Breast augmentation with implants: finally feel good again

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The appearance of the female breast, its size and shape are among other things a central component of your female identity. Do you want to be able to wear any dress you like? Do you feel unattractive because of a small breast? The reasons for breast augmentation with implants are individual and very different. Below we explain what you should know about breast augmentation with implants.

Decide on a neckline that suits you:

  • Finally be able to wear low cut dresses
  • Balance the body through the right proportions
  • Increase attractiveness through breast augmentation
  • Be able to do without annoying push-up bras



Centerplast is your specialist for breast surgery with implants. Feel free to schedule an individual consultation for your breast augmentation.


Beautiful proportions of the female breast

Harmonious proportions and symmetry of the breast are perceived as beautiful and sensual. Shape, size and the position of the nipple on the breast are essential features that influence the perception of beauty.


Implant calculator: determine implant size free of charge


What does breast augmentation with implants mean for you?

Commonly expressed desires include a more feminine silhouette, a natural balance to the rest of the body, a better love life, wearing clothes without worry, and a more attractive appearance. Do you feel the same way?

Aesthetic breast augmentation: your path to wellness decolonization

Breast augmentation is one of the most common aesthetic procedures in the world. It is estimated that over 1.5 million breast augmentations were performed in 2017. Scientific studies show that breast augmentation is usually associated with high patient satisfaction and a significant improvement in quality of life.

Breast augmentation by means of implants is one of the classic medical procedures in plastic and aesthetic surgery, which makes it possible to achieve the desired size.

Breast augmentation or breast lift after pregnancy?

Perhaps the following sounds familiar? Often, after pregnancies or severe weight loss, women want to regain the lost volume of their breasts and their previous cup size. In the event that a correction of the breast shape is desired at the same time, a breast augmentation can also be combined with a breast lift. So you can have both.

On this page you will find detailed information on surgical methods for breast augmentation with implants and receive help in deciding on the right implant for your needs. In addition, common questions are answered and you will receive a lot more information and details that you should know if you want a safe breast augmentation with a natural look. For the creation of an individual treatment plan you have of course the possibility to contact us for a first consultation.

What you should know about breast implants

Implants are classified on the one hand according to their shape, i.e. whether they are anatomical (teardrop-shaped) or round, and and furthermore on the basis of size, outer wall and the filling material selected. CE and FDA certifications attest to compliance with European and American quality standards. In order to select the right implant, your change requests and your individual anatomical conditions of the body should be taken into account.


Implants can be inserted into the breast through small incisions in various ways. Each way, also called access, has different advantages and disadvantages. Shown is the access in the underbust crease (1), the access around the areola (2) and the access via the axilla (3).

Facts about breast augmentation with implant: Your overview

OP duration 1h
Anesthesia General anesthesia / Twilight sleep / Fast recovery surgery
Clinic stay Outpatient
Costs to the price calculator
Aftercare 6 weeks
Thread tension Self dissolving threads
Socially acceptable after 5 days
Additions or alternatives Hybrid breast augmentation / breast augmentation with autologous fat



Which reference points are in your case used in the examination of the breast?

1.clavicle middle
2. Thrush pit (Jugulum)
3. Cleavage
4. Upper inner chest quadrant
5. Gutter between the breasts
6. Nipple
7. Breastbase
8. Underbust crease
9. Elbow

You can probably understand it well: Changes in breast shape and bust size can be emotionally stressful after puberty or in later life. Certain features and proportions are generally associated with beauty, harmony, youthfulness and health. In order to get a comprehensive picture, various reference points are measured during the investigation. These individually different characteristics are taken into account when creating a treatment plan.

This is how we make the Selection of the right breast implant

When choosing the right implant, decisions must be made regarding shape (round or teardrop), projection (implant thickness), surface (outer wall), filling material (inner material), strength level, manufacturer and size. We will be happy to advise you on how to achieve the optical result of a natural breast in the desired size. Take a look here at what implants can be used for breast augmentation.

