FAQ Breast Augmentation:
Here you’ll find answers
to the most frequently asked questions

What is the purpose of the Keller Funnel (implant insertion funnel) in the PRESERVÉ™ method by Motiva?

The Motiva Insertion Sleeve is a cone-shaped device made of medical-grade plastic that allows silicone breast implants to be inserted smoothly and gently during breast augmentation, for example when using the PRESERVÉ™ method by Motiva with SmoothSilk® Ergonomix2® implants.

The implant slides through the Motiva Insertion Sleeve directly into the implant pocket without coming into contact with the skin or wound edges. This approach is known as the no-touch technique.

By avoiding direct contact with the skin, the technique aims to reduce the risk of bacterial contamination of the implant. The intention is also to help prevent potential infections and capsular contracture (hardening of the tissue surrounding the implant).

The Motiva Insertion Sleeve allows the implant to be inserted through a small skin incision, which may help limit the length of the resulting scar. In addition, the technique aims to minimise mechanical stress on the breast implant during insertion.

What is the purpose of the Motiva® Inflatable Balloon (balloon expander) in the PRESERVÉ™ method by Motiva?

The tissue channel created above the pectoral muscle using the Motiva® Channel Separator prepares the way for the subsequent insertion of the Motiva balloon expander, which gradually stretches the tissue before the SmoothSilk® Ergonomix2® implant is positioned using an insertion sleeve (Keller Funnel).

The Motiva® Inflatable Balloon is a sterile, single-use surgical instrument available in various sizes. It has been specifically developed for minimally invasive breast augmentation and reconstruction using the PRESERVÉ™ method by Motiva.

What is the purpose of the Motiva® Channel Separator (tunnel separator) in the PRESERVÉ™ method by Motiva?

The Motiva Channel Separator is a sterile, single-use surgical instrument specifically developed for minimally invasive breast augmentation and reconstruction using the PRESERVÉ™ method by Motiva.

The instrument measures approximately 24 cm in length and features a 2 cm wide shaft, designed for use through very small incisions, as well as a symmetrical design.

It features a specialised three-point tip system that enables circular, atraumatic movements. Rather than cutting or cauterising the tissue, the blunt instrument gently and precisely separates and displaces the natural tissue layers along the anatomical plane, creating a tunnel towards the intended position above the pectoral muscle.

What is the PRESERVÉ™ method for breast augmentation?

The PRESERVÉ™ method is a particularly tissue-preserving, minimally invasive technique for breast augmentation with implants, offered at Wolff & Edusei Clinic in Berlin. Dr med. Isabel Edusei and Dr med. Andrea Wolff are the first female surgeons to have supported the introduction of this innovative surgical technique in Berlin. Rather than using an open dissection technique to create an implant pocket, the breast tissue is stretched from within, above the pectoral muscle. A MOTIVA Ergonomix® 2 implant is then precisely inserted through a very small incision, almost like a keyhole procedure. The aim of this approach is to preserve the natural structures of the breast as far as possible and allow for a comparatively short recovery period.

What are the potential benefits of breast augmentation using the PRESERVÉ™ method and MOTIVA implants?

The combination of the PRESERVÉ™ method and modern MOTIVA Ergonomix® 2 implants allows for breast augmentation that aims to preserve the surrounding tissue as much as possible, with the goal of achieving a natural-looking result.

Potential benefits include:

  • Preservation of tissue structures and maintenance of natural breast stability as far as possible
  • Preservation of the pectoral muscles
  • Small surgical scars due to a limited incision
  • Potentially less pain and discomfort following the procedure
  • A comparatively short recovery period, depending on the individual healing process
  • A greater visual volume effect, even with smaller implants
  • A natural-looking breast shape and a soft feel

What is the difference between the PRESERVÉ™ method and conventional breast augmentation?

In conventional breast augmentation, the implant pocket is created by surgically dissecting the breast tissue. Depending on the technique used, this may involve greater stress on the surrounding tissue structures and a longer recovery period. If the implant is placed beneath the pectoral muscle, movement-related discomfort may occur, particularly during physical activity.

