Motiva Breast Implants: Bigger Buzz, Better Boobs, or Bad Bet?

Dr. G (00:00):
I mean, the reason this isn't in the exam room is because nobody wants to see this. So then I just say, then I create a channel and I don't demonstrate this.

 

Bri (00:09):
Yeah, absolutely.

 

Dr. G (00:10):
Nobody wants to look at that.

 

Bri (00:11):
No, nobody wants to see it.

 

Dr. G (00:12):
But maybe I should, so they're like, actually, general anesthesia would be great. Okay. You're listening to another episode of All the B's with me, Dr. G and my scrub tech, Bri. So every month we get more and more patients that are asking about Motiva implants, right?

 

Bri (00:33):
Yeah.

 

Dr. G (00:33):
Okay. Even the ones that already have implants, they want to know if they can switch to Motiva. Patients who are brand new seeking implants, seeking an augmentation or coming in specifically asking for Motiva implants. They're the hot topic right now, but we're going to talk about what's new about the Motiva implant, the tech behind the implant. We'll talk a little bit about Preserve and then whether or not you should trade your implants out for Motiva or not.

 

Bri (01:02):
I might also do that.

 

Dr. G (01:05):
First, some celebrity news.

 

Bri (01:08):
Yeah. Miley Cyrus, you're just dropping Cyrus.

 

Dr. G (01:12):
I mean, I feel like that's a blow to her parents/dad, right?

 

Bri (01:16):
I feel like all their kids rebel.

 

Dr. G (01:19):
I mean, she's been rebelling from the beginning. Well, ever since her Hannah Montana days.

 

Bri (01:23):
Yeah. I feel like who else dropped their last name? Was it like Beyonce's kid or Kanye's kid or something?

 

Dr. G (01:29):
North West. She's just North? No.

 

Bri (01:32):
No, somebody dropped their last name. All these kids are just dropping their last names.

 

Dr. G (01:35):
Well, Elon Musk's kids tend to drop their last names as soon as they hit a certain age. She looks great though, I will say.

 

Bri (01:42):
Her skin looks so good.

 

Dr. G (01:44):
Of course she does because she's pretty young, but whatever she's doing is working for her.

 

Bri (01:50):
Yeah. She's giving the Lindsay Lohan glow up.

 

Dr. G (01:53):
Except she never had the rough patch Lindsay Lohan had.

 

Bri (01:57):
She did have a rough patch. It just wasn't this rough, as rough as Lindsay. Yeah. But no, she looks great. Now it's just Miley, which I mean, I've never. Yeah. Do it.

 

Dr. G (02:11):
I know. I would say if I didn't know better, I would think she's had a lip lift, but that's always been her look. She always has that upper tooth show and she's looked like that since she was a kid. And she knows how to play off of her features, I guess is the word I'm looking for.

 

Bri (02:29):
Yeah. Her skin looks very tight, tight and smooth.

 

Dr. G (02:33):
And then it helps that she has talent, in my opinion. She's a good singer. Whether or not you like her style or whatever, she still can sing. Speaking of talent, Alix Earle.

 

Bri (02:46):
I binge watched this entire season on Monday.

 

Dr. G (02:50):
I watched half of an episode last night and then we had to take a break to study math and then I wasn't feeling it to go back in, but we'll watch it later.

 

Bri (03:01):
It's great background noise. I feel like I scrolled through my phone most of the time I watched this season and then I looked up every time she cried. So I guess I did watch the show a lot.

 

Dr. G (03:10):
Which is a lot. Just the opening, she's crying all the time. What?

 

Bri (03:14):
Yeah. I love her vulnerability and this whole season was about her breakup and she did -

 

Dr. G (03:20):
Oh yeah. Who'd Braxton play for because I couldn't answer that question. Do you know?

 

Bri (03:24):
I know she dated Tom Brady.

 

Dr. G (03:26):
For like two seconds, but she was in a long term relationship with Braxton. He's a football player. That's all I got.

 

Bri (03:34):
Like Travis Kelce?

 

Dr. G (03:36):
Kelce.

 

Bri (03:37):
Kelce, Taylor Swift's husband.

 

Dr. G (03:39):
I'm going to look it up while you tell. I only watched the first half of the first episode.

 

Bri (03:45):
I feel like they're really getting into giving influencer shows.

 

Dr. G (03:48):
I know.

 

Bri (03:49):
And there's really no substance to it. It's just what they do in their life. And I actually really like her family and I liked the show.

 

Dr. G (04:00):
He's a baseball player. No.

 

Bri (04:01):
Baseball.

 

Dr. G (04:02):
Wait, social media star. No, NFL player. Okay. I was right. She also dated a professional baseball player.

 

Bri (04:09):
She likes athletes. That was said many times in the show.

 

Dr. G (04:13):
Why?

 

Bri (04:14):
It was great. I wish they honed in on the drama with Alex Cooper a little bit more. Maybe they did, but I don't remember seeing it. But yeah, she looks great. She has a great, pretty well-rounded family.

 

Dr. G (04:27):
She does?

 

Bri (04:28):
Yeah. I think the big drama was her dad cheated on her mom with an escort who he was married to for 17 years. It's really just about -

 

Dr. G (04:37):
He was married to the escort or the mom?

 

Bri (04:39):
The mom and then got married to the escort.

 

Dr. G (04:42):
Oh, really?

 

Bri (04:42):
Yeah. It was a big thing that nobody knew about until the show came out.

