Small Breast Implants Are Having a Moment: Motiva’s New FDA-Approved Sizes

Medically reviewed by John L. Burns Jr., MD, FACS · Board-certified plastic surgeon · Dallas, Texas · Updated October 2026

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For many years, breast augmentation was often associated with a noticeable increase in breast size. Today, that is changing. More women are asking for something subtler: a smaller, lighter, more proportional enhancement that fits their frame, preserves their lifestyle, and looks natural both in and out of clothing.

At the practice of John Burns, MD, FACS, this trend has been especially apparent among younger, athletic, and highly active patients. Many are not looking for a dramatic transformation. They want a breast augmentation that feels more like refinement than reinvention.

That is one reason the recent FDA approval of additional smaller Motiva implant sizes is so significant.

In October 2026, the FDA approved an expanded range of Motiva SmoothSilk Round and Motiva SmoothSilk Ergonomix breast implants, adding 28 new sizes to the U.S. portfolio. The expansion now includes implants as small as 105 cc, dramatically increasing the ability to match an implant precisely to a patient’s anatomy and aesthetic goals.

The Shift Toward Smaller, More Natural Breast Augmentation

Breast augmentation is becoming increasingly individualized.

Many patients today are asking for:

• a subtle increase in volume
• a natural slope rather than an overly full upper pole
• an implant that fits a smaller frame
• less overall implant weight
• minimal interference with exercise and athletics
• a result that looks proportionate rather than obviously augmented

This has contributed to what some have called the “ballerina breast” or “yoga breast” aesthetic—smaller, elegant, natural-looking breast augmentation designed to harmonize with the body rather than dominate it. Motiva itself highlighted this trend when announcing the new FDA-approved sizes.

For surgeons, smaller implants also create opportunities for greater precision. Rather than forcing a patient into the closest available size, we can select an implant based on base width, projection, breast tissue thickness, chest dimensions, and the patient’s desired degree of enhancement.

What New Motiva Sizes Were FDA Approved?

The FDA approval expands both the Motiva SmoothSilk Round and Motiva SmoothSilk Ergonomix product families.

Motiva SmoothSilk Round: 19 New Sizes

The newly approved Round sizes include:

Motiva SmoothSilk Ergonomix: 9 New Sizes

The newly approved Ergonomix sizes include:

That means Motiva implants are now available in the United States in sizes down to 105 cc, while also offering more combinations of width, projection, and volume across Mini, Demi, and Full profiles.

This is more than simply adding a few smaller implants. It gives surgeons considerably more flexibility to choose an implant that truly fits the patient.

New to the profile terms? Our guide to Motiva Round and Ergonomix implants explains how Mini, Demi and Full profiles differ, and breast implant sizes explained translates cc into cup-size expectations.

Why Smaller Implants Can Be Better for the Right Patient

Smaller implants offer several potential advantages in properly selected patients.

More Natural Proportions

For a petite patient or someone who already has reasonable breast volume, a 105–200 cc implant may provide exactly the amount of enhancement needed without overwhelming the chest.

The goal is not necessarily to create a larger breast. Sometimes the goal is simply to improve:

• upper-pole fullness
• shape
• symmetry
• cleavage
• postpartum deflation
• subtle loss of volume

A smaller implant can accomplish this while maintaining a very natural appearance.

Less Weight on the Breast

Breast implants exert weight on the breast envelope over time.

While implant size is only one factor in long-term breast shape, choosing a smaller, appropriately sized implant may reduce the mechanical load placed on the skin and soft tissues compared with a substantially larger implant.

This can be especially attractive for younger patients who may live with their implants for many years.

Better Fit for Athletic Patients

Highly active patients often prioritize comfort and freedom of movement.

Runners, dancers, Pilates enthusiasts, weightlifters, fitness instructors, and other athletes may prefer a smaller implant because it is less likely to feel cumbersome during exercise.

For these patients, breast augmentation should ideally complement an active lifestyle rather than interfere with it.

Motiva Ergonomix and the Natural Breast

The Motiva SmoothSilk Ergonomix implant is particularly well suited to patients seeking a natural result.

