Minimally invasive or conventional breast augmentation: mia Femtech®, Preservé® and the classic technique compared

In conventional augmentation the implant pocket is created by dissection, under general anaesthesia with one overnight stay, and it allows any volume, shape, incision site and plane. With mia Femtech® and Preservé® the pocket is created by expansion, above the muscle, under local anaesthesia with sedation, and the patient goes home the same day. In exchange, the volume and the corrections possible are more limited.

None is better in the abstract, and volume alone does not decide: below 200 cc all three are options. In practice, most patients seeking less than 200 cc end up choosing mia, and many who come for mia but prefer a little more volume (just over 200 cc) move to Preservé; that is the usual pattern, not a rule. With a discreet volume and an anatomy that needs no correction, mia and Preservé give a very similar result and we usually lean slightly towards mia for its armpit scar; Preservé is preferable if a high fold, a mild asymmetry or a mild tuberous breast needs adapting, and it is the minimally invasive option up to about 320 cc. Conventional augmentation fits any volume when the implant has to go under the muscle, there is sagging or a marked asymmetry to correct, you want to choose among all shapes and profiles, or budget matters; above about 320 cc it is the only option.

mia Femtech® uses implants from about 100 cc up to 195 cc, although 165–195 cc is the usual range. Preservé® reaches about 320 cc as its current practical limit and is also used below 200 cc; in our cases the usual range is 250–285 cc. Conventional augmentation has no such ceiling: our published cases range from 185 to 560 cc, with a median of 350 cc.

Yes, with mia Femtech® and Preservé®: local anaesthesia with intravenous sedation, no intubation, monitored by an anaesthetist, in an operating theatre at HLA Moncloa University Hospital. For conventional augmentation we use general anaesthesia. Exceptionally, any sedation may need to be converted to general anaesthesia.

In our experience mia and Preservé hurt clearly less than conventional augmentation, especially compared with the submuscular approach: the pectoral muscle is not touched, there is less dissection and local anaesthetic is infiltrated. They are not “painless” procedures, but returning to office work in 24–72 hours is common, compared with 4–7 days after conventional augmentation.

Very rarely. In more than 220 patients operated on at our clinic with mia Femtech® or Preservé®, clinically relevant loss of sensation has been virtually non-existent, and the multicentre series of 159 patients published in Aesthetic Surgery Journal in August 2026 recorded no sensory disturbance at 3 months. The prepectoral plane without cutting the muscle, minimal dissection by expansion and small incisions all contribute. After conventional augmentation, skin changes in the lower part of the breast are not rare, although persistent change in the nipple and areola stays below 5 % in our experience.

Conventional: about 3 cm, almost always in the inframammary fold. Preservé®: about 2.5 cm, also in the fold. mia Femtech®: about 2.3 cm in the armpit crease, with no scar on the breast.

If the nipple sits at the level of the fold or above, yes. If there is already sagging, they can serve for a few years, but you will probably need a breast lift later. For mild sagging in breasts that are not heavy we consider Preservé® mastopexy; for marked sagging we recommend a breast lift, usually with the implant under the muscle.

Preservé® allows fine-tuning of volumes and working on the fold and the gland through the same incision, so it works for mild or moderate asymmetries and mild tuberous breasts. mia only for very mild asymmetries, because it cannot lower the fold. Marked asymmetries and moderate or severe tuberous breasts are treated with the conventional technique.

Because the implants and the single-use material of these systems (expansion balloon and introducer) have a cost set by the manufacturer, and because they include an anaesthetist and a hospital operating theatre just like the conventional technique. In exchange, there is no overnight stay. Guide prices for 2026: conventional from €6,400, Preservé® from €7,900 and mia® €8,995. These are guide prices: the final quote is given in writing after the assessment and does not include costs arising from complications or unforeseen treatment. Surgical insurance is optional in all three (about €120).

As a guide from our protocol: after conventional augmentation, gentle static cycling at about one month, running at about two months and sports involving the arms or impact at about three; with mia and Preservé, static cycling at three weeks and running or upper-body training at six weeks. Always after checking at a follow-up visit that healing and the implant position are progressing well, and with a supportive sports bra.

They are implant surgeries, with the risks of any breast augmentation. In our series of more than 220 patients operated on with mia or Preservé the postoperative course has been very favourable, with no relevant differences between the two. We do not indicate them in irradiated breasts or when tissue coverage is insufficient.

All three can give a natural result if the volume, profile and plane are well chosen. mia and Preservé favour it through their contained volume range and by placing the implant above the muscle, which avoids the distortion when the pectoral contracts. Conventional augmentation allows a natural result at any volume and also in slim patients who need muscle coverage.

Yes. At the first consultation we examine you, measure tissue coverage (pinch test) and anatomy, and do a 3D simulation. With that we propose a technique and, when two options are valid, we explain the difference so you can decide. The quote is given in writing and the first consultation (€100 at the clinic or €70 by video) is deducted if you go ahead with surgery.