 

Dr. G (04:45):
What?

 

Bri (04:46):
And then she's like, "You aired out my dirty laundry on the show."

 

Dr. G (04:49):
The escort or the mom?

 

Bri (04:50):
So the escort is now his wife.

 

Dr. G (04:53):
Right. But who's mad about the dirty laundry?

 

Bri (04:55):
The escort chick. Yeah. Yeah. The now wife who's like, "Some of this didn't need to be shared." Honestly, the dad was the best part of the show. He's the dadager, that's what they call him. But he was very well grounded for being a girl dad managing his kids. Yeah. It was really just about maintaining how to be on social media and letting things affect you. Some of the juicy stuff, they cut out of the show, they'll do things and then they're all upset they're on camera and then the mom's like, "I'm leaving the show," but then they won't say things on camera, but that's the whole point of the show. Yeah. I feel like - Don't cut that stuff out. That's what we want to see. And if you know you're going to do that, you have to put it on.

 

Dr. G (05:38):
I mean, what a deal though to be an escort and then get married. That never happens.

 

Bri (05:42):
Yeah. He's a giant road construction guy.

 

Dr. G (05:45):
Right. That's crazy. That's crazy work.

 

Bri (05:50):
Yeah. But it was good. I love Alix Earle. So would you consider Alloclae in your butt a BBL though? I just don't feel like it's a BBL. I just feel like it's-

 

Dr. G (05:59):
It's a non-surgical BBL. What do you count that as?

 

Bri (06:03):
I don't know.

 

Dr. G (06:05):
I mean, there's nothing else to talk about it. I mean, to describe it as. And Sculptra and Radiesse both already had it and that's how we advertised for it is a non-surgical BBL was the sculptra.

 

Bri (06:17):
All right, I revoke that statement. But it does look really good.

 

Dr. G (06:21):
Yeah. Her butt looks good. And she essentially has this Instagram post, which is a little stylized for my. But I mean, I guess this is what you need to do. I don't know. Anyway, in one of the pictures in the carousel, she's like, "I paid for it," and is pointing to her ass.

 

Bri (06:44):
No, it looks so good.

 

Dr. G (06:46):
It does look good.

 

Bri (06:46):
It looks really, really good.

 

Dr. G (06:48):
And she's so skinny, there's nowhere you were going to get fat. Oh, no. It's 100%. At least she's admitting to it. But she's admitted to her. Is she the one that has the saline implants? I feel like she does.

 

Bri (07:00):
Does she?

 

Dr. G (07:01):
It's either her. I get the Alix's mixed up, unfortunately. And I know that's. Yeah, It says, "Kiss my ass. I paid for it."

 

Bri (07:09):
I love that.

 

Dr. G (07:11):
So Yeah. It looks good. It's not out of proportion. It just looks good. So good for her.

 

Bri (07:17):
Yeah. All right. Go off, Alix.

 

Dr. G (07:20):
All right. Moving on. So yes, thank you, Alix Earle, for confirming that you had Alloclae put in your booty because we've been seeing a lot more of that in our space and we like it. It's pretty easy to do. It isn't painless. I think people think it's going to be painless, but Alloclae actually stings a little bit going in, so it's uncomfortable. And then there's a whole people are just nervous.

 

Bri (07:46):
Yeah. And I think people also think it's really. I mean, it's almost kind of advertised like a filler, non-surgical, but it's pretty invasive. You have to make a little tiny incision poke and put tumescent in and then put Alloclae in. It's a little bit more than filler, but I feel like if you come in with the mindset you're just about to get filler in your cheeks and then you're like, "Oh shit, this kind of sucks."

 

Dr. G (08:12):
I know. We try to warn them, honestly, in the OR or in the consult about, because I know some offices will just do it in an exam room, but again, we like things clean and laid out and nice and sterile. And so we do bring our patients into the OR for that.

 

Bri (08:30):
There's a lot more room to do it.

 

Dr. G (08:31):
Yeah. And the lighting's better, but for the patient, it's a little intimidating.

 

Bri (08:35):
I think laughing gas really just does the trick though. I think that's what we've established.

 

Dr. G (08:41):
Yeah. After yesterday, I think that was the key. Yeah, because sometimes I feel like the oral sedative just makes people unhinged.

 

Bri (08:50):
Yeah. I don't think it helps as much as laughing gas does. I think A, obviously it helps, but it gives them a distraction because they're sitting there sucking on the thing.

 

Dr. G (09:00):
Yeah.

 

Bri (09:01):
Yeah.

 

Dr. G (09:02):
Two thumbs up.

 

Bri (09:03):
Yeah. Two thumbs up for laughing gas.

 

Dr. G (09:04):
And you can drive home.

 

Bri (09:06):
Yeah.

 

Dr. G (09:06):
Okay. Jennifer Lawrence, baby Botox only. Duh. She keeps toxin light so she can act and also wants buccal fat removal because she knows everybody would know, but won't do it. I think Jennifer Lawrence is also another one of those actresses who's cool about keeping it real, which I appreciate. So she says she likes Botox, but not enough to freeze her face, which I feel like is most people. You're just trying to prevent wrinkles.

 

Bri (09:35):
Not me. Well. I want to be frozen. But as an actor, you have to have facial expressions.

 

Dr. G (09:43):
Yes, we get that. We've all seen Nicole Kidman in certain shows where you're like, she's just-

 

Bri (09:49):
Happy , mad?

