FAQ Breast augmentation:

Here you will find answers

to the most frequently asked questions

If a breast implant is inserted under the pectoral muscle, the procedure is usually more complex and there is an increased risk of bleeding due to the muscle tissue. Pain may be temporarily increased after this breast surgery as the muscles are stretched by the implant.
If a breast implant is combined with a reduction and/or tightening of the breast tissue, the complication rate increases, especially the risk of implant site infections.
As the “inner bra” is a so-called local flap plasty, it is also possible that circulatory disorders and tissue loss (necrosis) may occur.
Overall, however, the surgical risk associated with the “internal bra” technique is considered to be rather low.

Breast augmentation using the “inner bra” technique is a standard method at our clinic that does not involve any additional surgical costs. The operation time may be longer. However, it is important to note that this technique is not applicable or appropriate for all patients.

Breast augmentation?
The use of the “inner bra” technique for breast augmentation is particularly beneficial for very slim patients who generally have less skin and tissue coverage. In addition, this method appears to be associated with a statistically lower rate of capsular fibrosis (thickening and hardening of the tissue around breast implants) overall.

By creating an implant site that is surrounded by the four pectoral muscles, the edges of the breast implant become less visible and noticeable, especially in very slim patients. It also reduces the risk of the implant sagging downwards after the operation, which is known as “bottoming out”.

In a breast augmentation with an “internal bra”, the implant can be placed either under the mammary gland or under the pectoralis major muscle. If the implant is placed under the muscle, the pectoral muscles act as a kind of “inner bra” that surrounds and supports the implant site.

The term “internal bra” is a marketing term that summarises several modern surgical techniques. The underlying idea is that the surgeon uses part of the breast tissue to create a permanently supportive “inner bra” from the body’s own tissue, similar to an outer bra.
The shaping of an inner bra can be used in various procedures such as breast augmentation, breast reduction and breast lift.

In a breast augmentation with implants, various different approaches can be selected. Not every kind of incision is suitable or feasible for every patient.
The incision currently in most common use is the one made in the inframammary fold (inframammary, submammary). This affords a very good overview of the site of the operation, especially in corrective surgery, and enables the glandular breast tissue to be conserved to a very large extent while the implant is being positioned in the breast. This is advantageous, both in terms of the general healing process and in terms of the patient’s subsequent ability to breastfeed. Ideally, moreover, the incision can be located in what will be the inframammary fold after the operation, so that the scar will hardly be visible at all. This type of incision for breast augmentation is mostly recommended for women with a small areola too.
Furthermore, the incision can be made in the vicinity of the nipple (periareolar). Especially if the patient has a breast deformity or a tubular breast, or if the inframammary fold is not clearly recognisable, perioareolar incision may make good sense for a breast augmentation with implants. In such cases, the incision is made in a semicircle and, ideally, exactly at the transition between the areola and the skin of the breast. Using this method, the nipple can also be lifted annularly and reduced in size.
If a breast lift is also planned alongside the augmentation, the implant can ideally be inserted near ​​the incision made for the (simultaneous) lifting operation.
There is also the possibility of making an armpit incision (axillary). For a variety of reasons, however, this kind of incision is not used in breast augmentations with implants at the practice clinic for plastic and aesthetic surgery Wolff & Edusei, for which reason there is no need for further explanation here.

One of the most frequently performed cosmetic operations is breast augmentation. The surgical procedures and products used at the practice clinic Wolff & Edusei meet the highest and most modern standards. However, given that breast surgery, inclusive of anaesthesia, is still a surgical intervention on your body, you should make sure that you have sufficient time to recover and relax after it. That also means that all movements should at first be made slowly and thoughtfully. Among other things, that means not moving your arms above shoulder height, subjecting your trunk to as little strain as possible, and sleeping on your back. Having said that, it’s important to get moving again on the day of the operation, and you should not under any circumstances adopt a cramped relief posture. After breast surgery the patient can shower from the midriff downwards right away on a daily basis. All the areas above that should just be given a quicker, more superficial wash. Apart from that, a compression bra and possibly also a compression bandage known as a ‘Stuttgarter Gürtel’ should be worn after a breast augmentation. Our specialists in plastic and aesthetic surgery Dr. Andrea Wolff and Dr. Isabel Edusei will give you personal and individual advice on that anyway. Even if there is no really dramatic pain to be expected after a breast operation, the way people perceive pain is a very individual matter. So we will give you some pain medication whatever happens, and you should take it in accordance with a carefully prepared therapy plan.
The first check-up takes place more or less straight away, on the first day after the operation, and the bandage will be changed for the first time. There will then be further check-ups and further changes of the bandage at regular intervals.

Pregnancy and breastfeeding are associated with great joy, but also with significant changes in the female body. As a rule, the size of the breasts also increases significantly in the first three months of pregnancy. And the female breast produces milk as from the 22nd week. Directly before the birth everything is geared to breastfeeding – the breasts feel heavy, may be as much as 1.5 times their original size, and the nipples are usually larger and darker. After the birth of your child, your breasts will feel heavy and full too. Although you will still be able to breastfeed, your breasts will begin to lose fatty tissue quite markedly as from about 6 months after the birth. After weaning there should be at least 3 months until your first appointment at our practice for plastic and aesthetic surgery, because it is not until then that your breasts will have returned to the size they were before the baby was born. We recommend that the actual breast operation itself should not be performed until 6 months after weaning at the earliest, since the weaning and post-weaning processes are as a rule accompanied by hormonal changes and other changes in weight.