The PRESERVÉ™ method is one of the various breast augmentation techniques offered at Wolff & Edusei Clinic in Berlin. The main difference lies in how the implant pocket is prepared: rather than extensively dissecting the tissue, the required space is gradually created through controlled stretching using specially designed instruments. The implant, often a MOTIVA Ergonomix® 2 implant, is then inserted through a small incision in the inframammary fold (the crease beneath the breast).

This approach focuses on preserving the existing tissue structures as far as possible. The limited tissue dissection aims to minimise surgical stress on the breast tissue. Depending on individual circumstances, this may offer benefits in terms of postoperative discomfort and recovery time. The aim is to achieve a breast shape that harmonises with the natural proportions of the body and feels as soft as possible.

What makes MOTIVA Ergonomix® 2 implants special for breast augmentation?

MOTIVA Ergonomix® 2 implants are characterised by their soft, biocompatible gel and elastic shell. They can adapt to body movements. When lying down, they appear rounder, while in an upright position, they take on a teardrop-shaped, anatomical form that resembles the natural shape of the breast.

The specially designed SmoothSilk® surface is intended to promote good compatibility with the surrounding tissue and aims to help reduce the risk of capsular contracture. Combined with the tissue-preserving PRESERVÉ™ method, breast augmentation can be performed by our specialists in Plastic and Aesthetic Surgery, Dr med. Andrea Wolff and Dr med. Isabel Edusei, with a high degree of precision and through a small surgical incision.

Who is suitable for breast augmentation using the PRESERVÉ™ method?

Breast augmentation using the PRESERVÉ™ method is suitable for patients who wish to achieve a natural-looking breast shape and prefer a tissue-preserving surgical approach.

Whether this procedure is suitable for you personally depends on your individual anatomy and aesthetic expectations. This surgical technique is not appropriate for every patient. In some cases, combining the procedure with a breast lift (mastopexy) and autologous fat transfer (lipofilling) may be beneficial to achieve the best possible aesthetic outcome.

At Wolff & Edusei Clinic in Berlin, Dr Isabel Edusei and Dr Andrea Wolff provide personalised consultations to help you choose the most suitable surgical technique and implant size for your individual needs. You can conveniently book your consultation appointment online via our website.

How is breast augmentation performed using the PRESERVÉ™ method?

At Wolff & Edusei Clinic in Berlin, the process begins with a physical examination and a comprehensive consultation with one of our specialists in Plastic and Aesthetic Surgery, Dr med. Andrea Wolff or Dr med. Isabel Edusei. Once you have decided to undergo the procedure, breast augmentation using the PRESERVÉ™ method is usually performed under sedation (twilight anaesthesia) at our Berlin clinic.

The procedure can be combined with autologous fat transfer (known as lipofilling) to create a smoother transition between the natural breast tissue and the implant if there is insufficient tissue coverage, as the implants are positioned above the pectoral muscle. MOTIVA Ergonomix® 2 implants are inserted through a small incision. Depending on the individual findings, the procedure may be performed on an outpatient basis.

How long does the healing process take after breast augmentation using the PRESERVÉ™ method?

After breast augmentation using the PRESERVÉ™ method, a compression bra specially fitted to the patient is applied and should be worn for the following six weeks. It supports the healing process, provides stability and ensures a comfortable fit during the sensitive initial recovery phase. A special stabilising band, known as a Stuttgart belt, helps stabilise the implants from above and can usually be removed after one week.

Thanks to the tissue-preserving, minimally invasive surgical technique and modern pain management, most patients generally feel comfortable again after a short period. They can usually resume social activities immediately and return to work after just a few days. Light sporting activities can generally be resumed after three weeks. However, strenuous sports and activities involving overhead movements, such as tennis and volleyball, should be avoided for six weeks.

Most of our patients find that the greatest challenge is having to sleep on their backs for six weeks after surgery. This recommendation generally applies to all breast surgery procedures. Our specialists in Plastic and Aesthetic Surgery, Dr Isabel Edusei and Dr Andrea Wolff, will provide you with detailed, personalised advice so that you know what to expect during your individual recovery period.

When will the final results of breast augmentation with MOTIVA implants be visible?

