AWAKE BREAST AUGMENTATION
Motiva Preservé can be performed under local anaesthetic with you awake. Prof. Hindocha numbs the breast, parts the tissue with a channel separator and a balloon, shows you the volume on your body, places the implant through a no-touch sleeve and a 2.5 to 3 cm incision. You see the result in a mirror and go home the same day.
AWAKE SURGERY
A conventional breast augmentation usually divides tissue, and often the chest muscle, which is one reason it is done under general anaesthetic. Preservé does neither. The implant sits in front of the muscle, and the pocket is made by parting and stretching the tissue with two purpose-built Motiva instruments rather than cutting through it. Less is disturbed, so local anaesthetic around the breast can be enough.
Awake does not mean unmedicated. Local anaesthetic numbs the breast, and sedation is available if you would rather be drowsy than alert. A general anaesthetic remains an option where it suits you better, and Prof. Hindocha agrees the choice with you at consultation. Awake breast surgery is also used in the NHS where a general anaesthetic is the riskier option, as Guy’s and St Thomas’ explains.
Being awake has one practical advantage that no sizing app offers: you see the volume on your own body before the implant goes in. See how Preservé compares with a traditional augmentation.
AT A GLANCE
Typical features of an awake Preservé operation. Your plan is confirmed at consultation.
Anaesthetic, Sedation Optional
Talking Throughout
Incision in the Breast Fold
Result Seen in Theatre
Home
Local anaesthetic numbs the breast; it does not remove every sensation. Expect pressure and movement rather than sharp pain, and tell the team if anything is uncomfortable. What you feel varies from person to person, and no surgeon can promise an operation is painless.
STEP BY STEP
STEP 1
Prof. Hindocha places local anaesthetic around the breast. You feel pressure and movement and can talk throughout. If you have chosen sedation, it is given now, so you are drowsy rather than fully alert.
STEP 2
A Motiva channel separator makes a small tunnel through the breast tissue from an incision in the fold under the breast. It parts the tissue rather than cutting it, and the chest muscle is left intact.
STEP 3
A balloon is inflated in the tunnel to stretch the space gently into a pocket. Because you are awake, you see the volume on your own body and settle the size with him before the implant goes in. It looks bigger on the table than the final result will, and he explains why.
STEP 4
The SmoothSilk Ergonomix2 implant goes in through a no-touch sleeve, so it is not handled on its way in, through an incision of about 2.5 to 3 cm. The incision is closed, you see the result in a mirror in theatre, and you go home the same day with a support bra and a follow-up booked.
WHAT YOU WILL NOTICE
Local anaesthetic is not a switch, so nobody should promise you it is painless. This is what to expect:
LOCAL, SEDATION OR GENERAL
You avoid a general anaesthetic and its after-effects, you watch the sizing step on your own body, and you go home the same day. For some patients the general anaesthetic was the part of surgery they most wanted to avoid.
If the idea of being alert in theatre worries you, sedation makes you drowsy and relaxed while the local anaesthetic does the work. You can still respond to the team, and you remember less of the operation.
A general anaesthetic still suits some patients better: if you would rather be asleep, if a lift or other surgery is being combined, or if the examination suggests it. Preservé itself can be done either way.
You and Prof. Hindocha, at consultation, with the anaesthetist’s input on the day. Your health, your anatomy and your preference all count. None of the three options is a lesser version of the operation.
THE OTHER REASON PATIENTS CHOOSE IT
Awake surgery has practical uses beyond avoiding a general anaesthetic:
EXPLORE MOTIVA PRESERVÉ
More on the Motiva Preservé technique from Prof. Hindocha.
Verified patient reviews
Independently published reviews from Prof. Hindocha's breast surgery patients, quoted in full and exactly as written.
★★★★★
After years of being unhappy with my breasts after breastfeeding, I'm so glad I trusted my instincts and waited until I found the right surgeon. From my first consultation, Professor Hindocha made me feel completely at ease and I knew I could trust him. I'm only a week post-op and already love my results. I feel incredibly lucky to have found him and truly believe I found the best surgeon.
K.N.
Breast surgery patient
★★★★★
Excellent surgeon, highly recommend for breast augmentation under the muscle. He made me feel comfortable and didn't make me feel rushed in making decisions during my consultation right up to having surgery has been brilliant and also the after care. So pleased with my results.
C.S.
Breast augmentation patient
★★★★★
If you are wanting a breast reduction I would recommend Dr Sandip Hindocha! He has been brilliant from the consultation stage right through to after care! His team are amazing and will ensure that you are managing after surgery! You will feel at ease! I would 100% recommend!
G.H.
Breast reduction patient
Read all verified patient reviews
Patient stories describe individual experiences. Results vary from person to person, and the risks, limitations and likely outcome of any procedure are discussed with you at consultation.
THE NEXT STEP
A private consultation, with no obligation.
Local, sedation or general is agreed with Prof. Sandip Hindocha, consultant plastic surgeon (GMC 6122218) and certified by Motiva in the Preservé technique, once he has examined you and confirmed that Preservé suits you. You can also read about the Ergonomix2 implant he places. A written, itemised quote follows your consultation.
FREQUENTLY ASKED QUESTIONS
What patients ask about having Motiva Preservé under local anaesthetic.
Page last updated 18 October 2026. The step-by-step description is of Prof. Hindocha's own awake Preservé operations. Awake breast surgery in the NHS is described by Guy's and St Thomas' NHS Foundation Trust.
