Motiva® brand silicone breast implants manufactured by Establishment Labs® in Costa Rica are now FDA (Food & Drug Administration) approved for use in the United States for breast augmentation and for breast reconstruction. Motiva® implants have been available to women in many nations for several years with a safety profile similar to implants used in the United States. Like competing brands Natrelle® (Abbvie®), Mentor® (Johnson and Johnson®), and Sientra® (Tiger Aesthetics®), Motiva® implants are available in two consistencies, one higher and more solid (Smoothsilk® Round) that maintains shape and breast projection, and a less viscous softer gel (Smoothsilk® Ergonomix®) that gravitationally conforms with positional changes in breast shape. Advantages of Motiva® implants over competitors are yet to be confirmed by long term objective scientific study. Establishment labs® promotes their implant surface (Smoothsilk®) as potentially diminishing capsular contracture, implant rippling, and the incidence of implant failure (rupture). Available warranty for Motiva® implants is similar to warranties for other implants. The Motiva® breast implant catalog does not match the larger range of sizes (width, projection, and volume) available from market competitors Natrelle®, Sientra®, and Mentor®. Sientra® and Mentor® offer both smooth surface and textured surface devices, but all Motiva® devices come with their proprietary 4-micron Smoothsilk® surface. Mentor® and Natrelle® are the only brands producing saline (salt water) filled breast implants, the preferred choice for many women. Dr. Steve Laverson is grateful to Establishment Labs® for their innovations and pursuit of improvement in the quality of breast implants available. We believe that current data does not prove significant advantages of Motiva® over other implant choices. Because longer world experience with Mentor®, Sientra®, and Natrelle® implants has proven their safety and effectiveness, we plan continued use of these brands and will also offer Motiva® implants to patients who select them.