Method
1. Consulting & Preparation
What happens during the initial consultation?
A detailed, personal consultation at our clinic in Munich is always the first step toward achieving your dream of scar-free breasts. This is particularly important if you are interested in breast augmentation in Munich. During this consultation, you will meet your surgeon and have the opportunity to ask any questions you may have. You will receive detailed advice on implant shapes and sizes as well as the optimal implant placement for you (submuscular or subglandular), and you can try on the implants using a special bustier to get a sense of what your breasts might look like. You will also learn everything about the surgical procedure, potential risks, and the advantages and disadvantages of endoscopic breast augmentation.
After the initial consultation, we recommend that you take plenty of time to think about the possibility of surgery. Only once you are completely certain that you want to proceed with the procedure and a relationship of trust has been established will we work with you to schedule the surgery. Of course, we will be there to guide and support you every step of the way as you make your decision.
Center for Endoscopic Breast Augmentation
What should you keep in mind before the surgery?
- Preliminary tests, such as a complete blood count with coagulation values
- Detailed written information about the surgery and associated risks provided at the office
- Resting ECG performed by a general practitioner, internist, or gynecologist
- Taking photos of the breast before surgery
- Breast cancer screening via breast ultrasound performed by a gynecologist
- Measuring and fitting the medical bra, including the chest strap
- Mammography in cases of a known history of breast cancer in the family
- Avoid blood-thinning medications and foods for 2 weeks before surgery
- Medical consultation with a certificate of fitness for surgery
- Stop using nicotine at least 2 weeks before surgery
- Pre-anesthesia consultation with the anesthesiologist at the affiliated hospital
- If necessary, purchase follow-up cost insurance
Request for Consultation
2. Surgical Procedure
What does an endoscopic breast augmentation involve?
1. Meeting
Before the surgery begins, Dr. Klöppel greets the patient personally once again, discusses the individual steps and her main concerns with her, and marks the necessary points for implant insertion and positioning accordingly.
2. Anesthesia
In the operating room, the anesthesiologist then ensures that the patient falls into a calm and gentle sleep while the procedure, which lasts approximately 70–75 minutes, is performed. The anesthesia used is TIVA, a modern anesthesia technique that is extremely tolerable and gentle for the patient.
3. Cut
The small 3–4 cm incision made for implant placement is located high up in one of the natural creases of the armpit. Because the skin in this area is very thin and naturally creased, the scar heals exceptionally well. The scars are barely visible after about 6–8 months.
4. Preparation of the implant site
Dr. Klöppel now uses the endoscope, along with a curved retractor and an electrosurgical scalpel, to make his way from the armpit to the breast in order to prepare the implant pocket. Thanks to the high-resolution imaging provided by the HD-3 chip camera with a cold light source and suction device, Dr. Klöppel can clearly visualize the interior of the breast and prepare the site accordingly. Both round and teardrop-shaped (anatomical) implants can be inserted either above or, preferably, beneath the pectoral muscle.
5. Insertion of the implant
Dr. Klöppel then inserts the silicone implant using the so-called Keller Funnel method. The Keller Funnel is a type of stable, funnel-shaped plastic bag used to gently insert the implant into the breast through a narrow incision without any skin contact. Using this method, which originated in the United States, reduces the risk of infection and thus the risk of capsular contracture, while also minimizing trauma to the tissue.
6. Closure
Once the implants are in their optimal position, the two incision sites are carefully closed with dissolvable sutures. Finally, the patient’s breast is secured with adhesive bandages and a medical bra with a support girdle to prevent the implants from shifting. She wakes up slowly and pain-free.
After the surgery, the patient usually wakes up without pain and is taken to her room to rest and be monitored. Following breast augmentation, the patient remains under observation as an inpatient at the affiliated hospital for one night and is discharged the next day after the doctor’s rounds, accompanied by a family member or friend. Follow-up appointments take place at the clinic.
What is endoscopic transaxillary breast augmentation?
Endoscopic transaxillary breast augmentation is a technique in which the implant is inserted through a small incision in the armpit, guided by an HD endoscopic camera. The breast itself remains free of incisions and visible scars; the small scar in the armpit fades into a natural fold within about 3 to 6 months.
