Hybrid breast augmentation helps to achieve a more feminine and aesthetic appearance. In addition to the natural result, the disadvantages of a breast implant can be reduced by the complementary treatment with autologous fat. For patients with small breasts who want to achieve an immediate result, this new procedure is the method of first choice.
Hybrid breast augmentation, also called composite breast augmentation, is the aesthetic surgical combination of conventional breast augmentation using implants and the grafting of autologous fat (lipofilling).
- With the body's own tissue, the contours of the décolleté can be adjusted harmoniously and naturally. Thus, round and softer implants can also be used. Anatomical (teardrop-shaped) implants are slightly firmer than round implants so that they maintain their shape. Hybrid breast augmentation has the advantage of giving you a natural shape and firmness.
- Implants are ready-made. Therefore, there is no such thing as an ideal fit that is individualized for each patient. However, by using the patient's own fat tissue, the contours can be individually corrected.
- Implants with a roughened (textured) surface in particular have been associated with the development of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). Since hybrid breast augmentation can eliminate the need for anatomical implants, the risk of developing BIA-ALCL is much lower.
- By using the patient's own tissue, the implant is better covered and the risk of wrinkling (so-called rippling phenomenon) is reduced. Therefore, the implant does not need to be placed under the muscle to avoid wrinkling. Placement of implants under the pectoral muscle is associated with a more painful and lengthy recovery period after surgery.
- Implant displacement is more common when breast implants are placed under the pectoral muscle. However, with hybrid breast augmentation, the implant can be placed above the pectoral muscle. The risk of displacement in this method of breast augmentation much lower.
- The autogenous fat treatment provides additional augmentation so that a smaller size implant can be used.
- By using softer and smaller implants in combination with autogenous fat treatment, the breast maintains a natural shape, both lying down and standing up.
- The transplanted autologous fat tissue also contains numerous stem cells. Therefore, the autologous fat treatment leads to an improvement of the skin tone.
- The décolleté and the hollow located between the breasts can be emphasized with hybrid breast augmentation.
- Round implants are cheaper with all manufacturers of breast implants.
Before the procedure, the plastic surgery specialist meticulously checks several times to ensure the highest possible patient safety. Only when all the prerequisites are met according to the checklist, the procedure is started.
At the beginning, the breasts are marked in a standing position. If the operation is performed in twilight sleep, you will be given medication to relieve anxiety and reduce sensitivity to pain. If you are not already deeply asleep, at most you will feel something going on at the surface of your body.
If the patient already has implants, they will be removed in the first step of the surgical procedure. For this purpose, the respective implant is carefully removed with the surrounding capsule via a small skin incision in the area of the underbust crease. The pectoral muscle is then reattached to the sternum. Towards the midline, the scar tissue is tightly closed. The pocket into which the new implants will be placed is formed above the large pectoral muscle. The Keller-Funnel method is now used to gently and precisely insert the new breast implants. This method is also known as the "no-touch" technique. This prevents the implant from coming into contact with the skin or the surgeon's hands. Depending on the findings, drainage tubes are inserted into the wound, which can be removed after a short period of time. The wound is closed with fine sutures, which dissolve themselves after about three weeks.
If necessary, an additional treatment with autologous fat can be performed for an optimal result of the breast augmentation. When both procedures are combined, the following advantages result: an accentuation of the décolleté, a prevention of wrinkling of the implant and an improvement of the skin quality and thus a more aesthetic appearance of the entire breast. In the operating room, before the breast augmentation surgery is completed, you will be placed in a sitting position (while still asleep) to verify that the shape of the breast, both sitting and lying, meets the highest standards. Finally, a bandage and a special support bra are applied.
The duration of the surgery is approximately 180 minutes. Immediately after the breast augmentation, you will be continuously monitored in a so-called recovery room. You will be able to drink something after you fully awaken and, if you tolerate it well, you will also be able to eat something. Before you leave the practice, control appointments will be made and the behavioral measures will be discussed with you in detail. You will be given a comprehensive written report and a telephone number where you can reach the surgeon 24 hours a day in case of emergency.
If the breast augmentation is not performed in twilight sleep, you as a patient will have the opportunity to watch movies or your favorite shows with virtual reality glasses before, after and even during the surgery. Not only is this entertaining, but the distraction has also been shown to reduce pain sensitivity.