A Ergonomic implant under the pectoral muscle
B Ergonomic implant over the pectoral muscle
C Round implant over the pectoral muscle

1.subcutaneous fat tissue
2. Greater pectoral muscle
3. Third rib
4. Cleavage
5. Intercostal nerves
6. Lesser pectoral muscle
7. Round implant
8. Mammary gland
9. Intercostal muscle
10. outer pleura


The position and shape of a breast implant affect the contour of the breast. Teardrop-shaped (anatomical) implants have more volume in the lower half of the breast (breast pole). These implants offer you the advantage of a natural transition in the décolleté. Unlike round implants, teardrop-shaped breast implants have a rough surface to maintain your alignment (more volume at the bottom than the top). The rough surface is suspected to cause blood cancer in rare cases. To make the implant less visible or palpable in the décolleté, it can be inserted under the large pectoral muscle. The large pectoral muscle is large enough to cover the entire implant in only a quarter of women (Madsen et al., 2015, Ann Plast Surg). In most cases, the origin of the large pectoral muscle extends to the 6th rib. The origin of the small pectoral muscle extends from the third to the fifth rib.

Breast implant facts
Different forms of the implant Anatomical breast implants or implants in the form of drops: natural shape, possible risk of twisting the implant. Anatomical breast implants therefore have a rough surface. Round breast implants: full décolleté. Round implants can accordingly have a smooth surface.
Implant thickness Medium projection: most natural results. High projection: tends to be a full shape.
Outer wall of the implant Silicone shell with a smooth surface: tends to be smaller access, increased risk of capsular contracture. Silicone cover with a rough surface: adheres better to the tissue (prerequisite for using anatomical implants), increased risk of ALCL.
Filling material of the implant Silicone: usually dimensionally stable material, lower risk of wrinkling. Physiological saline solution: poorly dimensionally stable, increased risk of wrinkling.
Degree of strength of the implant Low strength: more natural shape, less projection. High strength: unnatural shape, especially when lying down, high projection.

1. nagor® / shape: round; implant thickness: high profile; outer wall: micro-structured; volume: 240 ml
2. Eurosilicone® / Shape: round; Implant thickness: high profile; Outer wall: smooth; Volume: 350 ml
3. Eurosilicone® / Shape: teardrop-shaped; Implant thickness: moderate projection; Outer wall: micro-structured; Volume: 235 ml

4. motiva Ergonomix® / shape: ergonomic; implant thickness: corsé; outer wall: micro-structured; volume: 380 ml
5. motiva Ergonomix® / shape: ergonomic; implant thickness: demi; outer wall: micro-structured; volume: 300 ml
6. motiva round® / shape: round; implant thickness: demi; outer wall: micro-structured; volume: 300 ml

Breast augmentation (1) can be performed in different ways and can be combined with autologous fat treatment. The types of breast augmentations produce different fillings of the décolleté. For a smooth and natural transition between the upper chest border and the collarbone, the implant can be placed below the pectoral muscle (2). Alternatively, breast augmentation can be combined with autologous fat treatment (3). For more fullness of the décolleté, in addition to the location of the implant under the pectoral muscle, autologous fat treatment can be performed (4).

The size of a female breast is naturally proportionate to her physique. Different sizes of female breast occur in different frequency in the population. Average sizes are the most common sizes. The most common sizes correspond to the images of the diagonal from the bottom left to the top right of the image. For a natural result, we recommend aiming for an average sized breast.

Los Deline © liquid implant

The tissue filler Los Deline© was developed in 2005 and initially marketed under the name Aquafilling© (Biomedica, Prague, Czech Republic). The colorless, transparent gel consists of 98% saline and 2% of a multiple bond of acrylamide and N,N′-methylenebisacrylamide. There may be minimal differences in the bond structures between the structure of Los Deline© and other polymethyl methacrylate (PMMA) tissue fillers. However, the overall composition of these tissue fillers appears to be very similar [1]. With other PMMA tissue fillers (for example Aquamid®) complications such as inflammation, pain and nodule formation were seen in over 18 percent of cases [2]. The complications of Aquafilling© occur afterwards, in the time frame of 5 months up to 12 years after the injection (on average 3 years).

