Allure’s Best of Beauty Breakthrough Awards usually go to things that fit in a makeup bag. This year’s five winners include a color-shifting eyeliner, a foundation balm, eye shadow sticks and a face mask.
The fifth winner is a breast augmentation technique. Preserve by Motiva is the only surgical procedure on the 2026 list, chosen from 358 submissions by a panel that included plastic surgeons.
Southwest Plastic Surgery has offered Preserve since 2025. Dr. Frank Agullo, who founded the practice, was one of the first US surgeons Motiva trained on it. We asked him what the award means for a patient sitting in our consult room.
What Allure Recognized
In Elizabeth Siegel’s write-up, the surgeons Allure interviewed describe Preserve as a ligament-sparing technique. The pocket for the implant is made with a channel separator and a surgical balloon rather than by cutting, under ultrasound guidance. It is usually done under mild sedation instead of general anesthesia. The implant can be placed where volume was lost, instead of enlarging the whole breast. Development took 13 years, and the technique launched in the US in spring 2025.
Dr. Agullo describes the same operation in plainer words.
“Preserve is the technique. The technique can be done just under IV sedation. So it’s a short surgery. We don’t have to put the tube in, so the recovery is a lot quicker. The incision is a lot smaller. It’s only about two and a half centimeters right underneath.”
“And what we do, there’s actually no cutting. It’s called Preserve because we’re not cutting any nerves, any arteries, any breast tissue. What we’re doing is we’re creating a space with a balloon right behind the breast gland, over the muscle. It creates that space, and that’s where we put in the implant.”
Why It Matters for Recovery
Allure notes that most patients avoid general anesthesia. At Southwest Plastic Surgery the procedure is done in the practice’s own accredited surgery center, and the numbing is planned before the first incision.
“So we’re going to do an Exparel block, which is a long acting anesthetic that lasts three days. If we beat the pain early on, you usually don’t get pain. So most people don’t have pain. They feel more like pressure. But it’s very easy to get through.”
“So the recovery is ultra fast. You’re back to work the next day, you can go back to the gym in two weeks. So it’s definitely a lot faster than the traditional method. And the chances of numbness is way lower than with any other method, because we’re not cutting actual tissue.”
The day itself is short: “We usually come in an hour before, we do the surgery, and then you go out about an hour later.”
Our day-by-day account of the recovery is in the Forbes recovery post.
The Implant Behind the Award
Allure points out that Motiva’s Ergonomix implant won the same award in 2025, the first breast implant ever to do so, and that it is the implant Preserve is built around. Allure cites a capsular contracture rate under 1 percent at three years for its surface.
Dr. Agullo on why the pairing matters: “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.”
And on what patients feel: “It’s ergonomic, which means the implant actually moves with you. So this implant is a gummy bear, but it’s round when you lay down, and when you stand up, it kind of turns into a teardrop. So it’s more natural. It’s pretty soft.”
Who It Fits, and Who It Does Not
Allure’s surgeons were clear that not every patient is a candidate, and Dr. Agullo says the same thing in every consultation.
“Patients who are looking for a natural result are the ideal candidates. It’s important to note that 325cc is the upper limit of how big the implant can be with this technique. 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. This procedure by itself is not ideal for patients who have significant breast ptosis. They will actually require a breast lift, or a mastopexy, at the same time.”
Allure’s surgeons also mention very thin patients, where an implant edge can show, and anyone who already had an implant placed in front of the muscle. Those patients are better served by a traditional augmentation, which Dr. Agullo also performs.
The upside of the size ceiling is that the technique gets more from a smaller implant: “The other difference is that we obtain greater volumes in the end result of the breast using smaller implants. So the breast is indeed lighter, but we get more out of the implant in terms of size, compared to a traditional breast augmentation.”
What He Has Seen So Far
Dr. Agullo’s early results are his own and he keeps the caveat in: “After performing more than fifty Motiva Preserve procedures, I haven’t had to do any revisions, although it might be a little bit too soon to tell. Overall, my patients have been very happy. They have all returned to work the next day, and they have resumed exercise two weeks later.”
He was in the first group trained: “I was in the select thirty-surgeon group that launched the procedure in the United States, chosen by Motiva, and trained in Costa Rica with the surgeons who developed and invented this technique.”
About Cost
There are no price figures in this post. Starting prices are on the fees page, and an exact quote follows the consultation. One detail patients find reassuring, in Dr. Agullo’s words: “It ends up costing the same as a regular breast augmentation. Especially because we don’t have to use mesh, because we’re using your own breast ligaments as a mesh.”
Ready to Talk?
Southwest Plastic Surgery offers both Preserve by Motiva and traditional breast augmentation. The consultation, with measurements and a 3D simulation, decides which one is yours.
Call the office at (915) 590-7900, text us at 1-866-814-0038, or book a consultation at agulloplasticsurgery.com/appointments. #StayBeautiful
@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
