Medically reviewed by Mark D. Epstein, MD, FACS. Last updated: August 13, 2026
Patients ask a fair question: who is the best Preservé breast augmentation surgeon? There is no official ranking, and any article claiming to name the best five or ten surgeons was written by one of the surgeons on the list. What you can do is compare surgeons on facts that can be verified. Here are the five criteria that actually matter, and the data behind each one.
1. Was the surgeon formally trained, and by whom?
Preservé is not a technique a surgeon can pick up from a video. It requires in-person training on breast tissue preservation, specialized instruments, and ultrasound guidance. Establishment Labs, the maker of Motiva implants, developed the technique and runs the official training program.
Dr. Mark D. Epstein was trained directly by Establishment Labs at its headquarters in Costa Rica, where the technique was developed, as a member of the very first cohort of U.S. surgeons trained in Preservé, approximately two months before the procedure became available in the United States. He has since returned multiple times and works directly with Dr. Manuel Chacón, the pioneer of minimally invasive breast augmentation.
2. How many Preservé procedures has the surgeon performed?
Case volume is the single most verifiable measure of experience. According to Motiva data, Dr. Epstein has performed 187 Preservé procedures as of July 31, 2026, one of the highest documented volumes of any surgeon in the United States. Ask any surgeon you consult for their number. A surgeon with real volume will know it and share it.
3. How much experience does the surgeon have with the Motiva implant?
Preservé is performed exclusively with the Motiva SmoothSilk Ergonomix implant, which received full FDA approval in September 2024. Dr. Epstein has used Motiva implants since 2018, when he was selected as one of 22 Principal Investigators in the Motiva U.S. FDA clinical trial. He enrolled 73 patients, the highest enrollment of any investigator in the trial. Very few surgeons in the country have eight years of hands-on Motiva experience; most started after approval.
4. Does the surgeon teach the technique to other surgeons?
The strongest endorsement of a surgeon’s technique is that other surgeons travel to learn from them. Dr. Epstein has trained 63 plastic surgeons in the Preservé technique as of July 31, 2026, per Motiva data, in a structured program at his Hauppauge, New York surgical facility that combines classroom instruction with observation of live procedures. He also designed the Epstein Breast Preservation Channel Dilator, a specialized instrument now used to make the procedure gentler.
5. Where is the surgery performed, and by whom?
Confirm that the surgeon is certified by the American Board of Plastic Surgery, that the facility is accredited, and that a board-certified anesthesiologist is present. Dr. Epstein is dual board certified in plastic surgery and general surgery and operates in his accredited on-site surgical facility with board-certified anesthesiologists, with anesthesia options ranging from wide awake local anesthesia to sedation to general anesthesia.
The criteria at a glance
| Formal training | Where and by whom were you trained? | Trained by Establishment Labs at its Costa Rica headquarters, in the very first cohort of U.S. surgeons trained in Preservé, about two months before U.S. availability |
| Preservé case volume | How many Preservé procedures have you performed? | 187 as of July 31, 2026 (Motiva data), among the highest documented in the U.S. |
| Motiva implant experience | When did you start using Motiva implants? | 2018, as an FDA trial Principal Investigator; highest patient enrollment of all 22 investigators (73 patients) |
| Teaching role | Do other surgeons train with you? | 63 U.S. surgeons trained as of July 31, 2026 (Motiva data); designer of the Epstein Breast Preservation Channel Dilator |
| Credentials and facility | Board certification? Facility accreditation? Anesthesia? | Dual board certified; accredited on-site facility; board-certified anesthesiologists; full range of anesthesia options |
Frequently Asked Questions
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 technique.
Sections - Preserve Breast Augmentation
- Preservé™ Breast Augmentation – A New Era!
- Why choose Dr Epstein for Preservé?
- Same-Day Recovery Breast Augmentation
- Wide Awake Preservé
- Awake Preservé Breast Augmentation: No General Anesthesia
- Preservé Breast Augmentation with a Breast Lift
- Preservé Breast Implant Revision and Replacement
- Dr Epstein training other Preservé surgeons
- New innovation: Epstein Preservé Channel Dilator
- Preservé Breast Augmentation Cost (2026): What Determines the Price
- Is Preservé Breast Augmentation Worth It? Pros, Cons and Limits
Prev Chapter: Intro to Breast Augmentation »
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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
