PRESERVE®
Your breast. Your body. Your decision.
Medically reviewed by: Dr. med. Timo Spanholtz
Specialist in Plastic and Aesthetic Surgery | Medical Director
Your breast is a deeply personal part of your body and your identity. For many trans* women and non-binary people who want a more feminine breast shape, breast augmentation is a significant step on the way to their own body image – and often a central building block of transition or personal well-being.
At the same time, many people associate breast augmentation with images that can be off-putting: general anesthesia, days-long hospital stays, visible scars, weeks of restrictions. The Preservé® method by Motiva® fundamentally changes this image.
We at the Transgender Clinic of the Praxisklinik am Rosengarten offer you Preservé® breast augmentation in an environment that knows you, respects you, and accompanies you in every step – from the first question to the final aftercare.
What is the PRESERVE® method?
Preservé® is a surgical technique developed by Motiva® for breast augmentation with implants that relies on one principle: preserve as much as possible, intervene as little as necessary.
Instead of cutting through the breast tissue (as with classic methods), the tissue layers are gently moved apart using special single-use instruments, and a precise pocket for the implant is created – without cutting into the depth of the tissue, without muscle incisions, without destroying ligaments.
The three Preservé® instruments
- Channel Separator: Blunt preparation instrument that detaches the tissue layers from one another in a rotational and atraumatic manner. Access via an approx. 2.5 cm incision in the inframammary fold – at a spot that is not visible in everyday life.
- Inflatable Balloon: Inflatable balloon catheter that expands in a controlled manner within the tissue, thus forming the exact implant pocket. The Cooper ligaments of the breast are stretched in the process and form a stable, natural bed for the implant.
- Insertion Sleeve: Sterile insertion sleeve through which the implant is introduced into the prepared pocket without contact (no-touch technique). Minimized risk of infection.
Note on hormone therapy
If you are undergoing hormone therapy: We are happy to coordinate the timing of the operation with your supervising endocrinology practice or your family doctor. Estrogen preparations can affect the risk of thrombosis – together we clarify what is safest in your situation.
Your well-being and your safety have priority.
Who is suitable for PRESERVE®? – Honest assessment
We believe in being honest with you – even if that sometimes means critically questioning a procedure. Preservé® is an excellent method, but not equally well suited for every person and every wish.
Preservé® is well suited if you ...
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are seeking a primary breast augmentation (for the first time)
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want a natural, harmonious result (not a very large volume)
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prefer an outpatient procedure with minimal anesthesia
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want to return to everyday life quickly
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have an ongoing hormone therapy that is well adjusted
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have a stable body weight
Preservé® may be less suitable if ...
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a simultaneous breast lift is necessary (in which case a separate procedure is recommended)
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a very large volume is desired that overwhelms the existing tissue
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florid systemic diseases or uncontrolled bleeding tendency are present
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the hormone therapy is not yet stably adjusted
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the implant is to be placed under the chest muscle
Why PRESERVE® is particularly suitable for trans* women
The breast anatomy and the initial situation in trans* women differs in some respects from that of cis-female patients – and this is precisely where the Preservé® method plays to its strengths.
1. Less existing natural tissue – more precise implant positioning needed
Many trans* women have, even after years of hormone therapy, less of their own breast tissue than cis-women of comparable body shape. The Preservé® method creates, through balloon expansion, a particularly precise implant pocket that optimally uses the existing tissue and holds the implant stably – an important factor for a natural long-term result.
2. Faster return to everyday life and to hormone therapy
A minimally invasive approach means less surgical trauma. This not only shortens recovery but also reduces possible interference with an ongoing hormone therapy. Of course, we coordinate the procedure in consultation with your hormone treatment.
3. Sensitivity preservation
Changes in nipple and breast sensation are often particularly significant in trans* women. The Preservé® technique avoids cutting through nerve pathways, which are frequently damaged with classic methods. This improves the chance of fully preserving sensation.
4. Natural breast shape without the risks of general anesthesia
In view of individual health profiles (ongoing hormone therapy, possible pre-medication), the option of performing the procedure under local anesthesia and/or twilight sedation is a relevant safety advantage.
5. Tiniest scar – barely visible even on a slim body
Since the scar (approx. 2.5 cm) lies in the natural breast fold, it is not visible in everyday life even with slim natural tissue.
The implant: Motiva SmoothSilk® Ergonomix2®
For Preservé®, exclusively Motiva SmoothSilk® Ergonomix2® implants are used – among the safest and most biocompatible breast implants worldwide.
- Ergonomix® shaping: The implant behaves like natural breast tissue – when standing it fills out, when lying down it flattens. The result looks natural at all times.
- SmoothSilk® surface: Patented nanotopography: extremely low capsular fibrosis rate, no BIA-ALCL risk (in contrast to textured implants), FDA and CE certified.
- ProgressiveGel® ULTIMA: Highly cohesive silicone gel – soft, dimensionally stable, no leaking.
