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 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.

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.

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.

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 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.

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 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.