Wide Awake Motiva Preservé Breast Augmentation, No General Anesthesia | Long Island & Suffolk County NY

Q: Can breast augmentation really be done without general anesthesia?

Yes. The Preservé technique uses blunt dissection rather than cutting, which makes the procedure tolerable under local anesthesia with no sedation or light sedation. Patients are comfortable, awake, and able to go home shortly after surgery.

Q: Is awake breast augmentation safe?

For appropriately selected healthy patients, it removes the risks associated with general anesthesia entirely. The procedure is performed in a QUAD A-accredited surgical facility with full monitoring throughout, with anesthesia services provided by a board-certified physician anesthesiologist.

Q: Will I remember the surgery?

Patients who choose no sedation or light sedation typically remember the experience as relaxed and surprisingly uneventful. Patients who prefer to remember nothing can choose intravenous twilight sedation or general anesthesia instead.

Medically reviewed by Mark D. Epstein, MD, FACS. Last updated: July 9th, 2026.
Next scheduled review: October 9th, 2026.

Yes, breast augmentation can be performed while you are awake, without general anesthesia, and the Preservé technique is what makes it practical. Because Preservé creates the implant space with gentle blunt dissection instead of cutting through tissue or muscle, the procedure is tolerable under local anesthesia with either no sedation or light sedation. No breathing tube, no IV general anesthetic, no grogginess, and you walk out of the operating room shortly after we finish.

Dr. Mark Epstein performs wide awake Preservé breast augmentation at his QUAD A-accredited surgical facility in Hauppauge, on Long Island in Suffolk County, New York. As of August 19, 2026, he has performed 200 Preservé procedures, including 11 wide awake. Here is exactly how it works and who it suits.

To find out whether wide awake Preservé is right for you, call our Suffolk County office at 631.689.1100 to schedule a consultation.

How does awake breast augmentation work?

For awake cases, we use either no sedation at all or light sedation to relax you, depending on your preference. Using a very tiny needle, I then numb the surgical area thoroughly with local anesthetic. Patients barely feel this. I give the numbing medication ten full minutes to do its magic. Next, a small incision in the skin is made. That is where the cutting ends! The Preservé instruments create the implant pocket with blunt dissection, which is the key: there is no sharp cutting of tissue deep in the breast, so the sensations are at most that of pressure, not pain. Most patients chat with us during the entire case. The entire procedure takes about 30 minutes.

What if I would rather not be aware of the surgery at all?

You have a middle option between fully awake and general anesthesia: intravenous twilight sedation, the same kind used during a colonoscopy, administered by a board-certified physician anesthesiologist. You breathe on your own, there is no breathing tube, and almost all patients have no memory of the procedure. And for patients who prefer general anesthesia, I offer that as well, but only one of my patients has requested this for a Preservé augmentation alone. The surgical result is identical with all three options.

Why avoid general anesthesia?

No airway instrumentation, no ventilator, and none of the rare but real risks that come with general anesthesia
Post-anesthesia nausea, vomiting, and brain fog are very rare
Faster discharge and a quicker return to feeling like yourself, often the same afternoon
Many patients simply feel safer and calmer knowing they will be conscious and in control
Patients who receive no sedation at all may even drive once they get home, although we still recommend having someone drive you home after surgery

To be clear, modern general anesthesia is very safe. Awake surgery is an option, not a requirement.

Will I feel pain during awake surgery?

You will feel touch and pressure but not sharp pain. The local anesthetic is placed methodically before anything else happens, and we test it before proceeding. If at any point you want more medication, we give it. In my awake cases to date, nine patients completed awake surgery with no issues; one required a little more sedation and was no longer awake for the surgery.

Who is a candidate for awake Preservé?

You need to be a Preservé candidate first: typically a first-time augmentation patient whose goals fit the 150 to 315 cc Ergonomix range, though many women with prior below-the-muscle implants are also candidates for the modified Preservé approach. Beyond that, the best awake candidates are calm about the idea of being conscious during surgery and are medically healthy. If the idea of being awake makes you anxious, twilight sedation or general anesthesia is the better experience, and the surgical result is identical either way.

