Everything about breast augmentation – procedure, methods, costs

Brief overview: What is breast augmentation?

Breast augmentation, also called mammary augmentation, is a surgical procedure of aesthetic surgery in which the female breast is enlarged and, if necessary, the shape of the female breast is adjusted, even asymmetrical breasts can be aligned. Often this is done by inserting implants, however, there is also the method of enlarging the female breast with the help of autologous fat.

With over 65,000 procedures per year in Germany alone and over 1.6 million procedures worldwide, it is one of the most popular cosmetic surgeries in the world.

For whom is breast augmentation useful?

Breast augmentation is a useful procedure for women who want to enlarge their breasts, improve the shape of their breasts, or restore the volume lost due to aging, pregnancy or breastfeeding, or weight loss. It can also be used to correct asymmetry between the two breasts. Women who have had an amputation of the breast (mastectomy) may opt for breast augmentation as part of reconstructive surgery.

What are the requirements for breast augmentation?

Physical and mental conditions

Aesthetic surgery defines the requirements for breast augmentation as follows: To be eligible for breast augmentation, you must be in good physical and mental condition. You should also have realistic expectations about the outcome of the procedure. Your doctor will evaluate your medical history and perform a physical exam to determine if you are a candidate for the procedure.

Women who are pregnant or breastfeeding should wait until they have finished breastfeeding before undergoing breast augmentation.

You should also be aware that there are certain risks associated with breast augmentation, such as infection, scarring, or rupture of the implant.

Age

The minimum age for breast augmentation is usually 18 years. However, some surgeons require a patient to be at least 21 years old before she can undergo the procedure. In addition, women older than 40 may need to undergo additional exams to make sure their breasts are healthy enough for surgery, in part because the risk of breast cancer is increased after that age.

It is important to discuss any age-related concerns with your doctor before scheduling a breast augmentation.

What are the methods for breast augmentation?

Breast augmentation can be performed with the use of implants or with the use of autologous fat. It is important that breast augmentation should always be performed by an experienced surgeon (specialty: plastic and aesthetic surgery).

Breast augmentation with implant

Implants are the most commonly used method of breast augmentation. Modern implants are usually made of silicone and are available in various shapes and sizes. So-called saline implants, in which a silicone shell is filled with a saline solution during the procedure, are now used much less frequently. Implants come in different shapes: round implants enlarge the entire breast. Teardrop-shaped implants or anatomical implants tend to enlarge the lower part of the female breast. Normally, implants have a volume of 60 to 600 ml, which makes it possible to cover different wishes for breast enlargement well.

The implants used for breast augmentation are subject to the highest risk class for medical devices in Europe, which means that they are subject to particularly strict quality requirements.

Breast augmentation with own fat

Autologous fat transfer is a method of breast augmentation in which the patient’s own fat is used to enlarge the breasts. This method is less invasive than implants, but has its limitations in terms of breast enlargement. In addition, sufficient fat reserves are necessary for an augmentation with autologous fat, for example on the abdomen, hips or inner thighs. The patient’s own fat is taken from the appropriate location and placed in the breast through small injections, resulting in fewer scars.

As a result, augmentation with autologous fat has a more natural look, but only a maximum augmentation of one cup size can be achieved. Larger volumes can be achieved through repeated interventions.

What is the procedure for breast augmentation?

Treatment duration

The duration of the breast augmentation procedure depends on the method used. For implants, the procedure usually takes one to two hours, while fat transfers can take up to four hours. After the procedure, patients may need to stay in the hospital for a few days for observation and recovery.

In addition, patients should plan on at least one week of downtime after the procedure. During this In this period, patients should avoid strenuous activity and follow their physician’s instructions for postoperative care.

Consultation

The breast augmentation procedure usually begins with a personal consultation with your surgeon. A detailed consultation helps to ensure that the breast augmentation meets their expectations and risks of the treatments are minimized. At this appointment, you will discuss your desired outcome and the surgeon will evaluate your current breast size and shape. The attending physician will also explain different types of implants and the risks associated with the procedure.

If you regularly take medication, have allergies or known illnesses, be sure to inform your doctor. If you have a tendency to bruise or bleed for a longer period of time from minor injuries, you should also inform your doctor, as a blood clotting disorder should be ruled out before the procedure.

In addition, be sure to tell your plastic surgeon if you plan to lose more weight or become pregnant, as these can affect the shape of the breast in ways that are difficult to predict, affecting the results of breast augmentation.

Preparation for the operation

14 days before surgery, the patient should stop taking painkillers containing acetylsalicylic acid (e.g. aspirin), as these have a blood-thinning effect. Furthermore, the consumption of nicotine and alcohol should be reduced to a minimum.

In some cases, it may be useful to perform a mammogram or ultrasound examination prior to surgery to detect possible tissue changes before the procedure.

Operation procedure

The treatment procedure differs slightly depending on whether breast augmentation with implants or breast augmentation with autologous fat is performed.

Breast augmentation with implant

Breast augmentation surgery is usually performed under general anesthesia. During the procedure, the surgeon makes an incision either in the armpit, around the areola, or in the breast crease. This cut is about five centimeters long. Through this opening, the plastic surgeon creates a cavity, the location and size of which are crucial to the outcome of the procedure. The implant is then placed through the incision in the cavity (either behind or in front of the pectoral muscle).

Once the implant is in place, the surgeon closes the incision.

Breast augmentation with own fat

The procedure for breast augmentation with autologous fat is similar to the procedure for implantsb, but instead of inserting an implant, the surgeon takes fat from another area of the body and injects it into the breasts. Fat is usually harvested from areas such as the abdomen, hips, or inner thighs.