 

Dr. G (09:50):
-moving her eyes.

 

Bri (09:53):
Yeah. See, no one wants to see my facial expressions.

 

Dr. G (09:57):
So her buccal fat removal. I mean, she has a fuller face and she could do buccal fat removal, but I feel like she'd start to look like Miley Cyrus or something after that. Yeah. It would change how she looks dramatically enough that I think it would -

 

Bri (10:12):
All these people that have done it have just done way too much. Jenny Ortega, I don't know if I said that right. Yeah. The girl from Wednesday, Miley Cyrus, all these people, they remove too much and it looks very. And I wanted that so bad and I'm so glad I didn't do it. I just needed a couple lasers.

 

Dr. G (10:30):
It looks gaunt.

 

Bri (10:31):
Yeah.

 

Dr. G (10:32):
It's an aesthetic and it does age you faster too if you don't have it.

 

Bri (10:37):
Yeah. I feel like there's other things. And you can't put that fat back in. No. Yes. Once it's gone, it's gone. And she looks so much more youthful with fat in her cheeks. If you hate the shape of your face, I don't know, do some masseter Botox and a little virtue, like a skin tight, I don't know, something.

 

Dr. G (10:55):
Yeah. I think masseter Botox back to Botox is probably the way to go before you take the fat out. Unless you're really, really round and she wasn't to start with Jennifer Ortega, right? Is that who it is? Yes. Yeah, so I think Jennifer Lawrence is probably good not doing it. That would be my two cents. And then this is another promotional, I'm going to talk about my implants and what I'm going to do about them, but actually not do anything about it. So Jesse James Decker explains decision to remove very large implants, but she's just still thinking about it.

 

Bri (11:34):
She's been saying this.

 

Dr. G (11:35):
Yes.

 

Bri (11:37):
For so long.

 

Dr. G (11:39):
She's claimed to have locked a date to ditch very large D cups for smaller implants that she doesn't want a full explant, but I guess so. She has some fitness app now and I think this is -

 

Bri (11:53):
She's so into fitness.

 

Dr. G (11:54):
Tied into that. And then it just gives her something to talk about to say, "Yeah, I'm thinking about getting my implants out or downsized." And that is a decision. Some people are like, "I'm ready to take them out," but have either really large implants and no breast tissue or are afraid of what they're going to look like without implants. And so the option is to downsize them. I think that's not unreasonable in the right patient. Probably with her, because she has such large implants, she's going to need a lift. That's something to factor in.

 

Bri (12:29):
Yeah.

 

Dr. G (12:30):
It's interesting to watch people who've already come to terms with what it is they're going to do, and then those that want something but without any of the sacrifice. So it's like wanting smaller breasts, but you don't want to lift or you want no implants, but you want it to look great like it did before. There's always a trade off. Yeah. So she's doing her fitness thing. She talks about how she's lost 50 pounds four times, and I didn't understand that until I realized she meant she's had kids four times. Duh. So good for her. Yeah, she's in great shape. She working out.

 

Bri (13:10):
I think her implants fit her body well.

 

Dr. G (13:12):
Don't look that big. I know, honestly. I don't know what she's ranting about.

 

Bri (13:15):
I'm inspired to go bigger all of a sudden. What's the biggest size Motiva has?

 

Dr. G (13:22):
Oh, I think it taps out at like 600. They don't have very large implants.

 

Bri (13:26):
I can do 600.

 

Dr. G (13:27):
They have limited sizes for sure. I wonder if your Jesse James Decker and your PR person puts that out, keeps throwing it out there, hoping that somebody like Motiva or Allergan comes to you and says, "We'll downsize your implants." You know what I mean?

 

Bri (13:47):
Yeah. Maybe it's like you want a free surgery.

 

Dr. G (13:49):
Throw it out there for some Spon Con.

 

Bri (13:54):
I will upsize if anyone wants to pay for mine.

 

Dr. G (14:00):
So let's talk about Motiva implants. They were FDA approved for the US at the end of 2024, so they've been around for almost two years now. Obviously they did a FDA approval study, so they put them in for five-ish years prior to that and then had to do post-market surveillance. So you had to have all that data before they could get approved in 2024. And I do feel like their market approval was delayed just because of all the nonsense that the FDA is up to these days and not extremely efficient. So you have implants. If your implants are fine and working, you do not need to switch to Motiva. There's no reason for extra surgery. I would never suggest that if your implants are not ruptured, don't have capsular contracture, you're not looking to change your size, you don't need a lift, you don't need any tweaking, don't mess with them.

 

(14:59):
Because every time you have surgery, you run the risk of having a new problem. And so it would be horrible to risk exchanging your implants for no reason and then have an issue. So that's for sure. And I think we all know that there's four implant companies out on the market. You have Allergan has the Natrelle implants. That's what you have, correct? Okay. That's what we use primarily in this office. I use them in my course of my career. When I first started at Navy, we had Allergan implants and then we switched to a Mentor consignment. So Mentor implants, which is actually what I have in place.

 

Bri (15:38):
Oh, really?

 

Dr. G (15:39):
Yeah.

 

Bri (15:39):
I didn't know that.

 

Dr. G (15:41):
I really liked Mentor implants for a while, and then we switched -

 

Bri (15:47):
How about the sizing?

 

Dr. G (15:48):
It's about the same as Allergan.

 

Bri (15:50):
But the numbers on the sizing. The numbers on the sizing are

 

Dr. G (15:54):
Oh, the catalog.

