Mia & Preservé Breast Augmentation: Does Sagging Occur, Does the Implant Shift, Are the Results Permanent?

Classical techniques in breast aesthetics have a major disadvantage. During surgery, they often weaken the natural connective tissues around the breast (circummamary ligament, Cooper’s ligaments, SFS, IMF, lateral-septal fascia). As these structures lose support, the breast can change in unpredictable ways over time.

Tissue-preserving techniques such as Preservé and Mia follow the opposite philosophy. These approaches aim to keep these supporting structures as intact as possible and to maintain the biomechanical balance of the breast for many years after surgery.

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1. Does Sagging Occur Over Time in Preservé & Mia Breast Augmentation?

No. Compared with classical techniques, the breast sags noticeably less.

Three main mechanisms reduce sagging in Preservé and Mia:

a. The SFS and ligaments that carry the lower breast pole remain intact → the natural suspension system continues to support the breast.

In classical breast augmentations with a standard implant pocket, damage to this structure leads, over time, to:

• Widening of the lower pole,
• Downward pressure from the implant,
• Loss of upper pole fullness,
• A “pseudo-ptosis” appearance.

Preservé and Mia change this picture. Because the natural suspensory system of the lower pole remains intact, the breast keeps a more balanced position even years after surgery.

b. The breast base does not widen, so the load on the lower pole does not increase.

In classical techniques, a wider base increases tension on the lower pole. Over time the ligaments stretch and sagging accelerates.

Preservé and Mia keep the base width controlled. This approach prevents accumulation of excessive pressure on the lower pole.

c. The implant footprint on the anterior chest wall stays in its anatomical position.

When the breast sags in classical techniques, the footprint gradually moves downward.

Preservé keeps the footprint stable. This anatomical anchoring significantly reduces the tendency of the breast to “slide down.”

👉 Conclusion:

Patients who undergo Preservé or Mia breast augmentation experience a dramatically lower rate of “downward drift of the breast” over the years compared with patients who receive classical augmentation.

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2. Can the Implant Move Upwards in Preservé & Mia Breast Augmentation?

Many patients wonder about this:

“Since you preserve the tissues, could the implant be pushed upwards?”

“If the capsule feels tight, could the implant sit higher than the nipple?”

The design of these techniques makes upward migration of the implant biomechanically very unlikely.

a. The implant pocket follows the anatomical boundaries one-to-one.

In the classical technique, the surgeon decides where to set the upper limit of the pocket and sometimes opens it too high.

Preservé and Mia follow a different strategy:

• They respect the boundaries of the circummamary ligament,
• They protect the superior fascia and stable zones,
• They do not leave an empty space where the implant could ride upwards.

b. The ligaments of the upper pole remain stable, so no upward-directed force develops against the implant.

When the upper pole tissue stays healthy and supported, the implant settles into its pocket and does not migrate upwards.

c. Ergonomix 2 implants naturally carry their center of gravity downward.

The cohesive gel changes shape with movement and encourages the implant to center itself inferiorly rather than climb higher.

👉 Conclusion:

The “high-riding implant” look that often appears after classical upper-pole augmentations rarely occurs with Preservé or Mia.

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3. Does the Implant Shift Toward the Armpit in Preservé & Mia?

Patients also frequently ask:

“Can my implant move sideways?” “Will my breast open toward the armpit?”

The Preservé and Mia techniques reduce the chance of lateral shifting to almost zero.

a. The lateral septal fascia and lateral ligaments stay intact.

In classical techniques, extensive lateral dissection allows the implant to spread toward the sides.

Preservé and Mia protect the lateral limits and use them as a natural side wall for the pocket.

b. The breast base does not expand excessively, so the implant does not sit in an overly wide pocket.

Pocket width defines how much room the implant has to move.

A narrow, anatomical pocket significantly increases implant stability.

👉 Conclusion:

With Preservé or Mia, shifting of the implant toward the armpit does not represent a typical complication and appears dramatically less often than with classical techniques.

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4. Do the Results Last in Preservé & Mia?

Preservé and Mia focus on protecting the natural suspension system that carries the lower breast pole, including ligaments and fascia. The surgeon positions the implant footprint within the anatomical limits of the chest wall and maintains this footprint over time.

Because of this strategy, upper pole fullness, implant position and breast base length tend to remain stable for many years.

In other words, these techniques do not only target short-term aesthetics; they aim for long-term biomechanical stability as well.

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Conclusion: More Stable, More Natural and Longer-Lasting Breasts with Breast-Preserving Techniques

Preservé and Mia represent more than an aesthetic method. Both techniques follow a modern surgical philosophy that protects the natural biomechanics of the breast while enhancing shape.

For this reason, in suitable patients these approaches typically provide:

• Less sagging over time,
• No upward ride of the implant,
• Minimal tendency to shift toward the armpit,
• Very limited form distortion over many years,
• More effective upper-pole fullness even with smaller implants,
• More stable and longer-lasting aesthetic results.