Motiva Preservé^®

The most meaningful advancement in breast enhancement in a generation — now offered in Austin by a Motiva USA Pioneer.

Consider what a first-time breast augmentation has always meant: general anesthesia, a week of recovery, carefully managed activity restrictions, and the sense that you’ve undergone a significant surgery — because you have.

Now consider something different. A procedure performed under Propofol-only IV sedation, the same kind used for a colonoscopy. An incision small enough that your implant is placed through it without cutting through your natural breast tissue. Ultrasound guidance to confirm precise implant position. You walk out. You eat dinner at home. Many patients return to work the next day.

This is Motiva Preservé. We think of it as a procedure, not a surgery. The distinction is not marketing language, it is the practical difference between walking out feeling like yourself vs. spending a day or two sleepy and fuzzy-headed as general anesthesia wears off. It is the difference between preserving your natural breast tissue vs. cutting through it.

In 2025, Dr. Ashley Gordon was selected as one of 35 plastic surgeons nationally to participate in Motiva’s USA Pioneers Session at the Sulàyöm Innovation Campus in Costa Rica. The program included comprehensive training in the full Preservé technique, including the Motiva Channel Separator, Inflatable Balloon, and the clinical principles behind tissue preservation. Restora Austin is among the first practices in Central Texas to offer Preservé. Dr. Gordon was personally trained by the inventor of Preservé, Dr. Manuel Chacon.

The photo on the right shows Dr. Gordon training hands-on in the Preservé technique with Dr. Manuel Chacon, inventor of Preservé, at the Sulàyöm Innovation Campus in Costa Rica

The photo below shows Dr. Gordon with Dr. Chacon and Dr. Steven Sigalove after a day of training at the Sulàyöm Innovation Campus.

What Is Preservé?

Traditional breast augmentation uses sharp dissection to create a pocket for the implant, cutting through tissue and, in many cases, through the chest muscle if the pocket is under the muscle. It also requires general anesthesia.

Preservé takes a different approach. Rather than creating a pocket using sharp dissection, we gently create one using a specialized channel separator and a controlled inflatable balloon. This specialized balloon expands the circummammary ligament and creates a “nest” for the Ergonomix implant. The inner structures of the breast are preserved, and the chest muscles are left undisturbed. Nipple sensation is also preserved. With Preservé, we control exactly where the nest is created, which lets us position the implant higher on the chest than is possible with traditional augmentation. A higher starting position means we can achieve the upper pole fullness you want with a smaller, lighter implant. No oversized implant, no supportive scaffolding, no mesh.

We intentionally call Preservé a procedure, not a surgery. The distinction is critical. Preservé uses Propofol-based IV sedation rather than general anesthesia, preserves tissue rather than cutting it, and leaves patients feeling like themselves the same evening. These are not marketing claims. They are the day-one experience our patients describe to us, in their own words the evening of their Preservé procedure.

Every Preservé procedure at Restora Austin follows the same careful sequence:

1. Precision planning with Crisalix 3D

Before your procedure, we use Crisalix 3D imaging to simulate how different implant sizes and projections will look on your specific anatomy. Since we can’t use intra-operative sizers with Preservé, Crisalix is a critical planning tool. We know exactly what implants we are going to use before we ever get to the operating room. Remember, the goal of surgery is for you to love your look. We don’t focus on cc’s because Preservé flips traditional breast planning on its head.

2. Propofol-based IV sedation, no general anesthesia required

Preservé is performed under IV sedation with Propofol in our fully accredited Inspire Surgery Centre, the same medication used for a colonoscopy or a minor endoscopic procedure. You are completely asleep and comfortable. You feel nothing and remember nothing, but without a breathing tube or paralytic agents. No deep systemic effects to wear off.

This is a meaningful clinical distinction, and it is a large part of why we describe Preservé as a procedure rather than a surgery. General anesthesia is safe and appropriate for most traditional breast augmentations and we use it for most of our cases, but it asks something of the body. Many patients feel sleepy and fuzzy-headed for a day or two afterward as the medication clears their system. Propofol wears off very quickly. Patients wake up within minutes, feel genuinely like themselves by the time they get home, and can have a normal evening. For mothers, that means interacting with their children the same day. For professionals, it means a clear head by the next morning. This is what separates a procedure from a surgery, and it is the primary reason Preservé recovery feels fundamentally different.

