Most patients who ask about breast augmentation are weighing more than size. They want a result that still looks like them, without a long recovery, lost sensation, or an implant that sits high and moves in a way their own tissue never would.
Preservé® breast augmentation in Washington, DC, offers a different path. Instead of cutting through breast tissue and lifting the chest muscle, the technique gently separates tissue to create a pocket above the muscle. More of the breast’s nerves, blood vessels, and ducts stay intact, which often means lighter anesthesia and a quicker recovery.
Board-certified plastic surgeon Dr. Douglas Forman, who completed a subspecialty fellowship in breast and aesthetic surgery at Georgetown University, offers Preservé at the Plastic Surgery Institute of Washington (PSIW) in North Bethesda. In this blog, he explains how the technique works, which implant it uses, what recovery looks like, and who it suits best.
What Is Preservé Breast Augmentation?
Preservé breast augmentation is a tissue-sparing technique that places an implant while keeping the natural structure of the breast as undisturbed as possible. Rather than working through the breast, Dr. Forman eases the tissue apart to make room for the implant. That approach is where the name comes from, and it is the reason most of its benefits follow.
The technique is designed to protect several structures that a traditional augmentation can disrupt:
- Nerves, which play a role in breast and nipple sensation
- Blood vessels that supply the breast tissue
- Milk ducts within the breast gland
- The chest muscle, which stays in place rather than being lifted over the implant
How much of each is spared depends on your anatomy, which Dr. Forman evaluates during your consultation.
How Is Preservé Different From Traditional Breast Augmentation?
Preservé differs from traditional breast augmentation in how the space for the implant is created. In a traditional procedure, more of the surrounding tissue is cut, and the chest muscle is often lifted to hold the implant. Preservé leaves the muscle alone and separates tissue gently instead of dividing it.
The process follows a few controlled steps:
- Dr. Forman uses a small instrument to open a narrow channel beneath the breast tissue, keeping the incision short.
- A balloon is passed through that channel and slowly expanded.
- As it expands, the balloon creates a pocket between the muscle and the breast tissue, where the implant will sit.
Because the implant is placed over the muscle, there is less disruption to the tissue and chest wall. “Preservé is a great shift from the way breast augmentation is typically performed,” says Dr. Forman. For patients at our North Bethesda practice, that shift often translates into a gentler surgical experience overall.
Which Implant Is Used With Preservé?
Preservé is built around the Motiva® SmoothSilk® Ergonomix® implant. What sets it apart is the gel inside, which responds to your position. When you lie down, it settles and rounds out; when you stand, it shifts into a teardrop shape.
That behavior is why patients often describe the implant as moving like their own tissue rather than resting on top of it. The Ergonomix is also designed to pass through a smaller incision, which makes it the right fit for a technique built around a narrow channel.
Motiva implants are relatively new to the U.S. market. The FDA approved the Motiva SmoothSilk Round and Round Ergonomix implants in September 2024 for primary and revision breast augmentation in women 22 and older. According to the FDA’s summary of safety and effectiveness data, Motiva implants had been marketed outside the United States for years before that approval.
For patients who want a fuller look, Motiva also makes a round style. Dr. Forman will talk through which implant suits your goals.
What Is Recovery Like After Preservé?
Recovery after Preservé is usually quicker and more comfortable than after a traditional augmentation. Since the chest muscle is left alone and less tissue is handled, patients tend to have less swelling and discomfort in the days after surgery.
The gentler approach also changes the anesthesia plan. “A lot of the time, we can do the procedure under IV sedation alone,” explains Dr. Forman, rather than general anesthesia. Many patients need less pain medication afterward, and some can skip opioids altogether.
All of this adds up to getting back to your life sooner, whether that means picking up your child or returning to the gym. Dr. Forman will give you a recovery timeline based on your procedure and activity level.
Who Is a Good Candidate for Preservé in Washington, DC?
Good candidates for Preservé breast augmentation in Washington, DC, generally want a natural result and a subtle increase in size. Many are considering their first augmentation and lead active lives they want to return to quickly. Candidates also tend to be patients who do not need a breast lift to reach their goals.
Dr. Forman is candid that Preservé is not the right answer for everyone. A larger size increase, a revision, or a case that calls for a lift is often better served by a traditional approach. If your anatomy points that way, he will tell you honestly and walk you through the options PSIW offers, including traditional breast augmentation, breast lift, and breast revision.
“What I tell every patient is that the right technique is the one that fits your body and your goals. That is the only thing that decides it.” — Dr. Douglas Forman
Considering Preservé? Dr. Douglas Forman Can Help You Decide
If a natural-looking augmentation with an easier recovery is what you have been picturing, a consultation with Dr. Forman is the place to start. He is certified by the American Board of Plastic Surgery, a Fellow of the American College of Surgeons, and has been recognized as a Washingtonian Top Doctor and Castle Connolly Top Doctor.
At PSIW, procedures take place in our AAAHC-accredited surgery center in North Bethesda, with anesthesia overseen by board-certified anesthesiologists. Dr. Forman will evaluate your anatomy, listen to your goals, and tell you honestly whether Preservé breast augmentation in Washington, DC, is the right fit or whether another approach will serve you better.
To schedule your consultation, contact us online or call 301.359.6747.
Sources
- U.S. Food and Drug Administration. Premarket Approval Order, P230005: Motiva SmoothSilk Round Ergonomix and Round Silicone Gel-Filled Breast Implants. September 2024.
- U.S. Food and Drug Administration. Summary of Safety and Effectiveness Data, PMA P230005.