The initial results are usually visible shortly after surgery. The aesthetic outcome continues to develop throughout the healing process as swelling gradually subsides and the tissue adapts to the implants. Depending on individual anatomical factors and the ageing process, MOTIVA Ergonomix® 2 implants may continue to settle into a lower position for up to two years after breast augmentation.

What does aftercare involve following breast augmentation at Wolff & Edusei Clinic in Berlin?

All follow-up examinations and aftercare following breast augmentation using the PRESERVÉ™ method take place directly at our clinic in Berlin. The first follow-up appointment is usually scheduled within the first two days after surgery. During this appointment, the surgical wounds are examined and the fit of the compression bra is checked. Further follow-up examinations are then arranged at individually determined intervals, typically after approximately two weeks (suture removal) and six weeks (approval to stop wearing the compression bra).

Our specialists in Plastic and Aesthetic Surgery, Dr Andrea Wolff and Dr Isabel Edusei, personally support you from your initial consultation through surgery to complete healing, with the highest standards of safety, natural-looking results and aesthetics.

What does “minimally invasive breast augmentation” mean?

Minimally invasive breast augmentation refers to a particularly tissue-preserving surgical technique that requires only very small skin incisions in the inframammary fold (the crease beneath the breast).

Rather than extensively dissecting the tissue with a scalpel, a specially designed instrument (Motiva® Channel Separator) is used to gently separate the breast tissue from within, creating a tunnel without cutting through the tissue. The Motiva® Inflatable Balloon is then used to carefully stretch the tissue to the required volume, allowing the implant pocket to be precisely prepared.

Why is a personal consultation particularly important before breast augmentation with PRESERVÉ™?

Breast augmentation is always a very personal decision. In addition to medical considerations, questions relating to body proportions, the desired outcome, the healing process and aftercare also play an important role.

Particularly with modern surgical techniques such as the PRESERVÉ™ method, it is important to carefully assess whether the procedure is genuinely suitable for your individual circumstances. Not every anatomical situation can be treated using the same approach.

At Wolff & Edusei Clinic in the heart of Berlin, Dr med. Andrea Wolff and Dr med. Isabel Edusei therefore take the time to provide honest, professional and personalised consultations tailored to your individual needs.

How much does breast augmentation with MOTIVA® implants and the PRESERVÉ™ method cost in Berlin?

The cost of breast augmentation using the PRESERVÉ™ method depends on various factors, including your individual anatomy, the complexity of the procedure, the choice of implants and the extent of the planned treatment. It is therefore not advisable to provide a general price estimate.

During a personal consultation at Wolff & Edusei Clinic in Berlin, you will receive a transparent assessment of the expected costs and a clear overview of the services included.

It is also possible to finance medical treatment through external finance providers by paying in instalments. Dr Andrea Wolff and Dr Isabel Edusei will be happy to discuss the options available to you during your initial consultation.

Are long-term follow-up examinations advisable after breast augmentation with MOTIVA® implants?

Yes, regular follow-up examinations are advisable even after the initial healing phase. Breast implants should be monitored by a medical professional in the long term to identify and assess any changes at an early stage.

These examinations focus not only on the implants themselves but also on the surrounding tissue, breast shape and any individual symptoms that may develop over time. The recommended intervals between follow-up examinations depend on your personal circumstances.

At Wolff & Edusei Clinic, we therefore regard aftercare not merely as short-term wound monitoring, but as responsible, specialist medical care that extends well beyond the surgical procedure.

How long do MOTIVA® breast implants last?

Breast implants are high-quality medical devices, but they are not necessarily expected to remain unchanged for a lifetime. How long implants can remain in the body depends on various factors, including the condition of the implants, individual changes in the surrounding tissue and other factors that may arise over time.

Routine replacement after a fixed number of years is not necessary for every patient. At present, it is not possible to predict how average implant replacement rates will develop in the future. What matters most is regular medical monitoring and each patient’s individual clinical circumstances.

We recommend registering your implants with Establishment Labs (the manufacturer of the well-known Motiva® Implants) after your surgery. Registration confirms the authenticity of your implants and activates the warranty programmes. Registration is completely free of charge but must be completed within 90 days of your surgery for the extended warranty cover to be valid.

