Breast Augmentation, Awake — Without General Anesthesia
Preservé™ by Dr. Darren Smith, in Manhattan — a tissue-preserving breast augmentation performed under local anesthesia, by a surgeon who authored the technique's surgical chapter.
Request a Private ConsultationBoard-Certified Plastic Surgeon · President, New York Regional Society of Plastic Surgeons · Dual Fellowship-Trained
Most surgeons learn new techniques from a textbook. Dr. Smith wrote the one for this.
If you've been looking for a breast augmentation that doesn't put you fully under, doesn't cut through muscle, and lets you return to your life sooner — there's a name for it. It's called Preservé.
- Performed while you're awake, under local anesthesia — no general anesthesia required.
- Designed to preserve the pectoral muscle rather than cut through it.
- A refined, smaller-incision approach.
- Built around a gentler, quicker return to daily life.
What is Preservé?
Preservé is a tissue-preserving approach to breast augmentation built around Motiva implants. Rather than relying on general anesthesia and broader tissue disruption, it is performed under local (tumescent) anesthesia while you remain awake, with the goal of preserving the surrounding muscle and tissue.
How it compares
A traditional breast augmentation is typically performed under general anesthesia. The Preservé approach is designed to be performed awake, under local anesthesia, with attention to preserving the pectoral muscle.
Will I feel it?
Awake does not mean aware of pain. The area is thoroughly numbed with local anesthesia, so you can remain conscious and breathing on your own.
The implants
The technique uses the Motiva SmoothSilk® / Ergonomix® family of implants.
- Authored the chapter “Preservé™ Breast Augmentation with Motiva Implants” in Elsevier's Expert Techniques in Aesthetic Surgery.
- Technical copy editor for all six volumes of Neligan's Plastic Surgery, the field's leading reference text.
- President, New York Regional Society of Plastic Surgeons.
- Dual fellowship training: craniofacial surgery (Hospital for Sick Children, Toronto) and aesthetic surgery (Manhattan Eye, Ear & Throat Hospital).
- 200+ peer-reviewed publications.
- U.S. patent holder.
- Medical degree, Alpert Medical School of Brown University.
The Experience
Both your consultation and your procedure take place entirely within our private, ultra-discreet boutique surgical suite at the Ritz Tower on East 57th Street — a self-contained Manhattan setting designed for complete privacy, from arrival through recovery.
Preservé™ is designed around local anesthesia for a gentler, quicker recovery — and we tailor the experience entirely to your comfort, offering IV sedation or general anesthesia upon request.
Many patients return to light activity the same day.
To preserve our commitment to completely private, unhurried appointments, a $500 consultation fee secures your visit and is fully credited toward your procedure.
Preservé may be a good fit if you:
- Are considering breast augmentation, often for the first time
- Prefer a natural, proportionate result over a dramatic one
- Would rather avoid general anesthesia
- Are in good general health and at a stable weight
- Value a private, boutique surgical experience
A consultation is the best way to determine whether Preservé is right for you.
Frequently Asked Questions
Is Preservé really performed awake?
Yes. It can be performed under local (tumescent) anesthesia while you remain awake.
Will I feel anything during the procedure?
The treatment area is thoroughly numbed, and light sedation is available for comfort. The goal is a calm, comfortable experience while you remain conscious.
How is Preservé different from a standard breast augmentation?
A standard augmentation is usually performed under general anesthesia. Preservé is designed to be performed awake, under local anesthesia, while preserving the pectoral muscle and surrounding tissue.
How soon can I return to work and normal activities?
Most patients can return to light activity the same day. The majority can be back in the office in 48 hours.
What implants are used?
The Motiva SmoothSilk / Ergonomix family of implants.
Why do so few surgeons offer Preservé?
It requires specific training and experience. Dr. Smith authored the surgical chapter on the technique.
Where is your office located?
Our private practice is at the Ritz Tower on East 57th Street in Manhattan.
Is there a consultation fee?
Yes. Consultations are $500, applied in full toward your procedure if you proceed. The consultation is private, unhurried time with Dr. Smith to assess your candidacy and design a plan specific to you.
“Have to leave a review of Dr. Smith - from the consultation all the way to the procedure and follow up appointments, he and everyone in his office have shown they are 10/10 at what they do.”
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Request a Private Consultation
Consultations are private and by appointment. Share your details and a member of our team will be in touch to arrange your visit.