Patients walking through the doors at Southwest Plastic Surgery this year have started asking a question the practice did not get six months ago. “Is that the implant that gets you back to the gym in two weeks?”

The implant they mean is the Motiva Ergonomix, placed using a technique called Motiva Preservé. The two together represent the most significant change in breast augmentation that the practice has adopted in more than a decade. Dr. Frank Agullo, MD, FACS, the medical director at Southwest Plastic Surgery and a double board-certified plastic surgeon with a Mayo Clinic plastic surgery fellowship, has been placing the system for the past year. We sat down with him to walk through what it is, what it changes, and who the right candidate is.

What Preservation Means When a Plastic Surgeon Says It

“Look, preservation isn’t a marketing word in this context,” Dr. Agullo said. “It’s a commitment in the operating room. The breast tissue, the muscle attachments, the lymphatic drainage, the neural anatomy. All of it gets handled like it matters, because it does. The technique was designed around minimizing what we touch.”

In practical terms, that means a smaller incision (2.5 to 3 centimeters, hidden in the natural fold under the breast), minimal release of the pectoralis muscle, and a no-touch funnel that allows the implant to drop into its pocket without contacting skin on the way in.

The result is a recovery curve that the practice’s patients have described, somewhat sheepishly, as “weirdly easy.” Less swelling. Less tightness. Less of the bruised-rib soreness that defines the first week of a traditional submuscular augmentation.

Worth noting on the anesthetic side: the case in the photos on this page was performed under light sedation rather than general anesthesia, and the operation itself was completed in under an hour. The patient was discharged from our accredited surgical suite the same morning. The shorter anesthetic exposure is part of why the recovery profile compresses.

“The day after a traditional submuscular augmentation, patients describe themselves as wrecked,” Dr. Agullo said. “After Preservé, they describe themselves as sore. Two different words, two different recoveries. Honestly, that single change in how patients answer the post-op day-one question has been the most striking part of adopting this technique.”

The Implant: Motiva Ergonomix Full, 315cc in This Case

The Motiva Ergonomix is a sixth-generation silicone gel implant produced by Motiva (a division of Establishment Labs), the company that earned FDA approval for its silicone implants in 2024 after years of leading the implant market in Latin America and Europe. The implant uses ProgressiveGel Ultima inside the shell and a SmoothSilk surface on the outside that has been shown in published data to lower the rate of capsular contracture compared to older textured surfaces.

The shape is what differentiates the Ergonomix line. The gel inside is engineered to behave the way breast tissue does. Upright, the implant takes on a teardrop drape that reads as natural anatomy. Supine (lying on the back), it flattens and rounds the way real tissue would.

“That’s what patients react to when they see results,” Dr. Agullo said. “It’s not the volume. It’s how the volume behaves when she sits up, when she lies down, when she walks. The implant moves with her. Older implants don’t.”

The Full profile is one of three Ergonomix projection options Motiva offers in the United States (Mini, Demi, and Full). For a slim athletic patient who wants visible projection but a natural silhouette, Full sits at the upper end of the range. The patient in the photos on this page received 315cc, sized in the office before surgery using the Motiva Sizers and a long conversation about her goals. The practice’s full breast augmentation procedure page covers the broader category and the consultation process.

A Recovery Ladder That Holds Up

The recovery numbers patients keep asking about are, in Dr. Agullo’s words, the part that drove him to adopt the system. “I kept hearing the manufacturer claims and I didn’t believe them. So I went and trained on the technique, placed it in my own practice, and started keeping notes. The recovery profile is real.”

For a patient with this body type and implant choice, the Preservé recovery ladder at Southwest Plastic Surgery looks like this:

“None of those numbers come from a brochure,” Dr. Agullo said. “I keep notes on every Preservé patient I place. The recovery times have not slipped. That’s the difference between a marketing claim and a real change in the operating room.”

How Preservé Compares to a Traditional Submuscular Augmentation

For patients comparing options, the short version:

Patients should understand that the technique is more demanding than a traditional submuscular augmentation, and the surgeon’s volume with the specific Motiva system matters. “I trained directly on the technique before I placed an implant in a patient,” Dr. Agullo said. “I would not place a Motiva implant the way I place every other implant in my OR. The technique is different and the implant rewards the difference.”

Where MedSpa Fits, and Where It Does Not

Southwest Plastic Surgery operates a clinic and a MedSpa under one roof. The MedSpa side handles Botox, fillers, Morpheus8 RF microneedling, BBL Forever Young, ElixirMD post-procedure recovery, laser resurfacing, hair restoration, and a regenerative aesthetics line that now includes YOU by Acorn.

For Preservé patients, the MedSpa intersects the surgical recovery in a specific way. ElixirMD post-procedure recovery is the practice’s structured early-recovery program. Lymphatic drainage massage and topical recovery support are layered in for patients who want the smoothest possible swelling curve. Patients who want their decolletage skin in optimal condition before surgery often start a Morpheus8 or microneedling protocol on the chest weeks or months in advance.

“What MedSpa is not, in the breast augmentation conversation, is a replacement for surgery,” Dr. Agullo said. “Filler in the breast isn’t a thing we offer here. We do real anatomy with real implants, and we use the MedSpa side to support the surgical recovery and the long-arc plan.”

Who Is the Right Candidate

The patient profile shown in the photos on this page is, in Dr. Agullo’s framing, one of the easier candidates to plan for. A young woman with adequate skin envelope, a defined inframammary fold, and goals that lean toward natural proportion rather than dramatic enlargement.

Patients with significant ptosis (drooping) may need a breast lift in addition to the augmentation. Patients with a history of prior augmentations and capsule issues need a more nuanced revision conversation. Patients with very thin tissue may need a different planning approach, with implant size and pocket choice tailored to their anatomy.

“Preservé is the default I now reach for first,” Dr. Agullo said. “But the planning is still individual. The right answer for the patient in front of me is the only answer that matters.”

About Dr. Frank Agullo

Dr. Frank Agullo is double board-certified by the American Board of Plastic Surgery and the American Board of Surgery. He is a Fellow of the American College of Surgeons, completed his plastic surgery fellowship at Mayo Clinic, and is a Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center as well as an Affiliate Professor at the University of Texas at El Paso. He has been named a Castle Connolly Top Doctor for thirteen consecutive years, was inducted into the Texas Super Doctors Hall of Fame in 2025, and was named Aesthetic Everything Top Plastic Surgeon for 2026. Southwest Plastic Surgery is an early adopter, in West Texas, of the Motiva Preservé breast augmentation system.

Two More Reads From Dr. Agullo Himself

For a more editorial take on Motiva Preservé, see his piece on drworldwide.com: Back to the Gym in Two Weeks: Motiva Preservé and What Preservation Surgery Actually Means.

For the longer clinical breakdown of the technique, the implant, and the recovery ladder, see his post on agulloplasticsurgery.com: What Preservation Breast Augmentation Looks Like on a Slim Athletic Body: A Motiva Preservé Case Study at 315cc.

See the case on social: originally posted by Dr. Agullo to Instagram and TikTok on @RealDrWorldWide.

Schedule a Motiva Preservé Consultation at Southwest Plastic Surgery

If you are weighing breast augmentation and want to understand whether Motiva Preservé is right for you, book a consultation. Dr. Agullo and the Southwest Plastic Surgery team will walk you through whether the technique fits your anatomy and your goals, whether the volume you have in mind makes sense for your frame, and where the MedSpa side of the practice can support your recovery on either side of surgery.

Call (915) 590-7900, text 1-866-814-0038, or book a consultation online. Follow Dr. Agullo on social at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook. #StayBeautiful