There are different methods to enlarge the breast. CenterPlast recommends the use of autologous fat if it suits the patient's wishes and conditions.
With an autologous fat treatment, the surgeon first gently removes the fat cells with microcannulas. The cells are then cleaned and filtered. The fat cells are then carefully injected. A gentle surgical method ensures that the transplanted own fat grows and improves the contour of the breast. The transplanted body's own fat cells serve to increase volume and improve the contour. In consultation with the patient, the surgeon removes the patient's own fat from the following body regions:
- Thigh inside or outside,
- Po region or
- The inside of the knees.
A minimally invasive and modern surgical method as well as the correct aftercare ensure that the transplanted fat cells heal. However, the body naturally degrades a certain proportion of the cells. Treatment with autologous fat can achieve an increase in volume of up to 30 to 50 percent. If you want to have your own fat breast enlarged by two cup sizes, you will have to expect two procedures. In order to achieve the desired result, the treatment can be repeated after three months. Even after breast augmentation with implants, more than one operation is usually necessary. The limited lifespan of implants and the changes in the breast tissue make a further operation necessary in the course of life.
According to the World Health Organization, adults are underweight with a body mass index (BMI) below 18.5 kg/m2. Many people believe that breast augmentation with autologous fat is not possible because of the relatively low body fat content. Many women with small breasts are underweight and many wish to have their breasts enlarged. As early as 2014, Chiu published a study showing that breast augmentation in underweight women can be performed safely and successfully. Fat cells can be taken from the abdomen, waist, hips, thighs or calves. On average, more than two hundred millilitres were injected per breast. Thus, it was possible to achieve an increase in breast circumference of almost four centimetres. Almost ninety percent of the patients were satisfied or very satisfied with the result. This is also in line with our experience.
Before each operation, the surgeon, the surgeon and the anaesthetist meticulously check all parameters according to the checklist several times. This ensures that the operation takes place under the best possible conditions. The greatest possible safety of our patients has absolute priority. Only then can the operation begin.
Before the operation, the surgeon marks the breasts and the liposuction regions in a standing position. You will be given medication that will relieve your anxiety and reduce your sensation of pain. If you are not already sleeping deeply, you may feel something happening on the body surface.
The surgeon injects the marked areas to remove the fat cells ("tumescence technique"). This enables a gentle operation and prevents the formation of bruises and irregularities in the contour. The tissue is injected with fine microcannulas and the fat is sucked off. The skin incisions of two to three millimetres are hidden in skin folds. After the tissue has been infiltrated and loosened, the surgeon removes the excess fatty tissue under vacuum using an aspiration cannula. The cannulas are inserted through several openings and guided in a fan shape to achieve a uniform suction image. The aspirated fat cells are cleaned and filtered. The surgeon then inserts the fat tissue cells into the breast. The breast volume increases and irregularities or asymmetries are compensated. Before the breast augmentation operation is completed and while you are still asleep, you will be placed in a seated position. The surgeon will check whether the shape of the breast meets the highest standards when sitting or lying down. Finally, a bandage and a special support bra are applied.
The outpatient procedure lasts about 90 minutes. Immediately after the operation you will be continuously monitored in a so-called recovery room. You can drink something after the complete awakening and, if you tolerate it well, eat something. Before you leave the practice, control appointments will be arranged and the behavioural measures will be discussed with you in detail. You will receive a comprehensive written report and a telephone number. The surgeon can be reached 24 hours a day.
Before, after and during the operation you can watch movies or your favourite series with virtual reality glasses. This is not only entertaining, the distraction also demonstrably leads to less sensitivity to pain.
- All your questions about possible complications and alternative treatments should be answered before the operation.
- Keep nicotine and alcohol consumption to a minimum.
- The intake of hormone-containing medication (pill) should be temporarily stopped.
- Blood-thinning medication (e.g. ASA, Thomapyrin®) must be discontinued ten days before the operation after consultation with your doctor.
- Stop taking vitamin preparations (A, E) and dietary supplements (e.g. omega-3 fatty acids, St. John's wort preparations) four weeks before the operation.
- Surgery limits the ability to travel by air. Do not plan any professional or private air travel during the four weeks following the operation.