During pregnancy, confinement and – if applicable – breastfeeding, your breasts will pass through various different stages, first gaining in volume and size, and then losing fatty tissue and decreasing in size again. So after pregnancy and breastfeeding, the shape and volume of the female breast may have changed markedly and that may greatly impair your self-assurance and the quality of your life. If you have decided in favour of a breast augmentation or other breast surgery, we recommend you not to come to our practice until after about 6 months after the birth of your child. The actual breast operation itself should not take place until at least 9 months after the birth. It is also important for the weaning process to have come to a complete end. See also the question “How soon after weaning is a breast augmentation possible?” For an optimum breast augmentation result, moreover, it will be an advantage if you have got back to the weight you felt happy with before the birth of your child.

Since a breast augmentation is, as a rule, a so-called beauty operation and thus not a medically indicated intervention, the costs will in most cases not be covered by your health insurance provider, nor will it be possible for you to be certified unfit for work. However, as with any other operation, your body will require sufficient time to regenerate after a breast augmentation. Depending on how much pressure you are under in your job or your private life – for example if there are young children in the family – you should plan for at least 2 weeks of absolute convalescence. If your work involves a lot of physical strain (e.g. caring or catering), you should plan for a considerably longer period of leave, at least for special activities. Our specialists in plastic and aesthetic surgery, Dr. Andrea Wolff and Dr. Isabel Edusei, and their staff at the practice, will be glad to advise you face to face as to how much recovery time is advisable in your own individual case.

In certain cases of breast surgery, a chest strap or so-called ‘Stuttgarter Gürtel’ may help in the healing process. A Stuttgarter Gürtel is an elastic, stabilising bandage worn round the ribcage but, unlike a normal bra, in the upper region. After a breast augmentation with implants, the Stuttgarter Gürtel can help to ensure that the implants are held in their pockets and do not rotate or slide upward. Apart from that, the chest strap can help to relieve pain by the compressing effect that it has. As a rule, it can be discarded some 6 weeks after the operation.

As after any other surgical operation, your body will need a certain period of rest after a breast augmentation so that the wounds can heal and an optimum result can be achieved. Given that a breast operation is often a so-called beauty operation, i.e. one that is not medically indicated, patients do not usually qualify to be certified unfit for work by their health insurance provider. So at least two weeks’ holiday should be planned after breast surgery. Altogether, you should take things easy in the first 6-12 weeks after a breast augmentation with autologous fat, and even more so after a breast augmentation with implants, refraining from strenuous work and heavy lifting. Six weeks after the operation, a six-week build-up begins, in which you can demand a little bit more of your body and the results of the operation begin to show. About 3 months after a breast augmentation with implants or autologous fat, the healing process should have progressed to the point where your body can function at full capacity again. Please note that the periods quoted here are average periods. Our specialists in plastic and aesthetic surgery and our practice team will be happy to advise you on an individual basis and will be available to answer any questions at all times.

After a surgical breast augmentation, your body needs enough time for the inner and outer wounds to heal in the best possible way. For example, it is very important to refrain from sport in the first 3 weeks after breast surgery. When you have talked to our specialists in plastic and aesthetic surgery after 3 weeks, you’ll be able to do some gentle leg exercises without any vibration or tensing of the trunk muscles. In addition, it is generally advisable to take it easy physically in the first 6 weeks after breast surgery and not to do any heavy lifting, so as to avoid disturbing the healing process and possibly having a negative influence on the result of the operation. After about 6 weeks, you can begin a build-up phase with some light training, which can be increased step by step depending on your symptoms. Swimming is mostly all right some 8 weeks after a breast augmentation, and jogging as from about 10 weeks. 3 months after a breast augmentation, as a rule, the healing process should have progressed to the extent that your body can cope with a full load again. From then on, very strenuous sports such as weight training, climbing, rowing and boxing will be possible. Whatever happens, you should wear a supportive sports bra that fits well for all kinds of sport. It goes without saying that our specialists in plastic and aesthetic surgery, Dr. Andrea Wolff and Dr. Isabel Edusei, and the practice team, will advise you personally and individually at all times on the treatment and healing process following your breast operation.

After breast surgery, you must refrain from doing any heavy lifting for approx. 12 weeks so as not to disturb the healing process. Sudden or unfavourable movements may cause painful injuries and complications, disturbing the way the wounds heal or the way the scars form. After a breast augmentation with implants, heavy lifting and the tensing of the trunk muscles associated with it could lead to a shifting of the newly inserted breast implants and thus have a long-term negative effect on the result of the operation.

After a breast augmentation with autologous fat, a bra which fits well and gives you gentle support while not squeezing too much is recommended. That way, the healing process in the breast tissue and the growth of the transplanted fatty tissue can be given optimum support without having pressure exerted or the blood flow in the area disturbed by a bra that cuts in or constricts. You should thus refrain from wearing a sports bra, underwired bra or compression bra in the first 6 weeks after breast augmentation with autologous fat.
As an alternative to a bra, your surgeon can fit you with a medical compression bandage directly after your breast augmentation with autologous fat, and that can then be changed at regular intervals. One advantage of such a bandage is that you can keep it on when you’re showering.