Unlike a traditional highly round, fixed-shape aesthetic, Ergonomix implants are designed to behave dynamically with changes in body position. The goal is a softer and more natural appearance and feel.

This can be especially appealing in smaller-volume augmentation, where the patient wants the breast to appear naturally enhanced rather than obviously augmented.

Motiva’s original U.S. FDA approval covered both SmoothSilk Round and SmoothSilk Round Ergonomix implants for primary and revision augmentation in women age 22 and older. The newest approval expands the available size range even further. (Establishment Labs announced that original approval in September 2024.) For a side-by-side look, see Motiva implants vs. traditional silicone implants.

The Perfect Match for PRESERVE Breast Augmentation

The expanded smaller-size portfolio may be especially important for the next generation of minimally invasive breast augmentation: PRESERVE.

PRESERVE is designed around a breast tissue preservation philosophy. Rather than creating a pocket through more extensive traditional dissection, the technique is intended to minimize disruption of the native breast tissues and supporting structures.

Motiva describes PRESERVE as a less invasive approach designed to preserve breast anatomy and redistribute, rather than extensively cut, surrounding tissues around the implant.

In Dr. Burns’ practice, PRESERVE can be performed with an above-muscle, tissue-preserving approach and, in selected patients, can be performed awake or with light sedation.

For the right patient, the combination offers several appealing features:

• no disruption of the pectoralis muscle
• no animation deformity
• minimal tissue trauma
• small-incision access
• rapid recovery
• natural breast shape
• the ability to return to normal activity relatively quickly

And now, with Motiva implants available down to 105 cc, surgeons can pair a minimally invasive technique with truly small-volume implants.

Why Smaller Implants Make Sense for Awake Breast Augmentation

Awake breast augmentation is not simply about avoiding general anesthesia. The entire concept is built around doing less to the tissues while still achieving a meaningful aesthetic result.

Smaller implants fit naturally into that philosophy.

Rather than creating a large pocket and inserting a large-volume implant, a carefully selected smaller implant can be placed into a precisely developed pocket designed around the patient’s existing breast anatomy.

This is particularly attractive for patients who say:

“I want to look better, but I don’t want anyone to know exactly what I did.”

That may mean going from an A cup to a small B, restoring mild postpartum volume loss, improving symmetry, or simply adding enough fullness to better balance the hips and shoulders.

For these patients, 105–200 cc may be exactly the range that was previously missing.

How the main options compare:

Smaller Does Not Mean Less Sophisticated

A smaller breast augmentation can actually require more precision, not less.

When the goal is subtle, even small differences in:

• implant width
• projection
• pocket position
• fold position
• symmetry
• soft-tissue coverage

can become very noticeable.

This is why 3D planning can be so helpful.

At Dr. Burns’ practice, Crisalix 3D imaging can be used to preview different implant volumes and profiles before surgery. This allows patients to compare subtle differences in size and choose an implant that fits both their anatomy and their aesthetic preference.

With Motiva’s expanded portfolio, those choices are now even more refined.

Small Implants Are Not Just for Petite Patients

While smaller implants are especially useful in petite women, they are also valuable in other situations.

They may be ideal for:

• postpartum patients who primarily need lost volume restored
• patients who already have a naturally attractive breast shape
• revision patients who want to downsize
• athletes who want minimal added weight
• patients who want a subtle upper-pole restoration
• patients combining an implant with fat grafting
• women who want to maintain a very natural silhouette

In some patients, a smaller implant can also be combined with fat grafting to soften edges, enhance cleavage, or improve upper-pole contour without increasing implant volume.

This hybrid approach can create a very natural result while keeping the implant itself conservative. Fat is harvested with gentle liposuction from another area.

Cost of small breast implant augmentation in Dallas

Choosing a smaller implant does not by itself set the price. Your quote reflects the technique (traditional or awake PRESERVE), anesthesia, facility, the implant line chosen and whether fat grafting is added. Your personal quote is provided at consultation.

Small breast implants in Dallas: recovery and your path

Dr. Burns’ PRESERVE page describes light activity in about 1–2 days, exercise in about one week and full activity within about 10 days for PRESERVE patients, with the procedure performed under local anesthesia and light sedation through a small incision. These are estimates; traditional augmentation recovery is planned individually.