Once the fat is injected into the breasts, the surgeon massages and shapes the breasts.

Healing process and aftercare

The healing process after breast augmentation varies from person to person. Generally, you should expect swelling and bruising for a few weeks after the procedure. You may also experience some discomfort or pain, which you can manage with medications prescribed by your doctor. These symptoms usually subside within a few weeks.

Patients should also expect to wear a compression garment for several weeks after the procedure to reduce swelling and support the breasts while they heal. In addition, sports activity should be avoided for at least 6 weeks (breast augmentation with implant) or 2-3 weeks (breast augmentation with autologous fat).

It is important that you follow your doctor’s instructions for the time after the procedure.

What are advantages of breast augmentation?

The benefits of breast augmentation are numerous, but can be summarized relatively briefly:

Improved size, shape and symmetry of the breasts: Breast augmentation can help improve the size, shape and symmetry of the breasts, resulting in a more aesthetic appearance. In addition, it can help restore volume to breasts that have lost fullness due to age or pregnancy.

Improved self-confidence and self-esteem: As an indirect effect, breast augmentation often also strengthens the patient’s self-confidence and self-esteem.

What are the risks of breast augmentation?

As with any surgical procedure, there are certain risks associated with breast augmentation. These include infection, bleeding, scarring, and changes in sensation in the breasts. In rare cases, rupture of the implant may occur.

General anesthesia: Breast augmentation usually takes place under general anesthesia. The risks of general anesthesia are low nowadays, but the surgeon must still inform the patient in detail about the risks of anesthesia before the procedure.

Side effects of surgery: In general, there is a risk of bruising and bleeding. Infections can interfere with wound healing. Blood clots can lead to a blockage of the vessels (thrombosis) or reach the lungs (pulmonary embolism). In addition, allergies or intolerances may occur due to the drugs or anesthetics.

Numbness: After surgery, compressed nerves or other positioning damage can cause numbness, although this usually subsides. The severing of fine nerves, especially in the case of large implants, can also lead to feelings of numbness, especially in the area of the nipples, but these normally subside. In rare cases, numbness may be permanent.

Capsular contracture: During breast augmentation with implants, the body forms a thin layer of connective tissue around the implant – the so-called capsule – because the implant is a foreign body. Depending on predisposition, this capsule may harden, causing the breast as a whole to harden and the implant to become palpable. In the worst case, this effect can lead to pain, displacement / twisting of the implant or deformation of the breast, so that the implant must be replaced in a new procedure.

Scarring: Depending on the incision and method, breast augmentation will result in scarring at different locations – there is no scar-free method of breast augmentation. It is important that the patient can minimize scarring through what is called scar care. The patient should be patient, as it can take up to a year for the scars to heal completely.

Rupture of the implant: Silicone breast implants are not permanent implants and are subject to material fatigue, which can lead to defects in the silicone shell. Implants can also burst due to external force (e.g. in an accident), but the capsule usually protects the filling material from escaping. The probability of rupture varies greatly by implant type, averaging about 10% over 10 years, but may be higher or lower.

To reduce the likelihood of rupture, women with breast implants should regularly discuss with their treating physician whether replacement or removal of the implants may be necessary.

Injury to the milk ducts: When implants are placed in the breast, injury to the milk ducts may occur, depending on the method used. If there is significant injury to the milk ducts, the patient’s ability to breastfeed after the procedure may be limited.

If the incision is made in the breast crease below the breast, injury to the milk ducts is virtually impossible.

How much does breast augmentation cost?

The cost of breast augmentation can vary greatly, even within the same country. It is important that patients choose the right doctor for them and also make sure that the surgeon uses high quality implants when choosing a doctor. Caution should generally be exercised with low-cost providers.

In Switzerland

Switzerland is one of the most expensive countries in Europe for breast augmentation, generally the following price ranges can be expected:

For breast augmentation with implants: CHF 5’300 – 12’000
For breast augmentation with autologous fat (first application): CHF 4’800 – 12’000

In European foreign countries

Germany and Austria are slightly cheaper than Switzerland, here patients should expect the following price ranges:

For breast augmentation with implants: EUR 4’000 – 10’000
For breast augmentation with autologous fat (first application): EUR 3’900 – 7’000

In Greece, the costs are even more favorable:

For breast augmentation with implants: EUR 3’000 – 6’500
For breast augmentation with autologous fat (first application): EUR 3’100 – 4’300

Czech Republic and Hungary are the cheapest countries for breast augmentation in this comparison:

For breast augmentation with implants: EUR 2’400 – 4’800
For breast augmentation with autologous fat (first application): EUR 3’000 – 4’400

The following table gives an overview of the costs of breast augmentation in the countries mentioned:

Country	Price breast augmentation with implants	Price breast augmentation with own fat
Switzerland	CHF 5’300 – 12’000	CHF 4’800 – 12’000
Germany	EUR 4’000 – 8’000	EUR 3’900 – 8’000
Austria	EUR 4’000 – 10’000	EUR 3’900 – 6’500
Greece	EUR 3’000 – 6’500	EUR 3’100 – 4’300
Czech Republic	EUR 2’500 – 4’800	EUR 3’600 – 4’400
Hungary	EUR 2’400 – 4’700	EUR 3’000 – 4’200

Sources: Various price lists of cosmetic surgeons and comparison portals for medical treatment costs (see end of source list).

When does the insurance cover the costs?

Basic insurance generally does not cover costs for purely cosmetic procedures, and this is usually also the case for breast augmentation.

However, if the breast augmentation is related to a disease or developmental disorder, the basic insurance usually covers the costs. This is the case, for example, if a breast has to be amputated as part of cancer treatment or if certain developmental disorders of the breast are present.

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