MOTIVA® WOMAN’S CHOICE PROGRAM TERMS AND CONDITIONS
This document (the “Terms & Conditions”) describes the terms,
conditions, and claim procedure for the Motiva Implants®Woman’s Choice Program (the “Program”). Subject to these Terms & Conditions, the
Program is offered by Establishment Labs S.A., with registered office at 4th Street, Coyol Free Zone #B15,
Alajuela 20102, Costa Rica, and its affiliates (collectively, “Manufacturer”)
and is available to individuals
implanted with Motiva Ergonomix2®
breast implants (the “WCP Participants”) purchased directly from
Manufacturer or its authorized distribution partners specifically via the JOY® branded product offering, as
evidenced by product serial numbers permitting registration for the Program (the “Qualified Implants”). The
Program is intended to enable WCP Participants’ choice by providing the financial support indicated in these
Terms & Conditionsin the event a WCP Participant elects to remove the Qualified Implants during the Program
Validity Period (defined below). There is no additional cost to WCP Participants to participate in the Program
provided that the eligibility and registration requirements contained in these Terms & Conditions are fully
satisfied and the Validity Period remains in effect.
PROGRAM OVERVIEW & PROGRAM CREDIT
Under the Program and subject to these Terms & Conditions, an eligible WCP Participant who elects for any
reason to have a Qualified Explantation (as defined in Section 2 below) can receive financial support (the “Program Credit”) towards the cost of such Qualified Explantation, as further described below. Except where
limited or prohibited by law, the Program Credit shall comprise a payment of up to One Thousand FiveHundred US Dollars (USD $1500) or its equivalent in local currency at the conversion rate in effect on the
actual date of payment as determined by Manufacturer in its sole discretion, and without reimbursement for
currency fluctuations or bank transaction fees. For further details on the Program Credit, see Section 7
Where legally permissible and authorized by Manufacturer, a WCP Participant may have the option to direct
that the Program Credit be issued to a licensed medical professional or clinic to directly offset the costs
associated with explanting the Qualified Implants.
A WCP Participant’s eligibility to receive a Program Credit is strictly subject to compliance with the following
criteria and the Claim procedure referenced in Section 6 below. An explantation procedure for removal of the
Qualified Implants which satisfies all of the below eligibility conditions and is not otherwise excluded under
Section 3 below shall be referred to as a
Each WCP Participant must duly register the Qualified Implants via the MotivaImagine® App, the
online registration link or QR code provided to the WCP Participant, or otherwise via the
Manufacturer’s MotivaImagine website at
https://motiva.health/motivaImagine/, within ninety (90)
calendar days following the original implantation procedure (the “Registration Deadline”). The WCP
Participant is solely and exclusively responsible for completing and submitting the Program-specific
online registration form, complying with the 90-day Registration Deadline, and collecting the
Qualified Implants’ serial numbers from the implanting physician or clinic to enable registration in
advance of such Registration Deadline. In no event shall Manufacturer or its representatives be liable
or responsible for any failure to successfully transmit any online registration link to a WCP Participant
due to incorrect email address, Junk/SPAM filtering, service level disruption or other factors. The
WCP Participant may submit a registration support ticket via Manufacturer’s website at
to request assistance with registration prior to the Registration
Deadline. Neither Manufacturer nor its representatives is able to provide implant serial numbers to
be used for registration, as they must be obtained from the implanting surgeon only.
By registering for the Program and/or initiating any Claim, each WCP Participant accepts and agrees
to comply in full with these Terms & Conditions.
A WCP Participant must elect to have the Qualified Implants completely and permanently removed,
and actually undergo the Qualified Explantation procedure during the Validity Period in order to claim
the Program Credit.
Any explantation procedure which is covered in whole or in part by private, public, government or
social insurance benefits or reimbursement is explicitly excluded from the Program and will not
qualify for the Program Credit.