 

Bri (15:55):
Yeah.

 

Dr. G (15:56):
I don't love the catalog numbers. So yeah, so the catalog numbers for Mentor are. For the silicone implants, it's always 350 dash, then the actual volume of the implant, and then a couple other numbers letters that tell you what the profile is. So if you have, let's say, a 300 CC high profile implant, it's 350-3251BC or something like that. So patients just see the 350 and they think they have 350 CC implants, but it's the next three numbers that is what's in there. So sometimes they'll have the card and they'll be like, "Yeah, I have 350 CC implants." I always look at the card and that's one of the reasons why, because I'm like, "No, actually you have 425s or you have 250s or whatever it is because those. I don't know why all their catalogs start with 350." So Mentor was good. When you work in a big hospital system, you're sort of at the mercy of the hospital system and the quirks of that system.

 

(16:56):
And we had issues with our consignment that was a little bit related to a combination of the hospital system and Mentor and our rep at the time. And so we switched to Sientra because we knew that rep and he could get us up and running. Sientra is another implant manufacturer. It's been around not as long as Mentor and Allergan. It was bought out by Tiger Aesthetics. It was its own standalone and it was set to disrupt the market, sort of like what Motiva's doing, but it didn't really, to be honest. So they had two cohesivities of implants, so two types of firmness of their implants. They had textured and smooth as all the other companies did, and their implants were about the same cost, maybe more, and they had equivalent sizes and their one catch was that they only sold to board certified plastic surgeons.

 

(17:50):
So that made them stand out a little bit. So you couldn't get Sientra implants unless you were a board certified plastic surgeon, which it's always touted that the number one breast augmentation person in Texas is some OBGYN, which is just crazy, right? And he's probably either using Mentor or Allergan implants. So that being said, we switched to a Sientra consignment, although that's their pro, they manufactured their implants in Brazil and the whole plant caught fire or something, and so they almost went bankrupt.

 

Bri (18:23):
Oh damn.

 

Dr. G (18:23):
Then the Navy hospital that I was working at pulled their consignment because of that whole thing. We were just about to get up and running with them. So then we switched to Allergan, which I had worked with at Kaiser. So you get used to all the different implants. So I had been using all three for a while and then Motiva came out on the market and this is the first time I've ever actually had people come in asking for a specific implant. Natrelle had it for a moment where people were asking for the gummy bear implant, but it wasn't branded Natrelle and you could argue that any of the implants are gummy bear because they're all cohesive silicone. So this is the first time that somebody's done whatever they needed to do to disrupt the market to have people coming in asking for this specific implant. And I can't put my finger on it, what they've done specifically, but whatever their marketing is, it's working.

 

Bri (19:13):
Marketing team should get a raise.

 

Dr. G (19:15):
Yeah.

 

Bri (19:15):
But I feel like also they came out and they said. Didn't they say the risk of CapCon was so low or something, which I know they say on every implant, but maybe things just swirl around TikTok. I don't know.

 

Dr. G (19:27):
Yeah. So their risk of capsular contracture is less than 1%. That's in their five-year data. And so that risk is 10 times lower than that of the other implants. The other implant studies were done 20 years ago though, so that's the issue. So the risk is lower, but I bet if you repeated the same study with Allergan implants, I would hope that your risk is lower because of things we do differently now in the OR that we didn't do back when those implants were out. I can almost tell you, you can almost tell someone's age by where their tattoo is located. Have you ever seen that?

 

Bri (20:07):
No.

 

Dr. G (20:09):
I think there's a category of women who have tattoos.

 

Bri (20:13):
What's the tramp stamp age?

 

Dr. G (20:15):
Those are millennials, older millennials. Right?

 

Bri (20:19):
I don't have one. I just want to clarify, but yes. I'm a very young millennial.

 

Dr. G (20:24):
But you have ladies in their 50s and 60s, breast, ankle.

 

Bri (20:30):
Yes.

 

Dr. G (20:30):
Right?

 

Bri (20:31):
My mom has. Well, she has ankle and then she has right here -

 

Dr. G (20:36):
Oh, right. In the upper thigh, groin area.

 

Bri (20:39):
Yeah. I was going to say vagina, but that's not technically correct.

 

Dr. G (20:44):
Yes. And then you move on to the tramp stamp.

 

Bri (20:47):
Yes. Giving more like midlife crisis tattoos.

 

Dr. G (20:51):
And now I think it's more the arm. You can tell Gen Z's got all the little arm tattoos.

 

Bri (20:58):
Covered in teeny tiny, dainty little random -

 

Dr. G (21:02):
Miley Cyrus is a classic little tiny tattoos.

 

Bri (21:06):
Finger tattoos. I'm about to get some finger ones.

 

Dr. G (21:10):
So that as you get younger, that's where they end up. So I can almost tell you, based on the year that they had their augmentation, what kind of implant it is, right? Because silicone didn't come back to market till 2006. So everybody in the late '90s to early 2000s, almost always saline, almost always periareolar incision. 2006, almost always dual plane silicone inframammary crease incision. You almost can see the shift. Now, are there outliers? Obviously, because some people don't change their practice, maybe didn't start doing silicone implants even after they came back to market, whatever. But definitely periareolar was the go-to between the '90s and early 2000s because it was easy to get a saline implant through that tiny incision. And that's mostly what we had to offer at that time, but that has a higher risk of CapCon.