How can you prepare for hybrid breast augmentation?
- All your questions about possible complications and alternative treatments should be answered before the surgery.
- Limit nicotine and alcohol consumption to a minimum.
- Temporarily stop taking hormone-containing medications (birth control pills).
- Blood-thinning medications (for example, ASS, Thomapyrin®) must be discontinued ten days prior to surgery after consultation with your attending physician.
- Discontinue vitamin preparations (A, E) and dietary supplements (for example, omega-3 fatty acids, St. John's wort preparations) four weeks before surgery.
- Surgery limits fitness for air travel. Do not plan any air travel for business or pleasure during the four weeks following surgery.
- Purchase follow-up insurance prior to cosmetic surgery.
- Shower with a disinfecting soap (e.g. HiBiScrub® Plus, Octenisan® Wash Lotion, Prontoderm® Shower Gel) on the day of surgery.
Hybrid breast augmentation is the ideal procedure for patients who are interested in an increase of at least two cup sizes. Approximately 300 to 400 milliliters of adipose tissue are needed to obtain the fat tissue cells. This amount of fat tissue cells can usually be obtained from slender women on the abdomen, outer or inner thighs, buttocks or inner knees.
During the consultation, we will first discuss your desired changes. Among other things, the surgeon will want to know what cup size you would like. It is also important for us to find out how satisfied you are with your breast shape and cleavage.
In order to identify any risks in good time and to be able to prevent them better, you will be asked questions about preventive check-ups, pregnancy, family planning, previous illnesses and allergies, occupation, medication and general surgical risks.
It is important to let us know if you smoke or take any dietary supplements, as these can have a major impact on your surgery.
Next, your breast will be measured accurately. Even slight differences in the sides of the breast will be noted here. Other characteristics important for planning, such as skin elasticity, any spinal curvature or chest deformities, will be examined.
All patients are photographed for accurate surgical planning. Based on this thorough examination and a discussion of your goals, you will be presented with various alternatives and any associated risks and limitations. During the consultation, you will be given all the information you need to decide which treatment is right for you. It is very important to discuss your expectations openly with your surgeon. Often a poorly informed patient or surgeon is the cause of an unsatisfactory result, even if there are no complications from the surgery.
The surgeon will discuss all the details of the procedure with you, including the type of anesthesia used, the facility where the surgery will take place, follow-up insurance, breast augmentation preparation measures, and post-breast augmentation behavioral measures. It will be explained to you in a transparent and understandable way how the cost of breast augmentation is composed.
If you are unsure or do not feel fully informed, do not hesitate to ask your doctor questions. At the end of the consultation, we are also happy to offer you a second consultation. It is not uncommon for patients to still have questions afterward. It is very important to us that all your questions have been answered before the operation.
Treatment is associated with opportunities but also with risks. When using breast implants, there is always a risk of capsular contracture (capsular fibrosis). Although today's implants are well tolerated, a certain immunological reaction will inevitably occur after several years or decades. During the healing process, side differences may occur with respect to breast size and shape, but also the position and size of the scars. In general, breast implants carry the risk of wrinkling, displacement, rupture or the development of anaplastic large cell lymphoma (ALCL). However, these risks are lower when using smooth implants in a smaller design as part of hybrid breast augmentation than when using traditional breast augmentation with anatomical textured implants without autologous tissue. Contour irregularities may occur during liposuction or fat grafting. However, the risks are lower than with classic liposuction, for example to remove fat deposits on the hips. The transplanted fat tissue may die if the supply of nutrients and oxygen to the breast is insufficient. The risk that the fat tissue cells will not heal is increased in smokers, as are the general surgical risks (inflammation, thrombosis). Since implants attenuate X-rays, the assessment of breast tissue may be limited during mammography. Alternatively, the breast can be examined with ultrasound or magnetic resonance imaging.