The complications occasionally have to be treated by surgery. The reasons for surgery are hardening in more than 80 percent, pain in more than 50 percent and inflammation in 7 to 8 percent (Cheng N, et al. 2002, Aesthet Plast Surg). The enlargement of a breast by injecting a liquid implant is seductive. All too often, these treatments are offered by doctors who, unlike plastic surgeons, are not proficient in alternative breast augmentation techniques.

Non-invasive procedures are neither harmless nor without risk to you. Tissue fillers for breast augmentation were therefore banned by the U.S. Food and Drug Administration in 2015 [3]. Since the term cosmetic surgeon is not protected, there are also providers of highly dubious methods of breast augmentation, such as a 24-hour push-up augmentation with a saline filling.

We therefore recommend that you not only question the quality of the implant, but also research the qualifications of the doctor in whom you place your trust. Always rely on high-quality implants of the latest generation. The combination of modern implants and experienced specialists in aesthetic surgery are the basic prerequisites for success. Inform yourself comprehensively.

The implants can be inserted in your case via these paths & accesses

Skin incision Advantages Disadvantages
Underbust crease
  • Good overview
  • Placement of the implant under the pectoral muscle is possible.
  • Use of an anatomical implant possible.
  • Implant exchange possible via the same access
  • Breastfeeding ability not affected.
  • Scar visible when lying down or, in the case of small breasts, when standing up.
areola border
  • Inconspicuous scar
  • Not possible with small nipples or large implants.
  • Breastfeeding may be impaired.
  • Possibly reduced sensation of the nipple.
  • Further scar in case of implant change in the underbust fold.
  • No scar on the breast itself.
  • Advisable if there is a tendency to scarring.
  • Advantageous for small to moderate enlargement of small breasts.
  • Breastfeeding ability not affected.
  • Precise placement of the implant is difficult.
  • Increased risk of asymmetrical underbust folds.
  • Keyhole technique with limited overview.
  • Risk of damage to cutaneous nerves of the arm and lymphatic vessels
  • Interferes with the examination of sentinel lymph nodes for the detection and treatment of breast cancer.
  • Further scar in case of implant change in the underbust fold.
  • Expensive equipment required.
  • No scar on the breast itself.
  • Breastfeeding ability not affected.
  • Only water-filled implants possible.
  • Keyhole technique with limited overview.
  • Further scar in case of implant change in the underbust fold.

How would breast augmentation with implants be performed in your case?

Step 1: Preparation

Before starting, a before picture (photo with specific settings) is recorded, so that you can compare the result optimally.

Step 2: The surgery

The medical intervention is not only carried out under local anesthesia, but also under general anesthesia as part of an outpatient procedure in the practice, in a special operating room.

Step 3: After the procedure

The wound after the operation is mostly sewn with self-dissolving skin threads. Depending on the findings, drainage tubes can be inserted into the wound as part of the breast augmentation operation in the operating room, which can be removed again after a short period of time. The duration of the operation including general anaesthesia is about 60 minutes. You will receive an implant passport / implant ID card in accordance with the legal requirements. In this way, the origin of the implants can be traced back to the manufacturer at any time.

These 3 things you should consider before and after breast augmentation with implants

The following tips should be followed after breast augmentation with implants. General recommendations for breast surgery can be found on the Breast Surgery FAQ page.

  • For the first 6 weeks, sleep only on your back to avoid any risk of the implants slipping out of place.
  • All your questions about possible complications and alternative medical treatments should be answered in advance by the plastic surgery expert.
  • Avoid fast, sweeping and powerful shoulder movements. These could cause the breast implant to slip or twist. Chest muscle training should be paused for six weeks.

Breast augmentation simulation: unfortunately too inaccurate

3D simulations and VR glasses have become very popular in recent years. The problem with current algorithms is that they feign accuracy that is not realistic, especially when combining different methods. The variety and complexity of breast augmentation are not captured by most programs.