You will find all the necessary information on your Motiva ID Card (patient implant card), which you will receive from Wolff & Edusei Clinic after your surgery.

  • Serial Number (SN): A unique 10-digit number (format: 00000000-00) for each implant.
  • Validation Code (VC): The corresponding code provided on the card.
  • Alternatively, for models equipped with a microchip (Qid® technology): The Electronic Serial Number (ESN).

At Wolff & Edusei Clinic, Dr Isabel Edusei and Dr Andrea Wolff will provide you with detailed information about appropriate long-term follow-up care and explain when breast implant replacement may need to be considered for medical reasons.

Can MOTIVA® implants shift after breast augmentation?

As with any breast augmentation procedure, changes in implant position cannot be completely ruled out following surgery with MOTIVA® implants. The risk depends on several factors, including the surgical technique used, tissue quality, the healing process and adherence to aftercare recommendations.

The PRESERVÉ™ method takes a gentle and precise approach to preparing the implant pocket. Nevertheless, long-term implant stability cannot be guaranteed in every case. Careful surgical planning, following aftercare recommendations and attending regular follow-up examinations are therefore particularly important.

Motiva Ergonomix2® implants may continue to settle into a lower position for up to two years after surgery.

Dr Wolff or Dr Edusei will explain which factors may be relevant to your individual circumstances during a personal consultation.

When can I wear an underwired bra again after breast augmentation with MOTIVA® implants?

An underwired bra should initially be avoided after breast augmentation to allow the tissue to heal without disruption or additional pressure. Instead, a special compression bra is worn for approximately six weeks to stabilise the breasts and support the healing process.

During your follow-up appointments at Wolff & Edusei Clinic, you can discuss with Dr Andrea Wolff and Dr Isabel Edusei, both specialists in Plastic and Aesthetic Surgery, when it is appropriate to switch to an underwired bra.

How long should a compression bra be worn after breast augmentation with MOTIVA® implants and the PRESERVÉ™ method?

After breast augmentation using the PRESERVÉ™ method, a specially fitted compression bra is worn for approximately six weeks. It supports the breasts during the early healing phase, stabilises the position of the implants and helps the tissue gradually adapt to the new breast shape.

During your follow-up appointments, Dr Isabel Edusei and Dr Andrea Wolff will discuss what you should bear in mind during this period and when it may be appropriate to gradually switch to other types of bras.

When can I go back into the sun or use a sunbed after breast augmentation with MOTIVA® implants and the PRESERVÉ™ method?

During the first three months after breast augmentation, intensive UV exposure should be avoided as far as possible. This includes both direct sunlight and the use of sunbeds.

Fresh scar tissue is particularly sensitive to UV radiation. Exposure may cause permanent discolouration that can be difficult to correct later. Heat can also affect the healing process and increase swelling. Even after three months, the scar area should be consistently protected with a high sun protection factor (SPF).

When can I shower, take a bath or use a sauna again after breast augmentation with MOTIVA® implants and the PRESERVÉ™ method?

Whether and when you can shower after surgery depends on your individual healing process and the condition of the wounds. In many cases, gentle showering is possible again after a short period (approximately five days), provided your surgeon has given approval. It is important to protect the fresh wound areas and follow the aftercare instructions.

Baths, saunas, steam rooms and swimming pools should be avoided during the first three months after breast augmentation. Heat and moisture can affect wound healing and contribute to swelling.

When can I sleep on my side again after breast augmentation using the PRESERVÉ™ method?

The question of sleeping positions is particularly important for many patients after breast surgery or breast augmentation. When you can sleep on your side again depends on the healing process, any feeling of tightness in the breast area and your individual surgical circumstances. As a general rule, patients should sleep on their backs for approximately six weeks after breast surgery, which can be challenging for those who normally sleep on their side or stomach.

During the first few days following the procedure, a gentle sleeping position is usually recommended. When it is appropriate to change your sleeping position will be discussed with you individually during your follow-up appointments.

At Wolff & Edusei Clinic, Dr Andrea Wolff and Dr Isabel Edusei will provide you with clear recommendations tailored to your individual recovery process.

How does the PRESERVÉ™ method differ from traditional breast augmentation?

