Medically reviewed by Mark D. Epstein, MD, FACS. Last updated: July 20, 2026.
If your breast implants have shifted, hardened, dropped, or simply no longer look the way they once did, you are not alone, and you may be a candidate for a fresh start. For many women with older implants, especially those placed below the muscle, the Preserve technique offers a second chance at natural, well-supported, beautiful breasts. This page explains who qualifies, how it works, and what to expect.
Why below-the-muscle implants often disappoint over time
For decades, most breast implants were placed under the chest muscle. Over the years, that approach can lead to predictable problems: the implant pocket stretches, the implant drifts to the side when you lie down, the lower breast fold drops while the upper breast loses fullness, and the muscle can distort the breast when it flexes. In the past, salvaging an overstretched below-the-muscle pocket was one of the most difficult problems in breast surgery, with a high rate of failure or disappointing results.
How Preserve changes revision surgery
Preserve places the new implant above the muscle in a fresh, precisely created space that preserves the breast’s natural supporting ligaments. Rather than trying to repair a stretched, damaged pocket, we bypass it. For the right patient, this restores upper breast fullness, corrects the tendency of the implant to roll to the side, and produces a soft, natural result, often with the same Same-Day Recovery my first-time Preserve patients enjoy. It is, in the truest sense, a second chance procedure.
Who is a candidate for Preserve revision?
Candidacy depends largely on where your current implants sit:
If your implants are below the muscle: Preserve is frequently an excellent option. This is where I see the most dramatic improvements, restoring beauty to breasts that had poor long-term results from the original surgery.
If your implants are above the muscle, or you have had a prior breast reduction: a Preserve-style approach may still be possible using balloon-assisted pocket creation, but the internal supporting ligaments must be presumed to be gone, so results are assessed case by case.
As with any Preserve procedure, the technique uses Motiva Ergonomix implants up to 315 cc. Patients wanting larger implants are better served by traditional revision, which I also perform.
What about combining revision with a lift?
Many revision patients also benefit from a breast lift at the same time to address skin that has stretched over the years. In my Preserve experience, adding a lift has not increased pain or downtime. In my series to date, a number of patients have had their old implants removed, new implants placed, and a lift performed in a single procedure, with excellent results.
What does Preserve revision cost?
Revision cases vary more than first-time augmentation because they depend on what needs to be corrected and whether a lift is included. The best way to get an accurate figure is a consultation, where we review your history, examine you, and use 3D imaging to plan your result. Our patient coordinator can then walk you through the exact fee and financing options such as Cherry.
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
- 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
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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