If the WCP Participant received two (2) Qualified Implants, both Qualified Implants must be
explanted to receive the Program Credit.
The WCP Participant must not intend to receive, actually receive, or undergo a revision surgery
involving, any replacement, substitute, new or alternate breast implants (of any manufacturer) and
must intend to remove the Qualified Implants to remain without breast implants indefinitely.
In order to limit fraud, misrepresentation and abuse, the explantation procedure must be performed
by appropriately qualified and licensed medical professionals who affirm their adherence to these
Terms & Conditions, as set forth in the Claim forms (each, an “Explanting Clinician”). See Section
5 below for more information.
EXCLUSIONS AND LIMITATIONS
The following Program exclusions apply:
The Program is not valid in any jurisdiction in which the JOY branded product offering is unavailable
(including but not limited to Japan), or to any individual who received Motiva Ergonomix2 or other
breast implants from surgeons or distribution channels not authorized by Manufacturer to offer the
JOY branded program, even if the applicable implants are successfully registered within
Manufacturer’s systems or records. Any registration of Ergonomix2 or other breast implants received
outside of the JOY branded program shall be valid only with respect to otherwise applicable
Manufacturer benefit programs and the registrant shall not comprise a “WCP Participant” as defined
in these Terms & Conditions
The Program is void where prohibited by law and has no cash value. For purposes of eligibility for
Program registration, the location of implantation shall control. For purposes of initiating a Claim
and receiving the Program Credit, the location of explantation and/or the WCP Participant’s residence
shall control to verify compliance with applicable laws for a Program Credit to be issued to the
Explanting Clinician or the WCP Participant, respectively. Based on the foregoing, and whether
prohibited by law or these Terms & Conditions, if a WCP Participant is ineligible either to register or
to receive the Program Credit in their geographic location, the Claim shall be denied in either case.
In no event shall the Program Credit be remitted in advance of the Qualified Explantation. WCP
Participants seeking a Program Credit are encouraged to complete the pre-qualification portion of the
Claim procedure referenced in Section 6 below to confirm eligibility, including in connection with
receipt of genuine Qualified Implants, valid Program registration in advance of the Registration Deadline, no local exclusion, continuity of the Validity Period, non-use of an Excluded Clinic, and
other Qualified Explantation criteria as set forth herein. For the avoidance of doubt, the Qualified
Explantation must be performed within the Validity Period to qualify for the Program Credit.
The Program will not apply to any Qualified Implants implanted, or explantations performed, without
adherence to Manufacturer’s then-current Directions for Use (DFU) and surgical manuals applicable
to the Qualified Implants.
The Program only applies to the surgical procedure for the complete and permanent removal of the
Implants. By accepting these Terms & Conditions, WCP Participants acknowledge that there may be
other procedures that may be necessary or appropriate in the medical professional’s judgment (such
as the replacement or revision of the Qualified Implants or other medical or surgical procedures) and
which are not covered by the Program or Program Credit.
The Program will not apply in case the removal of the Qualified Implantsis totally or partially covered
by a private or public insurance, reimbursement system, or similar scheme. Therefore, Manufacturer
will deny the award of the Program Credit to any WCP Participants who benefit from total or partial
private or public insurance, reimbursement system, or similar scheme covering the removal of the
Qualified Implants. Manufacturer reserves the right to investigate and request restitution of any
amount provided in relation to WCP Participants who benefit from private or public insurance,
reimbursement system, or similar scheme for the removal of the Qualified Implants.