Our office is at 9201 N. Central Expressway, Suite 350, in Dallas. See real patient outcomes in the before-and-after gallery and read patient reviews.

Risks to understand

Every breast augmentation carries risk, regardless of implant size. Risks include capsular contracture, implant rupture, the need for reoperation, asymmetry, changes in nipple or breast sensation, rippling or palpable edges when tissue coverage is thin, infection and bleeding. The FDA also tracks breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) and other rare cancers in the scar capsule (FDA).

In Motiva’s U.S. pivotal trial, the 451-patient primary augmentation cohort showed 0.5% capsular contracture, 0.6% confirmed or suspected rupture and 6.1% reoperation at three years (MedTech Dive). Trial results do not predict any individual outcome.

Why This FDA Approval Matters

The significance of the October 2026 FDA approval is not just that Motiva added more inventory.

It reflects a broader change in breast aesthetics.

Women increasingly want choice, subtlety, personalization, and preservation.

The newly approved range gives surgeons more options to match implant dimensions to the patient instead of relying on a relatively narrow set of sizes.

According to Establishment Labs, the expansion adds 28 new sizes and will make the newly approved implants commercially available in the United States before the end of 2026.

The Future of Breast Augmentation Is Personalized

Breast augmentation is moving away from a one-size-fits-all philosophy.

The future is likely to involve:

• smaller implants
• better implant technology
• more precise sizing
• tissue-preserving surgery
• above-muscle techniques
• awake procedures
• faster recovery
• hybrid augmentation with fat
• more natural results

The combination of Motiva’s expanded small-volume implant portfolio and the PRESERVE technique fits perfectly within that evolution.

For many women, the ideal breast augmentation is no longer about becoming dramatically larger.

It is about becoming more balanced, more proportional, and more confident while still looking like yourself.

At John Burns, MD, FACS in Dallas, patients interested in smaller-volume augmentation can explore the newest Motiva sizes, use 3D imaging to compare options, and determine whether traditional breast augmentation or awake PRESERVE breast augmentation is the best fit for their goals. Learn more about Motiva breast augmentation in Dallas.

Why patients choose Dr. Burns

John L. Burns Jr., MD, FACS

• Board-certified by the American Board of Plastic Surgery; Fellow of the American College of Surgeons (FACS)
• More than 25 years of experience
• First plastic surgeon in the U.S. to complete a fellowship in laser surgery (UT Southwestern Medical Center); Clinical Instructor of Plastic Surgery, UT Southwestern
• Plastic surgery residency at the University of Texas Medical Branch; summa cum laude, UTMB Research Honors Program; Alpha Omega Alpha
• Microvascular training at MD Anderson Cancer Center; cosmetic surgery training in Miami; Vanderbilt University graduate
• Medical Director, JOLA Aesthetics; Past President, Dallas Plastic Surgery Institute; Board of Directors, Share-A-Smile Foundation
• Newsweek/Statista America's Best Plastic Surgeons 2022, 2023, 2024, 2025 and 2026 (2024 categories: facelift, rhinoplasty, breast augmentation)
• D Magazine Best Doctors 2023, 2024, 2025 and 2026; D Magazine “The Face of Breast Augmentation” 2024 and 2025; Texas Monthly Super Doctors 2024
• Allergan Double Black Diamond practice (Botox and filler, top 20 in the U.S.)

Read Dr. Burns’ full biography · Read patient reviews · View the before-and-after gallery

Frequently asked questions

The takeaway

Small breast implants are now a first-choice option, not a compromise. Motiva’s 28 new FDA-approved sizes, down to 105 cc, let Dr. Burns match width, projection and volume precisely, and pair them with tissue-preserving PRESERVE or hybrid fat grafting. The result is a balanced, proportional breast that still looks like you.

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Sources: U.S. FDA; Establishment Labs via Business Wire; MedTech Dive; Establishment Labs announcement of 28 new sizes (October 2026). This article is for education and is not medical advice. Individual results vary.