What is recovery like after awake surgery?

Recovery from the surgery itself is the same rapid Preservé recovery: most patients resume normal daily activities the same day, and many go out to lunch or shopping within hours of surgery. What you skip is recovery from general anesthesia. Awake patients get dressed, walk out, and are typically eating a normal meal at home within hours. Patients who receive no sedation may drive the same day; everyone else may drive the day after surgery. For the full recovery timeline, see our Preservé Recovery FAQ.

Frequently Asked Questions

Can breast augmentation really be done without general anesthesia?

Is awake breast augmentation safe?

Will I remember the surgery?

Wide awake Preservé is available to patients throughout Long Island and Suffolk County. Call 631.689.1100 to schedule a consultation with Dr. Mark Epstein.

A breast augmentation option for patients who fear anesthesia

For many patients, the greatest concern about breast augmentation is not the procedure itself, but the idea of undergoing general anesthesia or intravenous sedation. Wide Awake Motiva Preservé® Breast Augmentation was created for patients who want breast enhancement but feel anxious about "going under"or just want to be mentally alert, clear and focused.

This approach allows breast augmentation to be performed using local anesthesia to numb the breast area, while the patient remains awake and comfortable. It is designed for patients who want a more reassuring experience without planned general anesthesia or routine IV sedation.

Importantly, this procedure is not performed as a way to avoid anesthesia support or reduce safety measures. An anesthesiologist is present throughout the procedure to administer intravenous antibiotics, monitor the patient, and address any medical concerns that may arise. This includes the ability to treat an allergic reaction to antibiotics or local anesthesia, manage anxiety, and provide sedation if needed.

Some patients remain fully awake and comfortable throughout the procedure. Others may prefer a small amount of medication to help them relax. If a patient needs a deeper level of sedation and prefers to be unaware of the procedure, the anesthesiologist is present to provide safe, appropriate care and help ensure the best possible patient experience.

Procedure at a Glance

Feature	What it means for the patient
Anesthesia approach	Local anesthesia is used to numb the breast area so the patient can remain awake.
Anesthesiologist present	An anesthesiologist administers IV antibiotics, monitors the patient, and is available to manage any medical or comfort-related needs.
Sedation backup	Relaxation medication or deeper sedation can be provided if anxiety or discomfort occurs.
Surgical technique	Motiva Preservé® is used as a tissue-respecting breast augmentation technique.
Best suited for	Appropriate candidates who want breast augmentation but have either fear of general anesthesia or IV sedation, or just want to remain mentally clear and focused. It is also great for those who want to remain conversant, but just want a little “touch of something” to reduce anxiety.

What Is Motiva Preservé®?

Motiva Preservé® is a modern breast augmentation approach designed to enhance the breasts while respecting and preserving the patient's natural anatomy as much as possible. The Preservé® philosophy focuses on thoughtful planning, precise implant selection, and a technique that minimizes unnecessary disruption to the breast tissues.

For appropriate candidates, the goal is to create a soft, natural-looking enhancement while preserving the natural breast tissue, support structures, nipple sensation, and chest muscles whenever possible.

Advantages of Wide Awake Motiva Preservé® Breast Augmentation

Avoidance of planned general anesthesia

This procedure is especially valuable for patients who have delayed breast augmentation because of fear of general anesthesia, intubation, or being completely unconscious. Local anesthesia is used to numb the breast area, allowing the procedure to be performed while the patient remains awake.

An anesthesiologist is present for safety

Wide Awake Motiva Preservé® Breast Augmentation is not a shortcut around medical safety. An anesthesiologist is present throughout the procedure to monitor the patient, administer IV antibiotics, and respond immediately if any medical issue occurs.

Sedation is available if needed

The patient does not have to "tough it out." If anxiety develops during the procedure, medication can be given to help the patient relax. If a deeper level of sedation becomes necessary, the anesthesiologist is already present and able to manage that safely.