The Program applies to Qualified Explantation procedures performed by Explanting Clinicians who
have adhered to these Terms & Conditions. Manufacturer may, in its sole and absolute discretion,
decline to issue the Program Credit (a) to any medical professional or clinic that: (i) is not licensed to
perform Qualified Explantation procedures in the applicable WCP Participant’s location, (ii) has been
debarred, excluded from any government healthcare program, or subject to any disciplinary action or
legal enforcement action relating to the practice of medicine or surgery, fraud or abuse of public or
private funds, corruption or bribery, crimes of moral turpitude, regulatory violations (including offlabel use of medical devices or pharmaceuticals), or violent crimes, (iii) in Manufacturer’s sole and
absolute discretion, is suspected of engaging in fraud or abuse relating to the Program and/or any
Manufacturer warranty, or (iv) raises concerns, in Manufacturer’s sole and absolute discretion, with
respect to compromising patient safety (e.g., as a result of patient complaints or similar evidence)
and/or the safe and effective use of Manufacturer’s products (an “Excluded Clinic”); or (b) directly
to any WCP Participant who elects to have the Qualified Implants removed at an Excluded Clinic. If
a WCP Participant’s Claim is denied at the pre-qualification stage of the Claim procedure referenced
in Section 6 below solely on the basis that an Excluded Clinic was selected as the Explanting
Clinician, such WCP Participant may re-apply for the Program Credit after selecting an alternate
Explanting Clinician. It is the WCP Participant’s sole responsibility to verify that the Explanting
Clinician is not an Excluded Clinic by initiating a Claim and obtaining Manufacturer’s determination
of pre-qualification prior to undergoing the explantation procedure in order preserve eligibility for the
Manufacturer reserves the right, in its sole discretion, to deny the issuance of multiple Program Credits
to any individual WCP Participant, including but not limited to any WCP Participant who elects to
purchase new Qualified Implants (i.e., excluding any implants received as part of a Manufacturer
warranty or replacement program) at any time after previously undergoing a Qualified Explantation
for which a Program Credit was remitted.
Except as explicitly set forth in this paragraph, WCP Participants may not combine the Program Credit
with any other benefits offered by Manufacturer, including warranty benefits. Issuance of the Program
Credit shall disqualify a WCP Participant from receiving any additional claimed benefits under any
other Manufacturer warranty or benefit program with respect to the applicable Qualified Implants,
including with respect to any procedures performed prior to the issuance of the Program Credit.
Notwithstanding the foregoing, a WCP Participant shall remain eligible for a Program Credit if such
WCP Participant (or their surgeon) applies for and receives Manufacturer warranty benefits or other
benefits offered by Manufacturer’s polices from time to time; provided, however, that the Validity
Period shall not be extended in such cases. For clarification, if a WCP Participant receives any nocost replacement implant under any Manufacturer warranty program covering the originally
implanted Qualified Implants, the applicable Validity Period to complete a Claim procedure to qualify
for a Program Credit with respect to a Qualified Explantation to remove the replacement implants
shall be calculated from the implantation date of the originally registered Qualified Implants and not
from the date of implantation of the replacement implants offered under Manufacturer’s warranty
INDEPENDENT PROGRAM; NO WARRANTY
The Program, while included as part of the JOY branded product offering, is a stand-alone and independent
policy which is unrelated to and not part of the Qualified Implants’ separate warranties. The Qualified Implants
may be subject to Manufacturer’s standard and extended warranty programs, which remain unaffected by this
Program. For full warranty terms, please click visit:
The Program is also separate from any contract between the WCP Participant and third parties, including any
medical professionals or institutions for providing surgical services to the WCP Participant, and does not limit
or exclude any warranties or representations established under such contracts. Manufacturer is neither part of
any contract between the WCP Participant and third parties, including for surgical services to implant or
remove Qualified Implants, nor does Manufacturer advise or otherwise influence such third parties or the WCP
Participants with regard to any surgical services in connection with the Manufacturer’s products. The Program
is intended as a courtesy benefit to support WCP Participants’ health and well-being and is not intended, and