The following remuneration components must be considered for hybrid breast augmentation:
- Value added tax of 19%
- Remuneration for plastic surgery
- Nursing services required in the course of the treatment
- Medical anesthesia services
- Cost of the implant
- Consumables required during the above-mentioned procedure, including filtering and cleaning of the patient's own fat
- Compression clothes including a change of clothes
- Follow-up insurance
- The operation-related dressing changes on the occasion of the wound checks
- The operation-related long-term control examinations
- Constant availability of the surgeon during the 2 weeks after the operation
- Medication to treat nausea or pain in the first 2 weeks after surgery
- Postoperative low molecular weight heparin for prevention of thromboembolic disease
- Medical thrombosis prophylaxis stockings
Many patients compare different offers before surgery. For a direct comparison, all expenses, including postoperative care, must be considered. A physician's training, experience, skills, and science competencies are more difficult for a layperson to compare than cost. Inquire about the qualifications of the doctor you are trusting. The terms "cosmetic surgeon", "aesthetic surgeon" or "cosmetic surgeon" are not protected. This is different for the professional title "plastic and aesthetic surgeon", these doctors have all completed a corresponding six-year training. This is similar for ear, nose and throat specialists and oral and maxillofacial surgeons, these specialists can acquire the additional qualification "plastic surgery" after two years of further training and are thus qualified for interventions in the area of the head. Medical activity also includes research, for example in the context of a medical doctorate or habilitation. The ability to incorporate scientific findings into rational treatment decisions is strengthened by independent scientific activity. Professional experience in a managerial role strengthens the sense of responsibility and the competence to solve complex and difficult challenges. Treatment costs are relevant to decision-making, but trust in the physician should ultimately be decisive.
Unfortunately, it is not possible to give an exact price without an examination, since, among other things, the scope of treatment and any previous illnesses and/or pre-treatments cannot be taken into account. We can therefore only tell you the exact costs after an examination as part of the consultation. We will also be happy to advise you on financing options without obligation. For a price framework, you can visit our cost page.
You will receive further information in an individual consultation.
The comparative pictorial representation of the treatment success by before/after photographs may not be published on the Internet according to § 1 paragraph 1 No. 2 of the Therapeutic Products Advertising Act. Nevertheless, before/after pictures of a breast augmentation can be used in patient education. Therefore, we will be happy to show you before/after pictures as part of a personal educational discussion and, of course, in compliance with data protection, in order to show you the possibilities and limitations of cosmetic surgery. You can find more information on our page on before and after pictures.
Brazil has been a pioneer in aesthetic surgery for decades and is considered the cradle of cosmetic surgery.
The techniques of breast surgery were significantly influenced by Brazilian plastic surgeons such as:
Ivo Pitanguy, Liacyr Ribeiro, João Carlos Sampaio Góes.
Dr. Santos Stahl has performed many hundreds of breast augmentations independently during her residency in Brazil with first class representatives of aesthetic plastic surgery. Later, Dr. Santos Stahl acquired the German as well as the European specialist qualification. Dr. Santos Stahl has also expanded her spectrum and knowledge with the most influential plastic surgeons in Dallas, Oakland and Salt Lake City - thanks to a scholarship from the largest professional society of plastic surgeons in Germany (VDÄPC).
Privatdozent Dr. Stahl became a senior consultant and permanent representative of the medical director at the University Hospital of Tübingen in 2015. From 2016 to 2018, he moved to Lüdenscheid as clinic director. PD Dr. Stahl has continued to refine his microsurgical techniques over the years, so that today he enjoys a reputation among experts as a particularly gentle and precise surgeon. Various fellowships have taken him to outstanding cosmetic surgeons in Brazil, New York, Atlanta and Salt Lake City.
Medical decisions and recommendations must be based on proven effectiveness. In order to assess the validity of scientific evidence, a physician's scientific skills are important. For this purpose, an additional qualification as an investigator and experience in the conduct of clinical trials is an advantage. These requirements apply to Dr. Santos Stahl and PD Dr. Stahl.
We systematically examine and compare the appearance, well-being and satisfaction of our patients after a procedure. This includes not only uniform photo documentation, but also surveying patient satisfaction with breast shape and size. Nevertheless, we also systematically check a possible influence of the surgery on the perceived self-confidence and attractiveness. We encourage our patients to rate us on Jameda and Google. Many patients are willing to share their experience with other patients to help them make the right decision. We are happy to put you in touch with these patients during your consultation. You can find more information on our testimonials page.