HB), a naturally derived biopolymer. It’s absorbed over a longer timeframe—18 to 24 months—and encourages robust collagen production. GalaFLEX is particularly helpful in patients with thin tissues, previous surgeries, or implants placed above the muscle.

Both meshes have excellent track records and can be selected based on the patient’s anatomy, surgical goals, and the surgeon’s clinical judgment. I tend to use internal bras more often in cases where larger implants are placed, or where subfascial augmentation is performed—because in those settings, the tissue support is often not enough to prevent long-term implant descent.

Choosing the Right Implant: Ergonomix™ vs. Round

Motiva® implants come in two popular styles: Ergonomix™ and Round.

• Motiva Ergonomix™ implants are designed to behave like natural breast tissue. They shift shape slightly depending on the patient’s position—more teardrop-shaped when standing, rounder when lying down. These are great for patients who want a softer, more subtle look and a highly natural feel.

• Motiva Round implants offer more upper pole fullness and are ideal for patients who want a bolder, more augmented appearance while still benefiting from the safety of the nano-textured surface.

When combined with the appropriate mesh-based internal bra, either implant can produce stunning, long-lasting results—even in challenging cases.

The Bottom Line

Motiva implants represent one of the most exciting advancements in breast augmentation in the last decade. With their ultra-low capsular contracture rates, natural aesthetics, and innovative nano-texturing, they offer patients a safer, more predictable experience. However, to optimize long-term outcomes—especially in patients with larger implants, thin tissues, or subfascial placements—the strategic use of an internal bra with TIGR® or GalaFLEX® mesh can be a game-changer.

As with all surgical choices, the best approach is highly individualized. In my practice, I take pride in tailoring each procedure based on a detailed understanding of anatomy, patient goals, and the latest in surgical science—whether that means selecting the right Motiva implant, reinforcing results with mesh, or combining both for the ultimate support and aesthetic outcome.