- BluSeal+® barrier layer: Prevents silicone migration.
- Q Inside Safety Technology® RFID: Chip in the implant – verifiable without contact. Full transparency about the implant that is in your body.
- Always Confident Warranty®: Lifetime rupture guarantee, 5 years Preservé program.
Your well-being begins at the first contact
We know that going to a medical practice or clinic is not always a matter of course for trans* people. Too many have had bad experiences with medical staff – wrong pronouns, insensitive questions, the feeling of having to explain or justify themselves.
With us, it's different. We have trained our team to ensure:
- We ask for your pronouns and use them consistently in all contexts
- We respect your name – legally changed or not
- We ask only what is medically relevant – never more
- We explain every step understandably and without technical jargon
- You always have the right to ask questions, postpone decisions, or decline – without pressure to explain
- Your data is treated strictly confidentially
This is how your Preservé® breast augmentation proceeds
Consultation
(60–90 minutes)
A detailed conversation with one of our specialists. We discuss your wishes, examine the breast anatomy, explain realistic results (if applicable with 3D simulation), present the implant, and answer all questions. You receive a written, transparent cost estimate.
Preliminary examination and information
Standardized preliminary examination (lab, ECG if applicable), discussion of the hormone therapy situation, detailed written information in accordance with medical professional law. You get sufficient time and time to reflect – no procedure without complete informed consent.
The procedure
(approx. 30-60 minutes)
Outpatient, under local anesthesia and/or twilight sedation. You are awake throughout the entire procedure and can communicate. Immediately after the procedure, you rest briefly in the recovery area. With an accompanying person, you return home the same day. No inpatient stay.
Aftercare
Check-ups after 3–5 days, 3 weeks, and 3 months – all appointments are included in the price. Bookable across locations (Cologne, Bergisch Gladbach, Hamburg). You have a direct line to your doctor if questions arise.
Costs and financing
The costs of a Preservé® breast augmentation at the Praxisklinik am Rosengarten are made up of the surgical fee, anesthesia costs, implant costs, and aftercare flat rate. As a guideline: The investment in the Preservé® procedure is higher than with a standard technique and is in the range of 11,000 euros – upon request, you will receive a detailed, transparent cost estimate immediately after the consultation.
We offer financing solutions through specialized partners (e.g., Medipay) and inform you during the conversation about options for monthly installment payments.
Note on cost coverage for gender-affirming measures
Note on cost coverage for gender-affirming measures
In certain cases, breast augmentations as part of gender reassignment can be covered as a benefit in kind by the statutory health insurance or by allowance schemes. Prerequisites include, among other things, an existing expert opinion and an approval according to SGB V § 27. We are happy to advise you on this – we cannot give a guarantee of cost coverage, but we will help you find the right path. Talk to us.
Safety and risks – open and honest
Every surgical procedure carries risks – and we inform you completely and understandably about them before you decide. The Preservé® method reduces known complications of classic methods through its atraumatic approach, but does not completely exclude them.
Frequently asked questions about PRESERVE® Breast Augmentation
We are happy to answer your questions about the treatment here.
Possibly, if your health insurance has approved the breast augmentation as a gender-affirming measure or if you are privately insured. We advise you on the formal procedures and help with documentation. We cannot provide a guarantee.
Absolutely. The result can be individually designed – we work with the volume and shape that suit your body image. Subtle changes are just as possible as more pronounced ones. No specifications, no standard.
Of course, and it is expressly recommended – both during the consultation and on the day of the surgery. Your companion can stay in the immediate vicinity during the procedure.
Yes, generally. We coordinate the timing in consultation with your hormone treatment. With a stable regimen, no waiting is necessary. We pause some estrogen preparations shortly before the procedure – we will discuss this individually.
Yes. Implant replacements are possible at any time. The Preservé® pocket design facilitates later corrections compared to the conventionally prepared pocket.
We register the name you tell us and use it in all internal documents. For invoices and prescriptions, we are legally bound to your official name – but we will inform you about this and handle it discreetly.
You have direct access to your treating doctor. We will give you a direct number for emergencies. Your well-being after the procedure is just as important as the procedure itself.
The incision (approx. 2.5 cm) is located in the inframammary fold – not visible in everyday life or in a bra or bikini. With consistent scar care, it usually heals to be barely visible.
Due to the sophisticated surgical technique and the high-tech implants, the costs are higher than those of a "regular" breast augmentation. Depending on the initial findings, costs of between 10,000 and 11,500 euros must be expected.
1–2 days of light rest are sufficient in most cases. Most patients are able to work again after 2–3 days (office work). Sports only from week 6 onwards.
Schedule an appointment
Get non-binding advice now on Preservé® breast augmentation. We clarify all open questions and talk about your desired change.
The good news: our team explains to you what the advantages really are! Alternatively, we also offer you other surgical techniques. So there's "something for everyone."
Without any pressure, completely non-binding, and above all at eye level and without prejudice!