We develop an individual treatment plan for each patient, which may include different techniques such as autologous fat treatment, tightening of the skin mantle or correction of fat deposits in front of the armpits. Since current simulation programs are not able to show such changes, we explain the expected changes on before and after pictures during the consultation. In addition, we offer you the opportunity to get a feel for sizing before surgery with the help of silicone bra inserts.

Our before and after pictures of breast augmentation with implants for a better insight

With cosmetic surgery, many patients expect to be able to view before and after pictures (after pictures / before and after photos). When it comes to the topic of breast augmentation with implantation, women insist on and you of course of course, particularly rely on placing yourself in the hands of an extraordinarily trustworthy expert in plastic aesthetic surgery to receive a detailed and competent individual consultation.

You want to make sure you’ll be completely satisfied with the results by looking at after photos and getting an idea beforehand. In this context, they also expect to be shown before-and-after pictures (before-and-after photos) of any surgeries that may have been performed. You can view such photos for a before and after comparison when you make an appointment for a personal consultation. Of course, this is done in compliance with data protection regulations. In addition, a trial bra will be put on at the appointment so that you can visualize the target size.

For further information, please consult the page on the subject of before and after pictures.

Testimonials about breast augmentation with implants: make your own picture

If you would like to read other patients’ experiences about their breast augmentation surgery with implants at Centerplast, you can check out our testimonials page.

Do you have textured breast implants? These recommended actions are for you:

Feel your breasts regularly. After the age of 30, you should have your breasts and armpits palpated annually by your gynecologist.. After, after the age of 50 annual mammography is recommended for you. Ultrasound or MRI examinations may be necessary if the mammography examination is not conclusive enough. Immediate examination by the plastic surgeon is required if you notice a change in the size, feel or shape of your breasts.

Frequently asked questions

What are the costs for breast augmentation with an implant?

The cost of breast augmentation with implant is determined during the personal consultation. Should you wish to get an idea of the price range in advance, please visit our cost page.

Frequently asked questions about breast implant associated anaplastic large cell lymphoma (BIA-ALCL)

BIA-ALCL is not a cancer of the breast tissue itself, but a form of blood cancer that affects the white blood cells. A link between the development of anaplastic large cell lymphoma (ALCL) and breast implants is considered to be established. Alternative procedures (breast augmentation with autologous fat) should therefore be considered.

Most cases of anaplastic large cell lymphoma occurred with implants with a roughened (textured) surface. For this reason, the CE certification of textured implants from the manufacturer Allergan was not renewed on 12/17/2018. On 5/04/19, textured implants from the following manufacturers were banned in France: Allergan Inc, Laboratoire Arion, Nagor Ltd, Eurosilicone, Polytech Health & Aesthetics, Sebbin.

The risk can be divided according to the outer wall of the implant as follows:

  • For smooth surface only in very rare cases: 0.0001% (1:704,000).
  • With fine rough surface (microtextured implants, Siltex® and similar): 0.001% (1:82,000)
  • For coarse rough surface (macrotextured implants, Biocell® and similar): 0.031% (1:3,200)
  • For a polyurethane coating: 0.035% (1:2,800) (Hamdi M, et al, 2019, Aesthet Surg J. 2019).

The following figures may be helpful to better classify the risk of developing BIA-ALCL after breast augmentation with silicone implants.

  • Risk of rupture of an implant over a 10-year period: 8.7% (1:11.5).
  • Risk of capsular contracture over a 10-year period: 13.5% (1:7.4).
  • Risk of reoperation over a 10-year period: 31.6% (1:3).
  • Risk of breast cancer over a woman’s lifetime: 12.5% (1:8).
  • Risk of breast cancer recurrence after mastectomy for breast cancer: 5% to 8% (1:12.5-20).
  • Lifetime risk of being killed in a car accident: 0.15% (1:645).
  • Risk of a life-threatening complication from cosmetic surgery: 0.002% (1:50,000).
  • Risk of developing advanced BIA-ALCL with lymph node metastases after breast augmentation with silicone gel implants: approximately 0.0004% (1:250,000).
  • Risk of developing BIA-ALCL after breast augmentation with silicone implants that is not treated within 3 months: 0.0002% (1:500,000) (Calobrace MB, et al. 2017. Aesthet Surg J).