The main difference lies in how the space for the implant is created.

In traditional breast augmentation procedures, the breast tissue is carefully dissected using surgical instruments to create a pocket for the implant.

The PRESERVÉ™ method takes a different approach: after the skin incision, the tissue is gently and carefully stretched from within using specially designed instruments. This gradually creates a suitable space for the implant.

The implant can then be inserted through a small incision via a prepared tissue tunnel. The elastic structures of the breast tissue surround the implant. The aim is to preserve the natural structures of the breast as much as possible and minimise stress on the surrounding tissue.

Which method is most suitable depends on your individual circumstances and will be discussed during a personal consultation at Wolff & Edusei Clinic.

Should I expect severe pain after breast augmentation using the PRESERVÉ™ method?

Pain after breast augmentation varies from person to person. Many patients describe the discomfort during the first few days as a feeling of tightness or pressure in the breast area. Localised pain may also occur around the incision site.

As the PRESERVÉ™ method is designed to preserve the surrounding tissue as much as possible, postoperative discomfort is generally perceived as relatively mild compared with other surgical techniques. However, the actual level of discomfort always depends on individual circumstances and personal pain sensitivity.

At Wolff & Edusei Clinic, you will receive structured aftercare and pain management tailored to your procedure to ensure that you are supported as effectively as possible during the initial healing phase.

Is breastfeeding possible after breast augmentation with MOTIVA® implants and the PRESERVÉ™ method?

In principle, breastfeeding is possible after breast augmentation with MOTIVA® implants using the PRESERVÉ™ method. Whether the ability to breastfeed is preserved after breast augmentation depends on several factors, including the surgical technique, implant placement and individual anatomical characteristics. It is therefore not possible to make a general statement.

The PRESERVÉ™ method takes a tissue-preserving approach. However, even with tissue-sparing surgical techniques, it cannot be guaranteed that the ability to breastfeed will remain unaffected in every case. There are numerous factors unrelated to breast surgery that can impair or prevent breastfeeding, making it difficult to determine the underlying cause in individual cases.

If you are planning to have children in the future, it is important to raise this topic during your consultation. Dr Edusei and Dr Wolff carefully consider such matters when planning your individual treatment.

Will breast sensation be preserved after breast augmentation using the PRESERVÉ™ method?

Many patients are concerned about whether sensation in the breasts or nipples may change after breast augmentation. In general, changes in sensitivity can occur after any breast surgery, regardless of the technique used.

The PRESERVÉ™ method is designed to treat the surrounding tissue as gently as possible. Nevertheless, it cannot be guaranteed that sensation will remain unchanged. Changes in sensitivity may be temporary, but in some cases they can be long-lasting or permanent.

Our specialists in Plastic and Aesthetic Surgery at Wolff & Edusei Clinic will explain the potential risks and complications associated with breast augmentation using the PRESERVÉ™ method during your personal preoperative consultation.

What is a Lucky-8 stitch, and why does the incision often appear indented for some time after breast augmentation using the PRESERVÉ™ method?

To secure and reinforce the inframammary fold and thereby reduce the risk of the implant shifting downwards (bottoming out), it is often necessary to use a special suturing technique known as the Lucky-8 stitch. This suture is placed in a figure-of-eight pattern and anchored deep within the tissue. Initially, it causes an indented scar and may result in discomfort for some time after surgery. By precisely closing the incision in the inframammary fold, the implant pocket can be carefully closed following breast augmentation using the PRESERVÉ™ method.

How large are the scars after breast augmentation using the PRESERVÉ™ method?

As the PRESERVÉ™ method uses a small surgical incision, the resulting scar is generally relatively short. However, its exact length depends on several factors, particularly the size of the implant selected, individual anatomical characteristics and the circumstances of the procedure.

Scar development also varies from person to person. Factors such as skin characteristics, individual wound healing and scar care all play an important role.

At Wolff & Edusei Clinic, Dr Andrea Wolff and Dr Isabel Edusei, both specialists in Plastic and Aesthetic Surgery, also provide postoperative care and detailed advice on how to support the healing process and promote optimal scar development.

Where are the scars located after breast augmentation using the PRESERVÉ™ method?

