Preserve by Motiva^® breast augmentation in London

Preserve by Motiva® breast augmentation is a way of placing a breast implant that aims to disturb as little of the breast’s natural structure as possible. Instead of cutting a pocket for the implant, the surgeon opens a natural tissue layer by gentle, controlled balloon expansion and then places the implant through a sterile sleeve so that it does not touch the skin.

At iQonic we perform it with Preserve by Motiva®, a set of instruments and implants from Establishment Labs, the maker of Motiva® implants. The implant sits behind the breast gland and in front of the chest muscle, in a layer the published literature calls the posterior intralamellar plane. Anatomical studies describe it as a consistent layer between the breast gland and the fascia covering the chest muscle, containing no glandular tissue.

The idea is that by respecting the supporting ligaments (Cooper’s ligaments), nerves and blood supply of the breast, recovery is gentler and the implant sits and moves more naturally. These aims are supported by early evidence, described below, but long-term data are still to come.

Preserve by Motiva® is one of three implant techniques at iQonic, alongside traditional augmentation and Mia Femtech®. Consultations take place at 15 Harley Street, London.

Preserve by Motiva® suits healthy adults over 18 who want a moderate increase in size and have enough breast tissue to cover an implant placed in front of the muscle. You may be a suitable candidate if you:

• want more volume or upper-breast fullness in proportion to your frame;
• have lost volume after pregnancy, breastfeeding or weight loss;
• would like a larger change than Mia Femtech® is designed to give;
• have little or no sagging, with nipples sitting above the breast fold;
• are at a stable weight, in good health and a non-smoker, or able to stop.

It may be less suitable if you are very slim with little breast tissue, where an implant partly behind the muscle may give better cover; if you have significant sagging, which needs a breast lift; or if you have a tuberous breast shape or marked asymmetry that needs the breast itself to be reshaped.

Your operating surgeon decides suitability in person. After your first consultation there is a reflection period of at least 14 days before you give written consent; further consultations are always available.

The three iQonic techniques differ in how the implant space is made, how large a change is possible and how much long-term evidence exists.

Tissue-preserving augmentation is new, and the published evidence is promising but early. The first clinical papers appeared in a 2026 supplement of Aesthetic Surgery Journal that was sponsored by Establishment Labs, the manufacturer.

The largest case series so far (Pittman and colleagues, 2026) reported 159 consecutive women treated at five centres:

• Implants were placed through a short breast-fold incision into the plane in front of the pectoral fascia.
• 58% had local anaesthetic with sedation, 36% a general anaesthetic and 6% local anaesthetic alone.
• At 3 months there were no haematomas; there was one infection, one malposition and one case of rippling (each about 1%).
• Half of the women reported returning to normal activities within a day.

What to bear in mind: average follow-up in that series was about 5 months, there was no comparison group, and the studies were supported by the manufacturer. An accompanying editorial notes that independent replication and longer-term data on capsular contracture and malposition are still needed. Traditional augmentation has decades of data by comparison.

Our guide to Mia Femtech® vs Preserve by Motiva® vs traditional breast augmentation sets the evidence for each technique side by side.

Preserve by Motiva® is usually a day-case operation, and you go home the same day with an adult.

Before surgery. You complete the Silhouette™ questionnaire through Adoreal so your surgeon understands your goals. At consultation your surgeon examines and measures you and uses 3D imaging to preview implant options on your own body. After at least 14 days’ reflection, you confirm your decision and give written consent; further consultations are always available.

On the day:

1. Your surgeon marks the plan with you standing. You have sedation with local anaesthetic, or a general anaesthetic, as agreed in advance. The depth of anaesthesia is tracked with BIS™ monitoring.
2. Fluid containing local anaesthetic is used to gently separate the tissue layers (hydrodissection).
3. Through a short incision in the breast fold, a narrow tunnel is made to the plane behind the breast gland.
4. A balloon device is inflated in stages to open the space for the implant, instead of cutting it.
5. The Motiva® implant is placed through the Motiva® insertion sleeve, so it never touches the skin.
6. The incision is closed with dissolvable stitches and a soft support bra is fitted.

Operations take place at our partner hospital, Fitzrovia Hospital in London. Follow-up reviews may include an ultrasound check.

1. Day of surgery

   A short stay in recovery, then home with an adult. Tightness, swelling and soreness are normal. Take pain relief as prescribed and wear your support bra day and night.

2. Days 1–7

   Many people feel able to do light activities within a few days. Keep your arms below shoulder height and avoid lifting. Your first check is usually around a week after surgery.

3. Weeks 1–2

   Most return to desk work after about a week. Drive once you can wear a seatbelt comfortably and make an emergency stop.

4. Weeks 2–4

   Walking and gentle lower-body exercise can usually restart. The breasts may still sit slightly high and feel firm.

5. Weeks 4–6

   Gradual return to upper-body exercise and heavier lifting when your surgeon advises.

6. 3 months

   Swelling has settled and the breasts feel softer and more natural. The breast-fold scar continues to fade over 12–18 months.

The increase in size is visible immediately, and the shape softens and settles over about 3 months. In one early study of the technique, most women showed improved upper-breast fullness with nipple position maintained, but individual results vary.

Implants are long-lasting but are not lifetime devices. The NHS advises they may need replacing at around 10 years, and many women keep them longer without problems. Preserving tissue does not stop the breast from ageing: pregnancy, weight change and gravity will still affect the breast around the implant.

Your implant details are recorded on the national Breast and Cosmetic Implant Registry. You can still take part in NHS breast screening, but tell the radiographer about your implants; implants in front of the muscle can make mammograms a little harder to read, so extra views are taken. Most women with implants can breastfeed, although milk supply may be slightly reduced. See results shared with patient consent on our before and after page.

Preserve by Motiva® is one of several options, and choosing not to have surgery is always reasonable.

• Traditional augmentation: the most flexible option, including placement partly behind the muscle for slim patients.
• Mia Femtech®: an armpit approach under local anaesthetic with sedation, for a smaller change.
• Fat transfer: your own fat instead of an implant, usually for a modest increase, sometimes over more than one session.
• Breast lift: if sagging is the main concern, with or without an implant.

Preserve by Motiva® breast augmentation at iQonic costs from £9,850. Your final price depends on your anatomy, the Motiva® implant chosen, the type of anaesthetic, the hospital and your aftercare plan.

After consultation you receive a written quote, valid for three months. Your deposit is non-refundable once the 14-day reflection period has passed. When comparing quotes, check whether they include consultations with the operating surgeon, implants and warranty, anaesthetic, hospital fees, garments and follow-up.

For comparison, traditional augmentation at iQonic starts from £9,750 and Mia Femtech® from £11,950. Our breast augmentation cost guide explains UK prices in more detail, and finance is available through our credit partner: see pricing and finance.

Your consultation is with the consultant who would operate. Check any surgeon on the GMC register.