Medically reviewed by Mark D. Epstein, MD, FACS. Last updated: July 9th, 2026.
Next scheduled review: October 9th, 2026.
The short answer: Motiva Ergonomix implants contain a softer, gravity-responsive gel that looks round when you lie down and settles into a natural teardrop slope when you stand, which makes them the natural-look choice. Motiva Round implants use a slightly firmer gel that holds consistent upper-pole fullness in every position, which makes them the choice for a fuller, rounder upper breast. Both share the same SmoothSilk shell and the same safety profile from the FDA trial.
I use both implants in my practice, I served as a Principal Investigator in the Motiva FDA trial, and Ergonomix is the implant used exclusively in the Preservé technique. Here is how I actually decide between them with a patient in the exam room.
What is the difference between Ergonomix and Round?
| Gel | Softer, highly viscoelastic, moves with position | Firmer, holds its shape in all positions |
| Shape standing | Natural teardrop slope | Fuller upper pole, rounder profile |
| Shape lying down | Rounds out like natural tissue | Unchanged |
| Feel | Closest to natural breast tissue | Soft, slightly firmer |
| Rippling | Very low | Lowest of the two, due to firmer gel |
| Best for | Natural look, active patients, thin tissue | Defined upper fullness, round aesthetic |
| Preservé compatible | Yes (exclusively) | Not recommended |
Who is Ergonomix best for?
Ergonomix suits patients who want their result to move and look like natural breast tissue in every position: upright, lying down, in a sports bra, in a swimsuit. It is my usual recommendation for patients with thin natural tissue, for athletes and yoga practitioners, and for anyone whose goal is 'no one can tell.' It is also the only implant used in Preservé breast augmentation, whether that is a first-time augmentation or my modified Preservé approach for women replacing below-the-muscle implants.
Who is Round best for?
Round suits patients who specifically want visible upper-pole fullness that does not soften when standing. If your goal photos show a rounder, fuller upper breast, the firmer gel of the Round implant is designed to deliver exactly that, and it is marginally more resistant to rippling in very thin patients.
Which one do I recommend?
Neither, until I examine you. The right implant follows from your tissue thickness, chest dimensions, existing breast volume, and the photos you show me, not from a brand preference. In my practice, roughly 99% of first-time Motiva patients choose Ergonomix, but the ratio matters less than the match. At your consultation you will handle both implants yourself, and with Motiva's sizing system we narrow to the exact volume and profile for your frame.
Frequently Asked Questions
Is Ergonomix better than Round?
Neither is better; they produce different looks. Ergonomix moves and settles like natural tissue for a soft, natural slope. Round holds constant upper-pole fullness. The right choice depends on your tissue, dimensions, and the look you want.
Do Ergonomix and Round implants have the same safety data?
Yes. Both use the same SmoothSilk shell and were studied in the same FDA clinical trial, which reported capsular contracture of 0.5%, a 0.6% rupture rate, and zero BIA-ALCL cases.
Can I get Round implants with the Preservé technique?
I do not recommend it. Some surgeons have used Round implants with the Preservé technique, but Preservé was designed around the Ergonomix implant in the 150 to 315 cc range, and that is the only implant I use for it. Patients who want Round implants or larger volumes are candidates for traditional augmentation, which I also perform.
Do Ergonomix implants cost more than Round?
We charge the same amount for either implant. I do not want any of my patients to factor cost into the decision of the actual implant. I want them to have the best result possible.
Disclosure: Dr. Epstein is a paid investigator in the Motiva U.S. FDA clinical trial and is compensated by Establishment Labs to train surgeons on the Preservé breast augmentation technique.
Sections - Motiva Breast Implants
- What is the Motiva Breast Implant?
- Are Motiva Implants Safe? FDA Data Explained by a Trial Investigator
- Motiva Ergonomix vs. Round: A Surgeon's Guide to Choosing
- Ergonomix vs Round: Breast Shape and Movement
- Dr. Epstein’s Eight Year Motiva Experience
- What Makes the Motiva Implant Different?
- Motiva – Is it Smooth or Textured?
- Motiva vs Other Implants
- How Motiva Implants Are Different from Allergan Natrelle, Mentor and Sientra Implants
- MOTIVA US Clinical FDA Trial
Prev Chapter: Preservation Breast Augmentation – A New Era! »
Next Chapter: Five key decisions you need to make »
Chapters – Breast Augmentation Guide
- Intro to Breast Augmentation
- Preservation Breast Augmentation – A New Era!
- Motiva Implants – What You Need to Know
- Five key decisions you need to make
- One-Day Recovery Breast Augmentation
- Anesthesia – General, Sedation or Local?
- Breast Lift (Mastopexy) with/without Implants or Fat
- What else should I know about breast augmentation?
- Important Things to Consider When You Decide to Move Forward With Breast Augmentation
- Revision of breast augmentation
- ALCL and Breast Implant Illness
