FAQ Breast implants:

Here you will find answers

to the most frequently asked questions

The Breast Implant Register is based on the Implant Register Act (IRegG), which was initiated by the Federal Ministry of Health and came into force on 1 January 2020. The registration of breast implants by healthcare facilities began in July 2024. The Implant Register Germany (IRD) is intended to give patients the opportunity to find out about the safety and quality of breast implants and medical care with implants. The register aims to improve the general provision of information and provide a transparent database.

Waterfall deformity is a potential complication that can occur after breast augmentation with breast implants, even in combination with a breast lift. With this deformity, sagging breast tissue slips over the firmly attached breast implant, causing the nipple to hang downwards. The name is derived from the side view, which resembles a waterfall. The cause is usually sagging connective tissue, and the ‘waterfall deformity’ can occur both immediately after breast augmentation with implants and for years afterwards. Prevention begins with the correct choice of surgical technique, such as the positioning of the implant or the combination of breast augmentation with a breast lift or the use of the ‘inner bra’ technique. Choosing the right implant in terms of shape, volume and material also plays a decisive role.
Our experienced specialists, Dr Andrea Wolff and Dr Isabel Edusei, will provide you with individual and competent advice to minimise the occurrence of this possible aesthetic complication. If you have a waterfall deformity, our plastic and aesthetic surgery specialists will be happy to advise you in detail on the various options for correction.

‘Bottoming out’ is a possible complication after breast augmentation with implants, in which the breast implant slips downwards due to gravity. This problem is characterised by the disappearance of the underbust crease or the downward movement of the implant, which often causes the areola to look upwards. If the scar has been placed in the underbust crease, it visually moves upwards. Bottoming out can be caused by material wear, especially with older saline or silicone implants. The choice of implants that are too large and too heavy or implant pockets that are too deep and large can also contribute to this. The implant then does not heal firmly in its implant site. For this reason, a competent consultation with a specialist in plastic and aesthetic surgery prior to breast surgery is of great importance in order to minimise the risks of a ‘bottoming out’ and to select the breast implant according to the physical conditions. If a ‘bottoming out’ is detected, correction is usually only possible through a new breast operation with the choice of lighter or smaller implants and/or an enlargement of the implant pocket upwards and fixation downwards to the side.

‘Rippling is an aesthetic complication following breast augmentation with implants and occurs when the implant surface appears as a visible, undulating structure under the skin. Rippling is more likely to occur if the implants are placed directly under the mammary gland. Particularly in the cleavage area, the breast implant is then not sufficiently covered by a delicate mantle of soft skin – for example in thin patients or after breast removal (mastectomy) for breast cancer. This visual complication can usually be prevented by positioning the implant under the pectoral muscle. The correction of ‘rippling’ usually requires breast surgery to be performed again. For example, the breast implant can then be moved to a new implant site under the muscle or autologous fat can be transplanted (‘lipofilling’) to improve soft tissue coverage.
Our plastic and aesthetic surgery specialists, Dr Andrea Wolff and Dr Isabel Edusei, will be happy to advise you personally on your options if you are concerned that you may have ‘rippling’.

Deciding on the right breast implant depends on various factors. These include personal wishes and expectations as well as physical requirements, such as the natural cup size, body type and the ‘pre-existing stress’ of the skin due to events such as pregnancy, breastfeeding or weight fluctuations. Our specialists in plastic and aesthetic surgery will be happy to take the time to advise you in detail about which breast implant with which shape and volume could be suitable in your individual case. During the second consultation, we will simulate various implant sizes using an implant case in preparation for the operation so that you can get a better idea of how your breasts might look in your bra and under your clothes after breast augmentation. You will also have the opportunity to hold real implants in your hands and get a feel for which implant would be most comfortable for you.
At our practice clinic, we always pursue an aesthetic goal with natural results so that you can feel completely comfortable.

There are different types of breast implants that differ in terms of volume, shape and material. Anatomical implants have a teardrop shape, which is modelled on the natural breast shape and concentrates the main volume in the lower part of the breast. A distinction is made between anatomical implants with a round and oval base. Round implants, on the other hand, have a round base and their highest projection in the centre of the implant. They may be suitable for patients who want a more even fullness and more volume in the upper part of the breast.
The volume of breast implants is measured in cubic centimetres.
The dimensions of the implant, namely height, width and projection, are also decisive for the result of breast surgery. The height defines the vertical distance from the base to the tip, while the width describes the horizontal diameter. The projection indicates the extent to which the implant is orientated forwards, i.e. how far it protrudes from the chest wall.
The selection of the right breast implant always depends on the patient’s aesthetic wishes and physical requirements. For the Wolff&Edusei Practice Clinic, the natural appearance of a breast is the ideal.
Our specialists in plastic and aesthetic surgery, Dr Andrea Wolff and Dr Isabel Edusei, provide individual and detailed advice on this.

The prices of breast implants may vary due to special shapes and materials, which we will inform you about during your consultation.

We are a manufacturer-independent practice for plastic and aesthetic surgery. We currently use breast implants from Polytech and Motiva. Both companies are characterised by the highest quality standards and offer breast implants with a high level of compatibility. The filling material is a cohesive (cross-linked) silicone gel, which imitates natural breast tissue as closely as possible.
The specially optimised surface of the implant shell ensures better tissue fixation, which reduces the risk of implant rotation. The implant surface also enables insertion via a small access point. The risk of capsular contractures (so-called capsular fibrosis), double capsule formation or late seroma (wound water formation in the implant site) is reduced.
Polytech breast implants are manufactured in Germany. A speciality in the implant range are the B-Lite implants, whose weight is considerably lighter than that of other silicone implants due to the tiny borosilicate hollow spheres, so-called microspheres, embedded in the standard silicone gel. They are nevertheless highly resistant. They are particularly suitable if the skin-soft tissue mantle is already sagging and cannot bear much weight.
Motiva’s breast implants are also particularly durable and robust. The Ergonomix range is characterised by a particularly optimised natural imitation of the look, feel and movement of the enlarged breast.
[Space]
However, not every breast implant is best suited to every breast.
We would be happy to advise you in detail on the various implant models in a personal consultation at our specialist practice for plastic and aesthetic surgery in Berlin.

Breast implants generally have a limited lifespan, although the newer generation of implants made from high-quality materials are theoretically designed to last forever. We cannot say with certainty how long the implants currently used by individual manufacturers will last.
All relevant data will only be recorded in the federal implant register from mid-2024.
Reasons for replacing breast implants can include wear and tear, ruptures (implants could burst or leak), physical changes due to e.g. weight changes, pregnancy or natural signs of ageing as well as complications such as capsular fibrosis or dissatisfaction with shape and size. In addition, technological advances in implant development could incentivise patients to replace their existing implants with more modern, improved models in a repeat breast operation.
In any case, regular medical examinations are important to monitor the condition of the implants and take action if necessary.