The first symptom of BIA-ALCL is swelling of the breast, which occurs on average eight years after breast implant placement (range from two to 28 years after breast surgery). The swelling is due to a buildup of fluid surrounding the implant. This fluid can cause the breast to become significantly larger afterward, over a period of days or weeks. There may also be lumps in the breast or armpit, firmness of the breast, or pain. BIA-ALCL is usually easily treatable and curable if patients seek treatment immediately after the first symptoms appear.

Since the disease was first reported nearly 20 years ago, there have been 16 confirmed deaths worldwide. If detected early, before it develops into lymphoma, BIA-ALCL is highly treatable and curable by removing the implant and surrounding scar or capsule.

If detected early, BIA-ALCL is readily curable. Current recommendations for treatment of BIA-ALCL include bilateral capsular resection (removal of all scar tissue) and removal of breast implants. Such procedures are also performed by plastic surgeons when an implant is damaged or capsular contracture has developed. The majority of patients do not require additional treatment. However, if BIA-ALCL has spread to the lymph nodes or adjacent tissues in the body, chemotherapy or radiation may be required.

Neither the German Federal Institute for Drugs and Medical Devices, nor the German professional societies, nor the U.S. Food and Drug Administration (FDA) recommend preventive removal of implants with rough surfaces. However, there are women who decide to remove their implants afterwards because of concerns about BIA-ALCL.

If due to concerns about the BIA-ALCL the implants are to be removed, there are the following options to get a beautiful breast shape afterwards:

If due to concerns about the BIA-ALCL the implants are to be removed, there are the following options to get a beautiful breast shape afterwards:

  • Replacing the previous implants with new ones with a smooth surface.
  • A breast augmentation through a treatment with the patient’s own fat, which usually has to be repeated three times.
  • A breast lift.

There is no blood test that can detect BIA-ALCL. According to experts, women who do not have any change in the female breast do not need additional examinations. However, if a patient has noticed a change in her breasts, such as swelling or a lump – an examination, imaging and consultation (in person) with a plastic surgeon should be arranged immediately. If there is fluid around the implant, the fluid should be aspirated under ultrasound guidance and sent for analysis.

Plastic surgeons, scientists and the manufacturers of implants are intensively studying this question. Possible risk factors are the implant surface and chronic inflammation (germs called Ralstonia picketti, pseudomonas, brevundimonas). Since very few cases have been reported in some regions of the world (for example, Asia), a hereditary predisposition is also being discussed as a favoring factor. It is possible that several factors must come together for BIA-ALCL to develop after some time.

Frequently asked questions about “Breast Implant Illness” (BII)

The author

Unsere Fachärzte für Plastische Chirurgie Saarbrücken
Dr. med. Stéphane Stahl

“We provide you with extensive expert knowledge so that we can work with you to select the best possible treatment path.”

Dr. med. Stéphane steel is the former director of the Clinic for Plastic, Reconstructive and Aesthetic Surgery / Hand Surgery at the Lüdenscheid Clinic. Dr. Stahl studied medicine at the Universities of Freiburg and Berlin. In 2011 he passed the European and 2012 the German specialist examination for plastic and aesthetic surgery. Further specialist qualifications and additional qualifications followed (including quality management, medical didactics, physical therapy, emergency medicine, laser protection officers, hand surgery) as well as prizes and awards. In 2015 he completed his habilitation in plastic and aesthetic surgery in Tübingen. He is an experienced microsurgeon, a sought-after expert and a regular speaker at specialist congresses. After a multi-stage selection process, Stéphane Stahl became a member of the American Society for Aesthetic Plastic Surgery (ASAPS), one of the world’s largest and most influential specialist societies for aesthetic surgery. His authorship includes numerous articles in respected peer review journals and standard surgical textbooks.


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