 

(22:04):
So are you comparing those patients to the Motiva implants? So the Motiva has a nanotextured shell, and the argument is that that technology is what's decreasing the CapCon rate, but there is no head-to-head trial. This is 80 patients or something that they did in their post-market survey, and at five years they had a less than 1% CapCon rate. And when they did the post-market 10-year survey for Mentor and Allergan, you're looking at nine to 10%, but were you controlling for all these other things? So first of all, is the incision that you put the implant in. So are you going periareolar or not? Second, the Motiva implants in that original study, the one that they quote all the time, were dual plane or submuscular, and now everybody's putting them in subfascial. So are we going to see a change in CapCon rates because we've switched to subfascial?

 

(22:53):
I don't know. Are we going to see more bottoming out because we're using Motiva implants? I don't know. I don't know. I would love to believe that this implant has a lower CapCon rate and it's due to the shell of the implant, but you cannot say that definitively.

 

Bri (23:11):
Can you put in any size implant subfascial or just smaller ones?

 

Dr. G (23:15):
No, you can put any size in. You just probably should do mesh if you're going to use a certain size.

 

Bri (23:22):
A bigger size.

 

Dr. G (23:23):
Because you really don't have much support for that implant the larger the implant you have in. Right. I think that's one reason. It also quoted a very. On TikTok they're throwing around low cap con rate, but remember dual plane cap con rate and all the technology we have now, which is irrigating the pocket, phase one, which is hypochlorous acid, using shields over the nipples. And there's one more thing. Oh, just the technique we use using Keller Funnels, those didn't exist either. So a lot of that stuff wasn't done. Okay. So then the other thing I do like about Motiva implants is the way that they're made is this monoblock technology so that the inner silicone and the outer shell are tight fit, like made almost as one. It's one, right?

 

(24:17):
Whereas every other implant, it's the silicone shell and then it's filled with gel and then patched and sealed. And so over time, I feel like the shell starts to pull away from the inner cohesive gel and/or you get gel bleed, the shell starts to bleed a little bit. All of those things can happen with the age of the implant. Now you're usually talking like 20 years, but we just had somebody who swore she had Mentor anatomic implants because they looked anatomic. Our older lady that's like BMI of 15, she's really skinny. But when we took them out, we'll see if we can put the picture of the implant in the video. The implant is pulling away from the shell. It's trying to make a break for it, even though it was all contained. That's not ideal. So if you can get this monoblock where it's all one, then you would assume that there's less mechanical friction and less risk of rupture, which would be lovely.

 

(25:21):
Then gel bleed, I don't know anything about their technology that makes them more or less likely to have gel bleed, but that would also be great because some of the older implants, when they get sticky, you're just like, "What's happening?" Awful.

 

Bri (25:35):
Yeah.

 

Dr. G (25:35):
As the shell breaks down. Whatever that is, they need to fix that. I've seen it in every implant that we've taken out that's had gel bleed, every implant company, except for Motiva because they haven't been around long enough. Okay. And then the last thing I thought was interesting because as I was doing a little bit of research for this podcast, when you Google Motiva versus whatever implant on these blogs, they talk about the radio frequency ID technology, like the chip.

 

Bri (26:05):
Oh yeah. I remember when they first brought them into the office to just show them and they were chipped and I was like, "Whose husband created these? Let me just chip my wife's boobs."

 

Dr. G (26:14):
So you can't currently get those in the US, so I don't even know. I was like, Wait, what website is this?" No, they're in Seattle. Why are we talking about the chip technology? That's not available in the US. I don't know that it'll be available in the US because nobody wants that. It's weird.

 

Bri (26:30):
It is weird.

 

Dr. G (26:31):
But it's not so that we can track you. It's not like a little -

 

Bri (26:34):
Where's my wife? Find my wife's boobs.

 

Dr. G (26:38):
It's supposed to be. It's just a scannable thing so that we could scan and see what implant you had. Like you would be able to pull the serial number off of that. And the origin of that is that in China, when they were doing these, people were using fakes. And so they wanted to know that their surgeon was putting in the actual Motiva implants and then you could scan the implants afterwards and basically -

 

Bri (27:02):
Imagine getting Temu implants.

 

Dr. G (27:07):
Amazon dupes. You're like, "How pissed would you be?"

 

Bri (27:11):
I know. I'd be so mad.

 

Dr. G (27:14):
I mean, for everything that's out there, there's a scam, honestly. There's those people who buy luxury handbags from Nordstrom and then return dupes.

 

Bri (27:25):
That's crazy. Yeah. That's crazy.

 

Dr. G (27:27):
Somebody on the East Coast got busted for that and I was like, "What?"

 

Bri (27:30):
I wouldn't even think about that.

 

Dr. G (27:32):
Resell the real ones. And you're like, "What?"

 

Bri (27:35):
I really feel like I need to spend more time thinking about criminal activities because these people are so smart. I would have never thought to do that.

 

Dr. G (27:43):
Well, they're smart up until the point they get caught and then you're like, "Oh, Okay." Then they always get caught.

 

Bri (27:49):
Yeah. These people that launder money out of their work, I'm like, "I don't even know how I would do that. I don't." It is a little wild. Okay. So. You would know. Who spent 5,000 at Louis Vuitton?

 

Dr. G (28:09):
Office supply.

 

Bri (28:10):
Office supply. Got you something.

