Lhuaire M, Chacon-Quiros M, Rehnke RD, Graf RM, Pittman TA, Stan C, Villalobos-Alpizar J, Clausen-Oreamuno C, Atlan M, Lantieri L, Noel G. Anatomical basis of a posterior intralamellar plane in breast tissue-preservation surgery. Aesthet Surg J. 2026;00(0):1-8. doi: 10.1093/asj/sjag059
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.
What This Study Found
Using dissection, tissue staining, and internal camera views on cadaver specimens, researchers found a distinct, consistent layer of tissue sitting behind the breast gland and in front of the chest muscle. This is the exact layer tissue-preserving surgery is designed to work within, rather than cutting through the gland itself.
Key Findings
- 16 breasts studied across 8 cadaver specimens at two academic anatomy centers
- A consistent, layered tissue plane (the "posterior lamella") was identified behind the breast gland in every single specimen, regardless of which augmentation approach was used
- Balloon-assisted, gentle tunneling techniques naturally followed this exact plane on dissection and camera view, sparing the gland and the nerves and blood vessels around it
- Tissue staining confirmed the layer is distinct from both the gland and the muscle fascia, with no glandular tissue found within it
Why This Matters for Preservé Patients
This is the anatomical "why" behind the whole technique: it explains, at the tissue level, what tissue-preserving augmentation is actually preserving. Pairs well with the Rehnke fascia paper below for a page built around the science behind Preservé.