In breast augmentation using the PRESERVÉ™ method, the implant is inserted through a small incision in the inframammary fold (the crease beneath the breast). The exact position of the incision depends on individual anatomy and surgical planning, for example in cases of pre-existing breast asymmetry.

At Wolff & Edusei Clinic, the incision is positioned to provide the least invasive access possible to the surgical area while ensuring that the resulting scar follows the natural contours of the breast as closely as possible.

Dr Edusei or Dr Wolff will explain the expected position of the scar in your individual case during a personal consultation, providing clear and detailed information tailored to your circumstances.

What is the “tenting effect” in breast augmentation using the PRESERVÉ™ method?

The so-called “tenting effect” describes a visual phenomenon in which the apparent breast volume after augmentation looks significantly greater than the actual volume of the implant would suggest. This is because the stretched breast tissue extends over the implant like a tent.

The implants can appear around 25% larger than their actual volume would suggest, as they are not compressed by the pectoral muscle. For example, a breast implant with a volume of just 200 cc can create a visual effect comparable to that of a 250 cc implant.

This makes it possible to achieve a considerable visual increase in breast volume even with implants that are considered relatively small and lightweight by conventional standards. These implants can offer a high level of comfort and place less long-term strain on the surrounding tissue. Women who are professionally or physically active, as well as women with young children who may be more hesitant about breast augmentation involving a foreign body, often consider this a significant advantage of the Motiva PRESERVÉ™ method.

Which implant sizes are available for breast augmentation using the PRESERVÉ™ method?

Which implant size is suitable cannot be determined in general terms. It depends on several factors, including your body shape, the amount of tissue available to cover the implant, the width of the breast base and your desired outcome. In practice, small to medium-sized implants are primarily used. The maximum implant volume is 350 cc.

The same applies to the PRESERVÉ™ method: not every implant size is suitable for every anatomical situation. The aim is not simply to achieve a particular volume, but to obtain a result that is compatible with your breast shape, tissue characteristics and overall body proportions in the long term.

At Wolff & Edusei Clinic, Dr Isabel Edusei and Dr Andrea Wolff take the time to work with you to select an implant size that is medically appropriate and aesthetically harmonious.

What type of anaesthesia is used for breast augmentation with the PRESERVÉ™ method?

At Wolff & Edusei Clinic in Berlin, breast augmentation using the PRESERVÉ™ method is generally performed under sedation (twilight anaesthesia). Depending on pre-existing medical conditions and the patient’s preferences (e.g. anxiety disorders), the procedure can also be performed under local anaesthesia with accompanying monitoring or under general anaesthesia.

Before the implants are inserted, the breast tissue is infiltrated with an aqueous solution (known as a tumescent solution) containing both agents to reduce bleeding and local anaesthetics. As a result, the procedure can generally be considered relatively low in pain.

Twilight anaesthesia generally allows for a very comfortable surgical experience.

The costs are the same regardless of the type of anaesthesia provided by our anaesthesia team.

Is the PRESERVÉ™ method also suitable for breast augmentation combined with a breast lift?

Yes, combining the PRESERVÉ™ method with a breast lift is possible and depends on the individual breast shape and the extent of any excess skin. Not every breast augmentation combined with a lift is suitable for the same surgical approach.

If significant lifting or reshaping of the breast is required in addition to augmentation, the most appropriate surgical technique must be assessed on an individual basis, taking both medical and aesthetic considerations into account. The key priorities are always safety, preservation of tissue and achieving a result that is suited to your individual anatomy.

Dr Wolff or Dr Edusei will discuss the options available in your individual case with you in detail during a personal consultation at Wolff & Edusei Clinic in the heart of Berlin.

What risks and possible complications are associated with the "inner bra" method?

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.

How does the cost of breast augmentation with an internal bra differ from other breast augmentation methods?

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.

For whom is the "inner bra" technique suitable for breast augmentation?

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.

What are the advantages of using an "inner bra" for breast augmentation?

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”.

What is "breast augmentation with an internal bra" and how does it work?

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.

What is an "inner bra"?

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.

Which incisions can be used for breast augmentation with implants?

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.