 

Dr. G (28:13):
Okay. So those are some of the main differences. So you have your nanotextured shell that's supposed to reduce CapCon rate. We have the monoblock kind of gel shell integrity. It has a blue shell in it so that you can tell if it's ruptured or not when you're putting it in. I mean, generally you can tell if you're rupturing an implant when you're putting it in. We know because we've ruptured sizers. You'll know. I'm not sure that's necessary, but that's okay. And then the little radio frequency tag thing, the QID microchip, which you can't get here. So the other thing that comes up when you're talking about Motiva implants is the ergonomics, is that's the type of implant they're talking about. And it's that their gel has a proprietary technology that's supposed to move with you, so it flows more like natural breast tissue when you move around.

 

(29:08):
I mean, I don't know, in a head-to-head, like an Inspira Allergan implant is also kind of moving around and Allergan makes three different cohesivities. So they make the Inspira, the soft touch, and then the cohesive, and they have different levels of cohesivity. But the ergonomix, I mean, its entire purpose is to move with you. And so people really like that. That being said, they offer the round, which is a more cohesive gel and is designed to stay just more gummy bear, which is also what sometimes people are asking for because then when you stand up, your gel doesn't go to the bottom of your breast and stays higher fuller. So more of an Alix Earle look.

 

Bri (29:51):
Yeah. Gives you a little more cleavage.

 

Dr. G (29:53):
Yeah. So those are the two options.

 

Bri (29:56):
But you can't do round with the Preserve technique, correct?

 

Dr. G (29:59):
Correct. Yes. So Preserve is its own technique. It uses their, again, proprietary kit to insert the implant and you're only supposed to use Motiva ergonomix implants because they're supposed to be soft enough to get through that little tunnel. I feel like you could probably squeeze an Inspira in there, but I think Allergan would be really annoyed if it ruptured or something. They'd probably be like, "What did you do? We're not covering that." So we use the Motiva ergonomix implant. There's a softer, there's an ergonomix two version that's out on the market, not in the US. And that's what they use with their minimally invasive augmentation that it's called MIA, but -

 

Bri (30:44):
That's actually what it's called?

 

Dr. G (30:46):
It's called the MIA. MIA. That's a chick. But anyway.

 

Bri (30:53):
I was like, I'm MIA.

 

Dr. G (30:54):
No, I think it's called MIA, honestly. Anyway, it's not available in the US, so it doesn't matter. And that implant's supposed to be softer, which would be nice to have that to get into the pocket. So the two things that limit you with a Preserve, which is a minimally invasive breast augmentation is has to be an ergonomics implant and it has to be under a certain size. And it's really designed for smaller implants.

 

Bri (31:19):
And does it have to be your primary aug or can you already have an augmentation and then do a Preserve for the next time?

 

Dr. G (31:27):
I don't think you can do it again. I don't think if you already have a breast augmentation, there really wouldn't be a point to be honest. Because I think one of the value of doing a Preserve is the recovery time. That's what you're gaining is a super fast recovery time because I'm not cutting anything. If I have to take an implant out and put your muscle down and then do the Preserve, you're recovering.

 

Bri (31:51):
Still have to cut things. You have to have that incision, right?

 

Dr. G (31:54):
Yeah. I have to make an incision. I have to take the implant out. I have to repair the muscle and I have to put all of that back together just to insert an implant subglandularly. I'm not sure why we would be doing tha.

 

Bri (32:04):
Yeah. It doesn't make any sense.

 

Dr. G (32:06):
I'm okay with changing planes, going from a dual plane to a subglandular or subfascial, that's totally fine, but I don't know that doing that work and then doing it minimally invasive after you already had to be invasive to get the other implant out and do whatever work you need to do makes any sense. Because a kit isn't free. The kit costs money. And so it makes a Preserve augmentation more expensive than just a standard augmentation. Still need the color funnel, still need anesthesia. In my opinion, we're not up to the point where we're offering it under local anesthesia. I think even if we did, I don't know that. I think I would have to have some guardrails.

 

Bri (32:49):
I don't love the thought of doing it under local at all. At all.

 

Dr. G (32:53):
I think in the right patient you could do it, but it would have to be somebody who wants a small implant.

 

Bri (32:59):
50 ccs.

 

Dr. G (33:03):
Less than 200 CC implant for sure. And the part that is hard to know is what's your pain tolerance? It's like awake lipo. Are they going to be fine or are they going to be babies about it.

 

Bri (33:16):
I give no one any credit.

 

Dr. G (33:18):
I feel like we give people less and less credit these days because they continue to disappoint.

 

Bri (33:22):
Yeah, they do. I don't know. I just don't see that. I don't see it being comfortable by any means.

 

Dr. G (33:31):
Even with like, because nothing of it is going to hurt.

 

Bri (33:35):
No? No, I don't. I give people no credit.

 

Dr. G (33:37):
Because if you think about it, I put a little numbing in, make a little poke hole. I do that all the time for Aveli, for Alloclae, no big deal. So just the numbing in. And then inject the tumescent, do it for Alloclae already. So no big deal. Let it sit for 10 minutes. Incision isn't going to hurt because it's numb.

 

Bri (33:59):
The giant stick being shoved through your boob. I need to have Cynthia, please hold, bring me the stick. I don't want it to tear anyone. I just have to.

 

Dr. G (34:11):
So yeah. So I would say the uncomfortable part would be putting that trocar, so the purple tube to create the tunnel, but that's not sharp. I feel like it's just going to be pressure.

 

Bri (34:24):
I just got to show you this stick.

 

Dr. G (34:26):
And then -

 

Bri (34:27):
Shoving this through.