3. A small inframammary incision

A small incision is made in the inframammary fold, the natural crease beneath the breast, so that any resulting scar is hidden both when you’re standing and when you’re wearing a swimsuit or lingerie. The incision used for Preservé is notably smaller than the one used for traditional breast augmentation because of the precision delivery tools the technique uses.

4. The “nest” is created, not cut

Using the Motiva Channel Separator and Inflatable Balloon, we create the pocket in the subglandular plane, above the chest muscle, by gently pushing tissue aside rather than cutting through it. This is the technical heart of what makes Preservé different. The inner support structures of the breast remain intact.

5. Ultrasound-guided implant placement

The incision is so small that we don’t have direct visualization, so we use our Clarius ultrasound as our “eyes.” First, we use it to ensure proper placement of the numbing medication or tumescent and then to ensure that the pocket created is above the muscle but below the breast gland.

6. The implant is placed, and we’re done

Since we are working with a smaller incision and a tight pocket or the “nest,” we use the Motiva SmoothSilk^® Ergonomix^® implant. The viscoelastic properties of the Ergo implant allow it to be pushed through the narrow tunnel with a Keller funnel. This allows for a “no touch” technique and avoids damage to the implant.

Against the advice of the company, some surgeons use the Motiva Round implant with Preservé. This is not recommended because the gel in the round implant is less elastic than the gel in the Ergo. It’s stiffer, so it should not be forced through the narrow tunnel. We’ve heard reports of implant rupture and shell damage when trying to use round Motiva implants with Preservé. If a patient desires a round implant, a more traditional augmentation approach is preferred.

The procedure takes less than an hour. You wake up immediately and are then transported to the PACU for about 30 minutes.

What Recovery Actually Looks Like

This is the part of Preservé that patients often don’t believe until they experience it. A realistic picture:

“For the modern woman who doesn’t have time to give a week of her life for recovery after breast augmentation, Preservé is a game changer.”  

— Dr. Ashley Gordon

Is Preservé Right for You?

Preservé was developed with a specific type of patient in mind: a woman considering a first-time breast augmentation, or a first-time augmentation with a lift, who wants a natural result, minimal downtime, and an approach that preserves her natural anatomy.

One caveat is that if you need a lift, we will have to do this under general anesthesia, as it’s a longer procedure. The incisions for the lift will require a bit of extra care, so your recovery will also be more traditional. You will have our rapid recovery and not the ultra-rapid recovery of Preservé.

Preservé is a great option for you if:

• You are considering your first breast augmentation (primary augmentation).
• You are considering your first breast augmentation combined with a lift.
• You want a natural look and not a huge boost in size or a lot of rounded upper pole fullness when naked.
• You value minimal downtime and a fast return to work and family life.
• You are interested in preserving your natural tissues.
• You prefer IV sedation to general anesthesia, where clinically appropriate.

Preservé may not be the right fit if:

• You have significant breast ptosis (sagging) that requires a more traditional lifting technique.
• You are undergoing a complex breast revision. Preservé is specifically designed for primary procedures, and revisions typically require a different approach.
• Your desired implant size or anatomy would be better served with either a submuscular (dual plane) or subfascial approach. Remember, your surgical plan is tailored to you and our surgeons are experts in each technique.
• You have a medical condition that would make IV sedation or the procedure less safe. We will discuss this carefully at your consultation.

At your consultation, we will tell you honestly whether Preservé is the right approach for you or whether a traditional breast augmentation would better meet your goals. Preservé is the hot new kid on the block, but it’s not for everyone. It was developed for a particular type of patient seeking breast enhancement. We consider it another powerful tool in our toolbox, but we still use the tried-and-true methods of breast enhancement.

Why Motiva Implants

Preservé was designed to be performed with Motiva SmoothSilk^® Ergonomix^® implants. There is a reason the two were engineered together.

Motiva Ergonomix implants contain the ProgressiveGel Ultima^®. This is the more elastic of the two Motiva gels and it’s known for adapting to your body’s movement and it will take a round shape when you’re lying down and a teardrop shape when you’re standing up, which mimics the behavior of natural breast tissue. The Ergos are also designed to be placed through the small incisions that Preservé requires, which is not true of every implant on the market.

