Preservé technique: what it is, benefits and candidates

The Preservé technique is a minimally invasive breast augmentation based on preserving the breast tissues. Instead of cutting with an electrocautery to make room for the implant, the surgeon stretches the tissues with a balloon and places the implant in that space, without cutting the ligaments of the breast.

The procedure starts with an incision of about 2 centimeters, usually in the inframammary fold. A dissector is passed through it and, once it reaches the planned point, a balloon is inflated to open up the space. The implant is then placed. Dr. Torres explains it like this:

"We stretch the tissues instead of making cuts with an electrocautery, and that shortens recovery."

In a conventional breast augmentation the pocket is created by cutting, and the implant can go above or below the pectoral muscle. Preservé does not replace that technique. It is one more option which, in the doctor's words, "works very well in certain cases".

The main benefit of the Preservé technique is the recovery: there is little pain and patients can go back to work and their routine the day after surgery. On top of that, the scar is about 2 centimeters long, in the inframammary fold or the armpit, and there is less trauma to the tissues.

According to Dr. Torres, that is why more and more patients ask for it, especially young women with very active lives. Many of them play sports and want harmonious breasts, a delicate size for their body, without spending weeks off work.

The other benefit shows over the years. Because the ligaments are not cut, the implant stays "nested" in the patient's own tissues, and the doctor links this to a result that holds up in the long term.

The ideal candidate for the Preservé technique is a young woman with a moderate breast volume that covers the implant well, with no sagging or drooping of the breast, who wants a small incision and a fast recovery. That is how Dr. Emiliano Torres describes her.

What matters most is coverage, that is, the amount of gland and tissue over the implant. A very small breast may not have enough tissue to cover it. What the patient is looking for also counts:

Preservé suits someone who wants a relatively small implant, in proportion to her build.

That is why, at the first consultation, the surgeon measures the breast and assesses tissue thickness and sagging before recommending the technique.

The Preservé technique is not indicated if the patient wants very large breasts, if she does not have enough coverage, if she has grade 2 or 3 breast sagging, if she has already had breast surgery with another technique or if she has capsular contracture.

Volume is the first limit. With a large implant, Dr. Torres explains, "however hard we try, we will never be able to preserve the tissues". Coverage is the second: if the gland is not enough to cover the implant, it has to be placed behind the pectoral muscle (retropectoral plane), and that is a different technique.

With marked ptosis, Preservé could be combined with a breast lift (mastopexy), although the doctor prefers to start from a breast that is in its natural position. In a patient who has already had surgery or has capsular contracture, the tissues cannot be preserved. In all these cases the surgeon will suggest another approach to breast augmentation.

The Preservé surgery Dr. Emiliano Torres performed at Instituto de Benito took 30 minutes. Forty minutes later the patient was already sitting up and moving her arms normally. She went home the same day and was back at work the next morning.

She was a 29-year-old patient with no children, good coverage and good breast tissue. She received 285 cc implants with a moderate profile, because she is slim and a high profile did not suit her. The 2-centimeter incision was made on the outer side so as not to affect nipple sensation.

At the 6-day check-up she could raise her arms without difficulty and the scar was barely visible. In the video the doctor explains that the implants will gradually settle lower.