A reassuring experience for anxious patients

Patients who fear anesthesia often feel more comfortable knowing they can remain awake, breathe on their own, and communicate with the surgical team. This can make breast augmentation feel more approachable for patients who otherwise may have avoided surgery.

Recovery from Wide Awake Breast Augmentation

All though the overall recovery from surgery itself is the same irregardless of the type of anesthesia used, those who choose “Wide - Awake” are immediately fully conscious and aware, have no effects from intravenous sedatives and leave our facility sooner and go about their day quicker. Furthermore, if you feel up to it and can do so safely, you may operate a motor vehicle the same day as your surgery. With intravenous sedation and general anesthesia, we instruct you to wait until the next morning to drive.

A tissue-respecting breast augmentation technique

Motiva Preservé® is designed to enhance the breast while respecting the patient's natural anatomy. The goal is to preserve natural breast tissue, support structures, nipple sensation, and chest muscles whenever possible.

Natural-looking breast enhancement

The Preservé® technique is well suited for patients seeking a refined, natural-looking result rather than an overly augmented appearance. Careful implant selection and precise surgical planning help create an enhancement that complements the patient's body.

Less tissue disruption for appropriate candidates

Because Motiva Preservé® is designed as a tissue-respecting approach, it may help reduce unnecessary tissue trauma in appropriate candidates. Each treatment plan is customized to the patient's anatomy, goals, and safety needs.

The ability to communicate during surgery

Because the procedure is performed with local anesthesia, many patients appreciate being able to communicate with the surgical team during the procedure. This can provide reassurance and allow the care team to respond quickly to the patient's comfort level.

Who May Be a Good Candidate?

Wide Awake Motiva Preservé® Breast Augmentation may be appropriate for patients who:

Have a fear of general anesthesia or IV sedation.
Want breast augmentation with a tissue-respecting approach.
Prefer to remain awake if it can be done safely and comfortably.
Want a natural-looking breast enhancement.
Are medically appropriate candidates for breast augmentation.
Understand that sedation is immediately available if needed.

This procedure is not right for every patient. Some patients may be better suited for traditional anesthesia, especially those having complex revision surgery, those requiring a more extensive procedure, or those who prefer to be fully asleep. A consultation is necessary to determine the safest and most appropriate approach.

What to Expect During Surgery

Before surgery, your anatomy, goals, implant options, medical history, and anesthesia preferences will be reviewed carefully. On the day of surgery, an anesthesiologist will be present to administer intravenous antibiotics and monitor you throughout the procedure.

The breast area is then carefully numbed with local anesthesia. Once you are comfortable, the Motiva Preservé® technique is used to create the implant space with a focus on preserving the natural breast tissues. The implants are then placed according to the surgical plan designed for your body and your goals.

You may remain fully awake, or you may receive medication to help you relax. The level of anesthesia support can be adjusted to your comfort and safety needs.

Important Safety Information

All breast implant surgery carries risks, including bleeding, infection, changes in nipple or breast sensation, capsular contracture, implant rupture or deflation, asymmetry, scarring, pain, the need for future surgery, and anesthesia-related risks. Breast implants are not lifetime devices, and patients should understand the risks, benefits, and long-term considerations before surgery.

Your consultation will include a complete discussion of your goals, implant options, anesthesia options, risks, alternatives, and whether Wide Awake Motiva Preservé® Breast Augmentation is right for you.

A Modern Option for Patients Who Fear Anesthesia

Wide Awake Motiva Preservé® Breast Augmentation offers a thoughtful option for patients who want breast enhancement but feel anxious about general anesthesia or IV sedation. By combining local anesthesia, the Motiva Preservé® tissue-respecting technique, and the presence of an anesthesiologist throughout the procedure, this approach is designed to provide a comfortable, safety-focused, and reassuring breast augmentation experience.

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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. Dr. Epstein owns stock in Establishment Labs.

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