Beyond their compatibility with Preservé, Motiva implants are distinguished by:

• A SmoothSilk surface that has been shown in published research to generate low inflammatory response.
• The ergonomic gel that creates natural-feeling movement.
• A published safety profile with low rates of capsular contracture and other complications (less than 1%) over a 5-year follow-up. They are the best implants on the market and the literature supports this statement.

At your consultation, we will discuss implant choice, projection, volume, and profile, in the context of Crisalix 3D planning, so that you see your simulated result before the day of your procedure.

Why Preservé at Restora Austin

Preservé is a technique, but what matters most for your result is the surgeon performing it and the surgeon’s experience. A great implant and a great technique are important, but they can’t deliver a great result on their own.

Motiva USA Pioneer training

Dr. Gordon’s USA Pioneers training session at the Sulàyöm Innovation Campus means she learned the Preservé technique directly from the inventor, Dr. Manuel Chacon, and the engineering team that developed the instrumentation. This is meaningfully different from self-directed learning. She now trains other U.S. Pioneer surgeons through the Motiva educational program.

Crisalix 3D planning and ultrasound guidance

Not every practice offering Preservé uses 3D simulation for planning or ultrasound confirmation during the procedure. At Restora, both are standard for every Preservé patient.

A fully accredited surgical environment

Your procedure is performed at Inspire Surgery Centre, our QuadA-accredited on-site operating facility, with a board-certified anesthesiologist managing your IV sedation. QuadA (formerly known as AAAASF) is the leading national accrediting body for ambulatory surgery facilities.

National recognition in breast and eyelid surgery

Dr. Gordon has spent nearly two decades refining breast enhancement outcomes and was recognized by Newsweek in 2025 on its list of America’s Best Plastic Surgeons for both breast augmentation and eyelid surgery.

Common Patient Questions

The Real Value of Preservé

Preservé is a premium procedure. It is more of an investment than traditional breast augmentation, and patients considering it deserve an honest answer about why.

The value comes from three places:

The Technology:

The Motiva Channel Separator and Inflatable Balloon are highly specialized, single-use instruments engineered specifically for breast tissue preservation. These tools are not standard breast augmentation tools. Crisalix 3D planning and Clarius intraoperative ultrasound guidance requires dedicated equipment and protocols. Each of these adds real cost and real precision.

The Training:

Pioneer-level training at the Sulàyöm Innovation Campus with Dr. Manuel Chacon and not a weekend course. Costa Rica is where the Preservé technique was developed and Dr. Gordon has had the privilege of being invited to operate there, not once but twice. She also co-chaired the Miami Breast Aesthetics Cadaver Course with Dr. Chacon in March 2026. They were able to train over 50 USA surgeons in the technique.

The Recovery:

What you are paying for, ultimately, is time. With Preservé, you will have an ultra-rapid recovery, which means you’ll be back to normal, back to exercise, back to you very soon after surgery. Patients who have a very busy lifestyle choose Preservé because they don’t have time to waste recovering from surgery.

A Different Category, Not a More Expensive Version:

Patients often ask how Preservé compares in price to a traditional breast augmentation. Preservé is a different category of breast enhancement, not a more expensive version of the same one. Comparing it to traditional augmentation on price alone overlooks what it offers: specialized instrumentation, AI-powered 3D planning, intraoperative ultrasound guidance, smaller incisions, and a recovery measured in days rather than weeks. For many women, that difference is priceless.

We are intentionally transparent about the fact that Preservé costs more. We are equally transparent that, for the right patient, the value is substantial. At your consultation, we will walk through the specific investment for your case and the financing options available.

The Next Step

If you are considering breast enhancement and want to explore whether Preservé is right for you, please reach out.

To schedule a consultation with Dr. Gordon, call us or request an appointment through our online form. We look forward to meeting you.

“My greatest compliment is when the surgical result remains my patient’s secret.”  

— Dr. Ashley Gordon

Important Information

Individual results vary. Preservé and Motiva SmoothSilk^® Ergonomix^® implants are subject to FDA-approved indications for use and important safety information. Preservé is indicated for primary breast augmentation and primary breast augmentation with mastopexy in women at least 22 years of age. Breast implants are not lifetime devices. For full indications, contraindications, warnings, and precautions, visit motivausa.com or ask during your consultation. Motiva^®, Establishment Labs^®, Ergonomix^®, SmoothSilk^®, and Preservé^® are registered trademarks of Establishment Labs Holdings Inc.