shall not to the maximum extent permitted by law, be construed as a promotional practice, kickback, rebate or
EXPLANTING CLINICIANS; FIXED BENEFIT AMOUNT
In certain jurisdictions, WCP Participants may be able to locate potential Explanting Clinicians via the
Manufacturer’s searchable medical professional locator database, available at:
For the avoidance of doubt, the physicians and clinics listed in Manufacturer’s searchable database are not
complete or exhaustive and Manufacturer cannot guarantee that the information represented by third party
clinicians on its website is current or accurate. WCP Participants must verify all information, including pricing
and explantation costs, with their selected clinician directly. Manufacturer does not endorse, approve, favor
or recommend any particular medical professionals and does not offer any medical advice, background or
licensing checks, or recommendations. In no event shall Manufacturer or its affiliates or representatives be
liable or responsible with respect to the performance of any clinical procedure by a third party healthcare
professional, including but not limited to claims of malpractice. Subject to Section 3.7 above, any medical
professional who complies with these Terms & Conditions and affirms the truthful and accurate submission of
Claim data may qualify as an Explanting Clinician for purposes of the Program, including physicians not listed
in the online locator database
WCP Participants are encouraged to seek the advice of a licensed medical professional with respect to clinical
judgment, patient safety and suitability for any medical procedure, potential risks and benefits of any Qualified
Explantation, procedure recovery times, prescription of medication or anesthesia, and related matters. Each
WCP Participant’s healthcare provider should advise whether any ancillary procedures are or are not necessary
or preferred in connection with a Qualified Explantation for either health or aesthetic purposes.
Manufacturer does not set or influence any medical professionals’ procedural or service costs, overhead or
facility costs. The Program Credit is fixed independent of the aggregate cost of the Qualified Explantation.
Accordingly, WCP Participants are encouraged to discuss all procedure, medication and facility costs with one
or more medical professionals in addition to seeking the Program Credit. Manufacturer is not liable to any
WCP Participant or third party for the cost of any procedure (including explantation) not covered by or within
the Program Credit, or for which a Claim was denied for noncompliance with these Terms & Conditions.
WCP Participants may initiate a request for a Program Credit (a
“Claim”) by visiting:
https://motiva.health/patients-contact/. Both the WCP Participant and the Explanting Clinician must verify the
criteria in Sections 2 and 3 above as part of Claim process. Manufacturer may, in its sole discretion, require
the submission of supporting documentation in order to validate and/or document any eligibility criteria, the
absence of exclusion criteria or compliance with applicable laws or regulations prior to approving any Claim.
All Claims must be initiated prior to the conclusion of the Validity Period and full verification details must be
submitted no later than 180 days following the conclusion of the Validity Period to qualify for the Program
All Claims shall be subject to an initial pre-qualification check which, if approved, must be followed by a
verification submission following the Qualified Explantation to confirm eligibility to receive the Program
As part of the initial pre-qualification step in the Claim procedure, the WCP Participant must submit, among
Accurate information or documentation to verify the WCP Participant’s identity, receipt of Qualified
Implants and timely registration for the Program prior to the Registration Deadline, such as the device
serial and lot numbers and registration e-mail address. Such information can be derived from
electronic records, transponder readings, and Qualified Implants purchase and delivery records with
the help of the medical professional that performed the implantation
The WCP Participant’s location of implantation and proposed location of explantation, in order to
verify geographical eligibility.
The name, clinic address, telephone number and email address of the Explanting Clinician in order to
confirm such Explanting Clinician is not an Excluded Clinic;
An acknowledgement that the WCP Participant has no plans to, and shall not, receive any substitute
or replacement breast implants in connection with the explantation procedure or at any point in the
Confirmation that the explantation procedure shall not be covered by private or public insurance,
reimbursement system, or any similar scheme.