- Take out follow-up insurance before an aesthetic operation.
- On the day of the operation, shower with a disinfectant soap (e.g. HiBiScrub® Plus, Octenisan® Wash Lotion, Prontoderm® Shower Gel).
- Your well-being and the result of the operation will be checked regularly.
- Make sure that your upper body is elevated by 30 degrees during the first five days, including when you sleep. This ensures better decongestation and wound healing.
- During the first six weeks you should sleep on your back.
- From the third postoperative day, you can take a shower in the CenterPlast Saarbrücken before the wound checkup.
- Wear the previously fitted support bras continuously for six weeks.
- Massage the scar several times a day for a few minutes from the third postoperative week. Use an oily cream such as Bepanthen® Ointment or Linola® Fat. Pay attention to circular, longitudinal and transverse movements of the scar. These measures help to create an inconspicuous scar.
- Avoid bending over, lifting heavy loads, swimming, sauna, sexual intercourse and sporting activities for four weeks. If swelling still exists, a longer period of rest may be advisable.
- Smoking prevents the transplanted fat cells from healing and increases the risk of inflammation and thrombosis. Avoid smoking tobacco and e-cigarettes for six weeks after the operation.
Breast augmentation with autologous fat is the ideal procedure for patients who want moderate enlargement and a natural result. 300 to 400 millilitres of fatty tissue are needed to obtain the fat cells. This corresponds to an enlargement by one cup size. Smaller fat pads on the abdomen, on the inside or outside of the thigh, on the bottom region or the inside of the knees are sufficient for this.
In the course of the consultation, we will first of all respond to your wishes for change. Among other things, the surgeon will want to know which cup size you would like. It is also important for us to know how satisfied you are with your breast shape and décolleté.
In order to recognize possible risks in time and to be able to prevent them better, we will ask you questions about preventive examinations, pregnancy, family planning, previous illnesses and allergies, occupation, medication and general surgical risks.
It is important to tell us whether you smoke or take dietary supplements, as these can have a major impact on your surgery.
Next, your breast will be accurately measured. This also includes small differences in the sides of the breast. Further important characteristics for the planning like the skin elasticity, a possible spinal column curvature or chest deformations are examined. In order to gain sufficient fat cells, smaller fat pads on the entire body are examined.
All patients are photographed for precise planning of the operation. On the basis of this thorough examination and a discussion of your goals, you will be shown various alternatives and all the associated risks and limitations. During the interview you will receive 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 outcome, even if there are no complications during the operation.
The surgeon will discuss all details of the procedure with you, including the type of anesthesia used, the facility where the surgery will take place, the follow-up insurance, the breast enlargement preparations and the post-operative procedures. You will be given a transparent and comprehensible explanation of how the costs of breast augmentation are made up.
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 will gladly offer you a second consultation. It is not uncommon for patients to have questions after the consultation. It is very important to us that all your questions have been answered before the operation.
- No visible scars remain.
- The breast feels more natural and softer.
- With an autologous fat treatment, the breast retains its natural shape when lying or standing.
- Patients who have had their own fat treatment recover faster than those who have had breast augmentation with implants.
- Every patient who opts for breast augmentation with implants should be aware that further surgery will be necessary over the course of her life. If you want a moderate enlargement, one operation is sufficient for a breast enlargement with autologous fat.
- With autologous fat treatment you are spared the risks of implants: implant rupture, implant displacement, capsule contracture, difficult breast cancer screening, breast implant associated anaplastic large cell lymphoma (BIA-ALCL).
- After breast augmentation with implants, the U.S. Food and Drug Administration (FDA) recommends a MRI examination three years and every two years thereafter. Changes in breast tissue following breast augmentation with autologous fat can usually be easily distinguished from other diseases by experienced radiologists using ultrasound and/or mammography. No examinations are necessary outside the usual breast cancer screening.