 

Dr. G (34:29):
Then once you have that in place, then the rest is just inserting the balloon and inflating it. Also, just going to feel tight. If it's a small implant, I feel like you could do that. And then put the implant in and close. You're not going to feel any of that.

 

Bri (34:44):
Yeah. Okay. That's fair. I think it's the stick thing that I just can't get past.

 

Dr. G (34:52):
I think if you get super nervous and you're. We've had people who insisted on IV sedation and then suck down a lot of sedation, right? Because they're so uptight and anxious about it.

 

Bri (35:05):
Yeah.

 

Dr. G (35:07):
Yeah. The thing is you need the -

 

Bri (35:10):
A whole breast aug under local.

 

Dr. G (35:12):
The whole thing. You need to be able to convert to an anesthetic if they can't. That's the issue.

 

Bri (35:20):
Yes. Do you have the -

 

Dr. G (35:23):
I think we got rid of the stick.

 

Bri (35:25):
No, it's definitely with the big pokey one. Sorry. But this is it, if you guys wanted to know. This, I don't see a problem because you just pumped this up.This is pretty cool.

 

Dr. G (35:38):
Yeah. It's going to stretch. Some people do get a little uncomfortable with it, but generally speaking, no. So yeah, that goes in the space and then we pump it up, over pump it and leave it pumped.

 

Bri (35:49):
People just do so well how we are now under -

 

Dr. G (35:53):
Why mess with it?

 

Bri (35:54):
Why mess with it?

 

Dr. G (35:54):
It's true. It's like if you're still committing to a breast dog, granted yeah, you might save a couple bucks, but you're already going in with the intentions of having a breast dog and having surgery. Instead of saving a couple bucks, let's just be comfy. Let's make everyone in the room comfy.

 

(36:12):
Yeah, I don't disagree.

 

Bri (36:13):
Making this about me.

 

Dr. G (36:16):
Yeah. I feel like IV sedation is probably fair.

 

Bri (36:19):
Yeah. That is totally fine. I was even kind of weary about IV sedation until we started doing it and I was like, "Oh, easy peasy." And then they just stroll on out.

 

Dr. G (36:29):
And you have that backstop for people who panic at the last minute and are like, "Actually just put me to sleep."

 

Bri (36:34):
Yes. And that has happened too. They come in with IV sedation and then they don't realize how nervous they are the morning of and they're like, "Just put me out." And then you have an anesthesiologist present and you're good to go, but you don't have that option. Yeah.

 

Dr. G (36:50):
I mean, the only advantage of doing it under local would be to drive yourself home, which is probably overkill.

 

Bri (36:56):
Yeah. You have a breast aug, commit to having help.

 

Dr. G (37:01):
All right. That's fair. Okay. So we're not going to offer it under local anytime soon. And hopefully we'll get the purple trocar.

 

Bri (37:07):
I just need you guys to see.

 

Dr. G (37:08):
Understand why. But I do like it. My patients have tended to push the limits of what size implant you can put in there, which makes me -

 

Bri (37:18):
Ah, thank you. Okay. So this is it. This is what you're getting shoved in your breast. I don't want to deter anyone because -

 

Dr. G (37:29):
It's just the pointy end.

 

Bri (37:30):
It's just pointy. And it's so easy under IV sedation, but under local. Come on.

 

Dr. G (37:41):
All right. We know Bri's opinion on this.

 

Bri (37:46):
That's my opinion.

 

Dr. G (37:47):
I feel like that's fair. I mean, the reason this isn't in the exam room is because nobody wants to see this. So then I just say, then I create a channel and I don't demonstrate this.

 

Bri (37:58):
Yeah, absolutely.

 

Dr. G (37:59):
Nobody wants to look at that.

 

Bri (38:00):
No, nobody wants to see it.

 

Dr. G (38:01):
But maybe I should. So they're like, "Actually, general anesthesia would be great." Okay. So that tunnel is just creating the space where I can get the balloon in. And then the reason it's called Preserve is because I'm not cutting anything at that. I'm not dissecting the pocket. It's just pushing out both the tumescent solution, the numbing fluid and the breast tissue out of the way to create a little space for the implant. And then we put the implant in. So the recovery is super fast. So that is the upside. Even with IV sedation or a light general anesthetic, you feel great, you're happy the next day. Depending on the size of the implant, that determines how fast you recover, honestly. The bigger the implant, the more stretch you feel. It's not nothing. And then the incision is still inframammary crease. Again, it's an ergonomic implant, but I still need an incision to get the implant through the funnel through the tunnel.

 

(39:01):
So it's three and a half centimeters, generally speaking. The largest size implant you can put in the middle of the range profile is a 265. And then you can put a 315 CC implant in if you're using the higher profile. And most of my patients have been choosing like 245, 265. If somebody comes in and is like, "What about a 285? What about a 320?" Then we're doing a regular augmentation. And I think that's fine. If you're debating between 180 and 190, yeah, then Preserve is probably a good option for you. But for some reason, we're not seeing those patients. So would love to see you if you're interested in a small aug, but a lot of patients are like, "Oh yeah, I think I want the 180." And then they're like, "Well, if I'm going to do it."

 

Bri (39:49):
Yeah. If I'm already going to do it, do a little bit bigger.

 

Dr. G (39:51):
I want to make sure it's worth doing. I'm like, "Okay, that's fair." Okay. The recovery is a lot faster. I will grant that.