As part of the verification step in the Claim procedure, each WCP Participant and designated Explanting
Clinician must affirm, among other things, that all facts in the Claim are true and correct, that a Qualified
Explantation was duly completed within the Validity Period, that the explantation procedure was not covered
by insurance or healthcare program reimbursement, and that the WCP Participant did not receive replacement
or substitute breast implants from the Explanting Clinician or any other medical professional in connection
with the explantation or otherwise. Each of the WCP Participant and Explanation Clinician must further
acknowledge the designated payee of the Program Credit and the bank account to which the Program Credit
will be remitted. Manufacturer may, in its sole and absolute discretion, require proof of invoice or other
documentation to evidence the completion and/or cost of the Qualified Explantation.
Manufacturer shall engage in commercially reasonable efforts to issue a determination with respect to prequalification eligibility and/or final Claim verification and approval within fifteen (15) business days following
complete and accurate submission of all information requested under the Claim procedure and associated
forms. If any of the required eligibility or verification information is missing or incomplete or requires
additional review or verification, Manufacturer will make up to three (3) attempts to reach the WCP Participant
via such WCP Participant’s indicated e-mail address in order to request the missing, incomplete or supporting
details to enable Manufacturer to make a determination pursuant to these Terms & Conditions. If no response
is received after the third attempt or if the WCP Participant fails to submit all requested information within a
reasonable period not to exceed 180 days following the conclusion of the Validity Period, Manufacturer will
deny and close the Claim, subject to such WCP Participant’s statutory rights under applicable laws. Each WCP
Participant is responsible for causing their designated Explanting Clinician to timely complete and submit the
Claim form(s) required to be submitted by the Explanting Clinician. No Program Credit shall issue unless the
Explanting Clinician has submitted verification of the Qualified Explantation.
Manufacturer reserves the right to investigate and request additional evidence and documentation, particularly
in the event of large numbers of Claims made with respect to a particular medical professional or medical
institution. Additional time required for such investigation and request shall not affect the WCP Participant’s
For guidance on providing the necessary information and verification documentation, WCP Participants and
their medical professionals may request support here:
encourages WCP Participants to submit and resolve any questions related to their eligibility for the Program
before a removal surgery is scheduled.
Subject to the criteria and exclusions in these Terms & Conditions, the Program Credit shall be remitted in the
amount of the lesser of: (a) One-Thousand Five Hundred U.S. Dollars (USD $1500) or (b) the actual fees
charged by the Explanting Clinician for the Qualified Implantation (as converted to U.S. Dollars applying the
conversion rates of Manufacturer’s bank). Manufacturer shall issue the Program Credit within sixty (60)
calendar days of its final approval and verification of a Claim. The WCP Participant and Explanting Clinician
shall agree ahead of the Qualified Explantation whether the Program Credit shall be granted in the form of a
reimbursement paid to either the WCP Participant or the Explanting Clinician .
Manufacturer shall remit the Program Credit by wire transfer or bank transfer in U.S. Dollars, which may be
converted by the recipient’s bank or any intermediary bank into the local currency of the receiving bank.
Manufacturer shall bear any costs charged by its own bank(s) in connection with the issuance of the Program Credit. The WCP Participant (or Explanting Clinician, depending on the case) shall bear any fees charged and
deductions made by their own bank, and by any third-party banks involved in the transfer, including any costs
or deductions related to currency conversions. Manufacturer is not responsible for any currency fluctuation
risk, sending or receiving bank conversion rates, wire transfer fees or other fees charged by the bank receiving
the Program Credit or any intermediary banks.
The WCP Participant is solely responsible for providing accurate and complete information within the Claim
procedure regarding the payee bank account to which the Program Credit shall be remitted. Manufacturer is
not responsible for any errors, typographical or otherwise, in the payee information or in the misdirection of
funds due to such error. Manufacturer’s sole obligation with respect to the remittance of the Program Credit
shall be to wire or otherwise initiate a funds transfer in the amount of the Program Credit to the payee
information exactly as listed in the Claim verification. Manufacturer shall have no obligation to reverse any
payment, recover any lost or misdirected funds or duplicate any payment not received by the intended payee
for any reason other than Manufacturer’s sole and direct error. Manufacturer shall have no liability in respect
of payments or debts owed between a WCP Participant and their designated Explanting Clinician. If the
Program Credit is remitted directly to any WCP Participant, such WCP Participant is solely responsible for
remitting full payment to their Explanting Clinician for any costs associated with the Qualified Explantation.