Treatment is associated with both opportunities and risks. Liposuction and fat transplantation can cause irregular contours. However, the risk is lower than with classical liposuction, for example to remove fat deposits from the hips. The transplanted fat tissue can die if the supply of nutrients and oxygen to the breast is too low. General surgical risks (inflammation, thrombosis) and the risk that the fat tissue cells do not heal are increased in smokers. Unhealed fatty tissue can liquefy and accumulate in cavities (oil cysts). In rare cases, this fluid must be removed by puncturing with a hollow needle. Larger oil cysts can lead to calcium salt deposits. The early detection of breast cancer is not affected by the autologous fat treatment. There is no fact-based evidence that autologous fat treatment promotes the development of breast cancer. Theoretically, it is possible to transfer the bloodstream through the injected fatty tissue (fat embolism). However, there are currently no reports on fat embolisms in the context of breast augmentation with autologous fat in world literature.
The following remuneration components must be taken into account for breast augmentation with autologous fat:
- Value added tax of 19%.
- Remuneration for Plastic Surgery
- Nursing services required within the framework of the treatment
- Medical anaesthesia services
- Consumables required during the above-mentioned procedure, e.g. for filtering and cleaning the own grease
- Compression garment including a changeover supply
- Consequential cost insurance
- The operation-related dressing changes on the occasion of wound inspections
- The operation-related long-term control examinations
- Permanent availability of the surgeon in the 2 weeks after the operation
- Medication for the treatment of nausea or pain in the first 2 weeks after surgery.
- Postoperative low molecular weight heparin for the prevention of thromboembolic diseases
- Medical thrombosis prophylaxis stockings
Many patients compare different offers before an operation. For a direct comparison, all expenses including aftercare must be taken into account. The training, experience, skills and scientific competence of a physician are more difficult for a layman to compare than the costs. Ask about the qualifications of the doctor you trust. The terms "cosmetic surgeon", "aesthetic surgeon" or "cosmetic surgeon" are not protected. The situation is different with the professional title "Plastic and Aesthetic Surgeon", these physicians have all completed an appropriate six-year training course. This is similar with ear, nose and throat specialists and oral and maxillofacial surgeons, who can acquire the additional qualification "plastic surgery" after two years of further training and are thus qualified for operations in the area of the head. The 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 work. The professional experience in a leading position strengthens the sense of responsibility and the competence to solve complex and difficult challenges. The costs of treatment are relevant for decision-making, but trust in the doctor should ultimately be decisive.
Unfortunately, it is not possible to give an exact price without an examination because, among other things, the scope of treatment and possible pre-existing conditions 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.
According to § 1 paragraph 1 no. 2 of the Heilmittelwerbegesetz, the comparative pictorial representation of the success of treatment by before/after photographs may not be published on the Internet. Nevertheless, before/after images may be used to inform patients. We will be happy to show you before/after images as part of a personal consultation in order to show you the possibilities and limitations of cosmetic surgery. It goes without saying that we comply with all legal data protection regulations.
Brazil has been a pioneer in aesthetic surgery for decades and is considered the cradle of cosmetic surgery.
Brazilian plastic surgeons, for example, have played a decisive role in shaping the techniques of breast surgery:
Ivo Pitanguy, Liacyr Ribeiro, João Carlos Sampaio Góes.
Dr. Santos Stahl has already operated many hundreds of breast enlargements independently during her specialist training in Brazil with first-class surgeons. Later, Dr. Santos Stahl obtained the German and European specialist qualifications. In addition, Dr. Santos Stahl has expanded her spectrum and knowledge with the most influential plastic surgeons in Dallas, Oakland and Salt Lake City - thanks to a scholarship from Germany's largest association of plastic surgeons (VDÄPC).
In 2015, Dr. Stahl became senior physician and permanent representative of the medical director at the University Hospital of Tübingen. From 2016 to 2018, he moved to Lüdenscheid as clinic director. Over the years, Dr. Stahl has continued to refine his microsurgical techniques so that today he enjoys a reputation among experts as a particularly gentle and precise surgeon. Various scholarships have led him to outstanding cosmetic surgeons in Brazil, New York, Atlantla and Salt Lake City.
Medical decisions and recommendations must be made on the basis of proven efficacy. The scientific competence of a physician is important for assessing the significance of a scientific proof. An additional qualification as an investigator and experience in conducting clinical trials is advantageous for this. 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 the survey of patient satisfaction with breast shape and size. At the same time, we also systematically examine the possible influence of the procedure on the patient's 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. During the consultation we are happy to put you in touch with these patients.