Breast augmentation - the first days after ...

One of the most frequently performed cosmetic operations is breast augmentation. The surgical procedures and products used at the Wolff & Edusei Clinic meet the highest and most modern standards. However, as breast surgery, including anaesthesia, is still a surgical procedure on the body, sufficient recovery and rest time should be ensured after breast augmentation. This also means that all movements should initially be carried out slowly and with caution. This means, among other things, that the arms should not be moved above shoulder height, the torso should not be strained too much and a supine sleeping position should be chosen. Nevertheless, early mobilisation on the day of the operation is important, and under no circumstances should a convulsive recovery position be adopted. Daily showering is possible immediately after breast surgery from abdominal level. All areas above the abdomen should be cleaned in the form of a ‘cat wash’. In addition, a compression bra and possibly a Stuttgart girdle must be worn after breast augmentation. However, our plastic and aesthetic surgery specialists Dr Andrea Wolff and Dr Isabel Edusei will always advise you personally and individually. Even if no dramatic pain is to be expected after breast surgery, the sensation of pain is always perceived very individually. We will therefore always provide you with painkillers to be taken according to a treatment plan.
The first follow-up check will take place on the first day after the breast operation. This is also when the dressing is changed for the first time. Further check-ups, including the dressing change, will take place at regular intervals thereafter.

How soon after weaning is a breast augmentation possible?

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.

How soon after pregnancy is a breast augmentation possible?

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.

How long will I be off sick after a breast augmentation?

As breast augmentation is usually a so-called cosmetic operation and therefore not a medically indicated procedure, the costs of this breast surgery are usually neither covered by health insurance nor is it possible to take sick leave afterwards. As with any other operation, your body still needs sufficient recovery time after breast augmentation. Depending on your professional or personal stress (e.g. if you have small children in the family), you should plan at least 2 weeks of absolute rest. In the case of heavy physical strain (e.g. in the care sector or in catering), a significantly longer downtime should be planned, at least for special activities. Our plastic and aesthetic surgery specialists, Dr Andrea Wolff and Dr Isabel Edusei, and the practice staff will be happy to advise you personally on the recovery period that is advisable in your individual case.

Will I have to wear a chest strap after a breast augmentation?

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.

How long do I need to take it easy after a breast augmentation?

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.

How long should I refrain from sport after a breast augmentation?

After breast augmentation surgery, the body needs sufficient time for the internal and external wounds to heal optimally. It is therefore essential to take a break from sport for the first 3 weeks after breast surgery. After consultation with our plastic and aesthetic surgery specialists, light leg exercises without jolting or straining the torso muscles are possible after 3 weeks. It is also generally advisable to take it easy physically in the first 6 weeks after breast surgery and not to lift any heavy loads so as not to disrupt the wound healing process and possibly have a negative effect on the surgical result. After around 6 weeks, a build-up phase begins with light training, which can be gradually increased in intensity depending on the symptoms. About 8 weeks after breast augmentation, swimming is usually ok again, as is jogging from about 10 weeks. 3 months after a breast augmentation, the healing process should be so far advanced that the body is usually fully resilient again. Physically strenuous sports such as weight training, climbing, rowing or boxing are now possible again. In any case, a well-fitting and supportive sports bra should be worn for every type of sport. Of course, our plastic and aesthetic surgery specialists, Dr Andrea Wolff and Dr Isabel Edusei, and the practice team will always advise you personally and individually on the treatment and recovery process of your breast surgery.

Why must I not lift anything heavy after a breast augmentation?

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.

What kind of bra can I wear after a breast augmentation with autologous fat?

After breast augmentation with autologous fat, a well-fitting, slightly supportive and non-restrictive bra is recommended. In this way, the healing process of the breast tissue and the growth of the transplanted fatty tissue can be optimally supported without exerting pressure and disturbing the blood circulation of the area with constricting bras. You should therefore refrain from wearing a sports bra, underwired bra or compression bra for the first 6 weeks after breast augmentation with autologous fat.
As an alternative to a bra, your surgeon can also apply a plaster bandage immediately after breast augmentation with autologous fat, which is then changed at regular intervals. These can also remain on the body while showering.

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