If the Program Credit is remitted to the Explanting Clinician, the WCP Participant shall directly coordinate
with the Explanting Clinician to ensure appropriate credit to their invoice or account.
If the Program Credit is determined by Manufacturer to be contrary to applicable laws in the WCP Participant’s
jurisdiction, Manufacturer may, in its sole and absolute discretion, offer a discount coupon, voucher, gift card,
clinic account credit or similar value alternative in lieu of the Program Credit, or may deny the claim for the
Program Credit without penalty or compensation.
The WCP Participant shall be solely responsible for the payment of any taxes or tax liabilities associated with
receipt of the Program Credit or its equivalent and shall pay any and all income, value added, stamp, or similar
taxes that are due and payable under applicable laws or tax codes in the WCP Participant’s jurisdiction.
PROGRAM VALIDITY PERIOD
With respect to each WCP Participant, the Program Credit benefit shall be available for a period of two (2)
years from the date of the original implantation of a Qualified Implant (without regard to any later revision
surgery dates) or such shorter period as determined by Manufacturer consistent with this Section (the “Validity Period”).Subject to applicable laws, Manufacturer reserves the right to modify, cancel, update, terminate,
limit or otherwise discontinue (each, a
“Modification”) the Program at any time, without notice to or consent
of the WCP Participant or any third party, and including with effect to WCP Participants who previously
registered for the Program prior to the Modification. Unless and to the extent retrospective Modification is
prohibited by applicable law in respect to a particular WCP Participant’s case, the most recent version of these
Terms & Conditions available on Manufacturer’s website shall govern and control all Program benefits
applicable to such WCP Participant. Notwithstanding the foregoing, in no event shall the Validity Period
exceed two (2) years from the date of the WCP Participant’s initial implantation with the Qualified Implants.
Where Manufacturer initiates a Modification applicable to WCP Participants that have previously registered
for the Program, Manufacturer will engage in reasonable efforts to provide notice of such Modification to such
WCP Participants in writing via the email addresses associated with the WCP Participants’ registration
accounts and/or via the Manufacturer website and such WCP Participants shall have the right to terminate their
participation in the Program upon receipt of any such notice. Nothing contained in these Terms & Conditions
or any other instrument shall be construed as an obligation of Manufacturer to maintain the Program for any
particular period of time.
To the maximum extent permitted by applicable law, the rights of WCP Participants under the Program are
non-transferable, non-contractual and non-promotional. Registration for the Program by a WCP Participant
comprises an opt-in to the then-available Program benefits and does not create a binding contract between
Manufacturer and any WCP Participant as of any particular date.
The Program and these Terms & Conditions, including any obligations, rights, and claims arising out of or in
connection with them, any questions regarding valid conclusion of agreements under these Terms &
Conditions, and any amendments thereto – irrespective of their legal grounds (e.g., under contract, tort or
otherwise) – shall be exclusively governed by and construed in accordance with the laws of Costa Rica,
excluding its conflicts of laws provisions, and the courts located in San Jose, Costa Rica will have exclusive
jurisdiction on potential disputes. If the WCP Participant is a consumer within the meaning of the Regulation
(EC) No. 593/2008, i.e., if the WCP Participant accepts these Terms & Conditions by registering for the
Program for a purpose which can be regarded as being outside their trade or profession, the foregoing choice
of governing law shall not have the result of depriving the WCP Participant of the protection afforded to them
by provisions that cannot be derogated from by agreement by virtue of the law of the country where the WCP
Participant has their habitual residence. Solely in such scenario, WCP Participants will be entitled to bring
claims before the courts of the place of their habitual residence.
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