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Breast operation procedure

The result of a breast enlargement heavily depends on the chosen form and size of the breast implants. The manner of the surgical execution of the breast enlargement, the so-called method of breast surgery, has a deciding influence on the aesthetic result.

Position of the breast implants

Your individual anatomical requirements are crucial in deciding where to position the implants. I distinguish between two implant positions:

  • On the muscle – with this position, a part of the breast muscle connective tissue is used (subfascial)
  • Under the breast muscle (subpectoral)

In most cases, I position the implants under the muscle, so subpectoral. My operation technique is a further development of the so-called Dual Plane / Multi Plane Method, by Tebbets in the USA. This method of breast surgery makes very attractive breast shapes and profiles possible. The results of subfascial positioning are as beautiful as those with subpectoral positioning if the specific anatomical requirements are fulfilled: The soft surface area and the prior mammary gland volume are the deciding criteria.

It is possible to position the implant completely under the muscle. I, as well as Tebbets, advise you against this method. This method contains risks of muscle scarring in the lower and external area. That can have many disadvantages for you.

Ways of entrance in a breast enlargement operation

There are many ways of entrance in a breast enlargement operation. All ways of entrance have advantages and disadvantages. My concept: The most beautiful and perfect individual result must be attained. Therefore, I choose to make the incision where I can use the best surgical technique to create an attractive result. I follow the argumentation of Per Helden in Stockholm and choose to make the incision in the inframammary fold. My main objective is a perfect, aesthetic, meaningful result with attractive breasts. Exact operation planning can plan for the incision to be in the inframammary fold in such a manner that the scar is hidden in the crease, and is unnoticeable as possible. Due to my plastic-surgical stitching technique, these very fine lines will heal to be almost unnoticeable and, according to experience, become invisible over time.

The incision on the edge of the nipple can be advantageous if a reduction of the nipple is desired at the same time. I choose this manner of entrance then and under certain conditions, if previous scars are already available, e.g. with breast implant exchanges.

But this method has the following disadvantages:

High risk of sensory disturbances. Compared to the conventional operation procedure, I dissect between the mammary gland tissue and the subcutaneous tissue, in order to care for the mammary gland. Injury of milk glands and milk ducts has a higher risk of infection. Furthermore, in the healing process, internal scar tissue can result in calcification and thus be misdiagnosed in subsequent mammographs.

Transaxillary incisions, i.e. incisions in the armpit, have substantial medical disadvantages. To date, I have seen no aesthetically pleasing results using this method. Therefore, I do not carry it out.

The priority lies in the result. A raised scar in the armpit is certainly not appealing. The lymph flow can be disrupted, which is important for the topic of breast cancer risk.

Breast enlargement with Macrolane?

Along with surgical breast enlargement, many doctors offer non-surgical treatment, which is supposed to lead to an enlargement of the breasts without surgery. For your safety, I do not offer you these procedures for breast enlargement.


A breast enlargement with a Macrolane injection should still be viewed very critically because a final assessment of the safety to health regarding long-term risks like breast cancer is yet to be completed. Q Med, the company that produces Macrolane, has denied responsibility for liabilities for Macrolane in relation with X-ray diagnoses for breast cancer! This information alone should alarm you and the doctors who still use Macrolane! As not really an alternative to breast enlargement, this method only causes very moderate and small breast enlargements. Unsightly lumps often appear after treatment. The injection with Macrolane normally has to be repeated again after 9-12 months, which means a doubling of costs until the next year.

Female breasts can fundamentally be enlarged with body fat as well. However, this only really works well with reinforced stem cells. These stem cells lead to a better circulation of the fat tissue, the transferred fat cells. An increased risk of breast cancer is still not completely ruled out with a fat transfer of stem cells. The German cancer society in Heidelberg, as well as the international plastic surgery association, therefore advises against a breast enlargement using body fat and stem cells. I am committed to that advice, you should also decide against it.