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. He discloses this relationship in all public communications involving Motiva or Preservé. Dr. Epstein owns stock in Establishment Labs.
In the first year since offering Preservé, Dr. Epstein performed 210 procedures on 420 breasts. Across every one of those breasts, there were zero cases of severe (Grade III/IV) capsular contracture, zero infections, zero implant ruptures, and zero reports of lost nipple sensation. Two breasts (0.4%) needed a return trip to the operating room for a complication: one hematoma and one case of the implant settling slightly too high. Two more breasts (0.4%) were electively revised at the patient's own request for a larger implant size, which is not a complication.
This is Dr. Epstein's own real-world experience, not a peer-reviewed published study, but it sits comfortably alongside the published research summarized elsewhere in this library, and in several respects (complication rate, case volume in year one) compares very favorably to it.
Key Findings
- 210 Preservé procedures performed, 420 breasts operated, September 10, 2025 through September 9, 2026
- 0% Grade III/IV capsular contracture (0 of 420 breasts)
- 0% infection (0 of 420 breasts)
- 0% implant rupture (0 of 420 breasts)
- 0% loss of nipple sensation (0 of 420 breasts)
- 2% hematoma requiring a return to the operating room (1 of 420 breasts)
- 2% re-operation for the implant settling too high (1 of 420 breasts)
- Total complication-related re-operations: 0.4% (2 of 420 breasts)
- Separately, 0.4% of breasts (2 of 420) were electively revised at the patient's own request for a larger implant, which is not counted as a complication
- Average patient age 39.3 (range 18–76); average implant size 202cc (range 150–315cc)
- 3% of cases were augmentation alone, with the remaining 26.6% including a breast lift
- Case volume has grown substantially over the year, from an average of about 7 cases a month in the first three months to about 22 a month most recently
- 15 cases (7.1%) were done wide awake, without general anesthesia; 12 of those needed no sedating medication of any kind