 

Bri (40:00):
Yeah. People are strolling in here the next day, like no biggie. That is nice. But you also do have to still take time to recover.

 

Dr. G (40:08):
Yeah. Two weeks of taking it easy, then you can go for it. And then if you want to lift, you can do it with a Preserve. It's just, it needs to be a small lift. Again, otherwise, what's the advantage? You're still going to need that recovery time. You can't use mesh with it. Like I said, you can't use a bigger size. I think those are all the limitations, but I go over that. Sometimes we have people who come in for Preserve and switch to a regular aug and people who come in for regular aug don't know anything about Preserve and are like, "No, that sounds like a good option." So it's nice to have options. Some people will argue that you can do the same thing with a saline sizer and a sound, a uretal sound, go in there and create space and put in a saline sizer.

 

Bri (40:52):
Sounds like a pain in the butt.

 

Dr. G (40:54):
I feel like they have this lovely kit for me to use. I'm going to use it.

 

Bri (40:59):
Exactly. That sounds like.

 

Dr. G (41:01):
I mean, it's just like a Temu version.

 

Bri (41:05):
That's the Temu version because then I don't know, what if you just. I like the fact that this is on a stick. It's easy to pull out. It's easy to inflate, deflate. I don't know.

 

Dr. G (41:17):
Yeah. They've thought it through. Yeah. It seems like I don't need to reinvent the wheel. I'll just get the kit.

 

Bri (41:23):
Yeah. That just seems like a cheap half ass version of doing it.

 

Dr. G (41:27):
Yeah. All right. So should we do.

 

Bri (41:31):
Rapid fire?

 

Dr. G (41:32):
Rapid fire. True or false?

 

Bri (41:34):
Myth or reality. The QID chip is a tracking device.

 

Dr. G (41:38):
That is a myth.

 

Bri (41:39):
That we know of. Motiva costs way more everywhere.

 

Dr. G (41:45):
I don't know what everywhere means, but they're more expensive implants here.

 

Bri (41:48):
Yeah. I don't think you can get them any cheaper. Preserve means no anesthesia at all. Absolutely not. If you learned anything from this podcast, you're still going under something.

 

Dr. G (42:00):
You're getting a little sleepy medication.

 

Bri (42:03):
Yeah. A little something, something. Once you go Motiva, you can never go back to traditional implants.

 

Dr. G (42:08):
That's not true.

 

Bri (42:09):
A lower cap con rate means zero risk.

 

Dr. G (42:12):
No, that's also not true. So we all know that cap con risk is increased in smokers and if there's bleeding around the implant at the time of surgery, radiation, and then all the things we don't know about. So those are the things we're trying to prevent. But yeah, it's not zero. It just means lower. If you already have CapCon, taking out your current implants and putting in Motiva is not a guarantee that you're not going to get recurrent CapCon, because there's usually a reason you got cap con in the first place for whatever it is. So yeah, the other thing about Preserve is as far as we know, it's a one and done. So once you do it, that technique, I'm not going to be able to get that implant out and put another one in through the same noninvasive.

 

Bri (42:56):
Right.

 

Dr. G (42:58):
But we'll see.

 

Bri (42:59):
We'll see where the trends go.

 

Dr. G (43:01):
Yes. Maybe something newer, better, faster, stronger will be out. All right. If you have questions or need information about scheduling or financing or want to see some before and after photos, we should have some Preserve before and afters coming very soon. Reach out or leave a comment.

 

Bri (43:23):
Yeah. If anyone wants to comment on their thoughts on this as well.

 

Dr. G (43:27):
Yes.

 

Bri (43:27):
Going under local, join my debate.

 

Dr. G (43:30):
Yes. Yeah, I'd give that a try or absolutely not. I agree with Bri. Please let us know.

 

Bri (43:36):
I also just want to preference, they did have to put not for human use.

 

Dr. G (43:41):
I know, on the sample.

 

Bri (43:42):
Yeah, because you know somebody has tried to take this home and do something weird with it. That was my very first thought when I saw it.

 

Dr. G (43:50):
No.

 

Bri (43:51):
100%. Everyone in the OR agreed.

 

Dr. G (43:55):
That's awful.

 

Bri (43:56):
It's terrible, but it's. Okay.

 

Dr. G (44:00):
Okay. You had to go there.

 

Bri (44:02):
Going to be my wand today. Yes, I do have to go there.

 

Dr. G (44:04):
Oh yeah. It's kind of an interesting wand. To me, this end, and I'm not really sure -

 

Bri (44:11):
A honey stick.

 

Dr. G (44:12):
Yeah. It's a honey stick, right? Yeah. To scoop up honey. I don't know why.

 

Bri (44:17):
Or other things.

 

Dr. G (44:19):
It's ergonomic, but anywho. All right. This is the object of the day. Send us your thoughts. All right. I think we're going to scrub in.

 

Bri (44:30):
And scrub out.

 

Dr. G (44:32):
Thanks for joining us.

 

Bri (44:33):
She might stab me.

 

Dr. G (44:36):
If you're listening today and have questions, need info about scheduling, financing, reviews or photos, check out the show notes for links. Restore SD Plastic Surgery is located in La Jolla, California. To learn more about us, go to restorestplasticsurgery.com or follow us on Instagram @RestoreSDplasticsurgery. If you enjoyed this episode, please share it and subscribe to all the Bs on YouTube, Apple Podcasts, Spotify, or wherever you like to listen to podcasts.