How does the transaxillary approach compare to other incision techniques?
| Approach | Incision site | Scar on the breast | Breastfeeding ability |
| Transaxillary (endoscopic) | Armpit | None – the breast remains free of incisions | Preserved as a rule |
| Inframammary | Fold beneath the breast | Fine scar in the breast fold, often noticeable with smaller breasts | Preserved as a rule |
| Periareolar | Edge of the nipple | Scar around the areola | Increased risk of impairment |
Advantages of the transaxillary technique: no scars on the breast itself, full visual control thanks to the HD endoscope, precise preparation of the implant pocket, and the mammary gland and milk ducts are not cut. What to consider: the technique requires specialised endoscopic equipment and considerable surgical experience, which is why only few centres offer it routinely. BREASTetics in Munich is one of these specialised centres.
Where can I find a specialist for endoscopic transaxillary breast augmentation?
BREASTetics in Munich, Germany, is a centre dedicated to endoscopic breast augmentation. Lead surgeon Dr. Markus Klöppel, a specialist in plastic and aesthetic surgery, has performed over 5,000 breast surgeries and has been using the endoscopic transaxillary technique for many years – patients from abroad regularly travel to Munich for consultations and surgery.
3. Implant Replacement
Is it possible to replace an implant through the armpit?
It is often claimed that implant replacement via the armpit is not possible. This statement is simply false. Dr. Klöppel has been performing implant replacements using the endoscopic axillary method for many years, ensuring that the breast remains completely scar-free. In particular, patients—often from Asian countries—who had breast augmentation surgery via the armpit many years ago wish to have their implants replaced using this method and sometimes travel from far away to our clinic.
Implant replacement may be medically necessary, for example, in cases of advanced capsular fibrosis or with older-generation implants that have a limited lifespan of about 10–15 years. On the other hand, the appearance of the augmented breast may also change over the years, and a change in shape or volume may be desired for aesthetic reasons. Even in the case of a capsulotomy or partial capsulectomy, the implant can be replaced through the armpit.
BREASTetics Breast Calculator
With our BREASTetics Breast Calculator, you can quickly and easily get all the important information about your potential breast augmentation in just a few steps – completely non-binding and free of charge.
4. Postoperative Care
What should I keep in mind after the surgery?
- Attending regular check-ups at the clinic, which can also be scheduled at any time at the patient's request
- Taking prescription pain relievers and anti-inflammatory medications
- Regularly applying cold compresses to the breast after surgery
- After 2 weeks, trim the ends of the sutures; the sutures in the skin are absorbable
- Wear the medical bra for up to 6 weeks after surgery
- Daily practice of lateral arm abduction up to 90 degrees
- Avoid saunas, tanning beds, and sports for 4–6 weeks, and refrain from strenuous physical activity
- Avoid sleeping on your stomach for 4 weeks
- Scar care for about 6 months
5. Potential Risks
While risks are relatively rare in this context, they cannot be completely ruled out. Our goal is to minimize risks as much as possible so that our patients achieve the best possible outcome: an enlarged, beautifully proportioned breast with no visible scars, making the surgery undetectable.
Studies of the patients we have operated on over the past 10 years show complication rates that are lower than average. The incidence of capsular contracture, postoperative bleeding, and implant displacement is well below the global average for complications associated with breast augmentation via an inframammary incision.
Short-term risks
- Postoperative bleeding (immediately) after surgery
- Thrombosis or embolism resulting from the occlusion of major blood vessels (e.g., in the legs)
- Circulatory problems & dizziness caused by very low blood pressure
Medium-term risks
- Wound infection due to inflammation of the tissue/implant, even 4–6 weeks after surgery
- Implant displacement due to failure to follow post-operative instructions
Long-term risks
- Capsular fibrosis due to the ongoing thickening of the connective tissue capsule surrounding the implant
- Implant failure or fracture
- Poor scar formation, e.g., due to impaired wound healing
Did you know? Feeling nervous before a breast augmentation is completely normal – many patients are at first. The best remedy is reliable information: our FAQ answers the most common questions, and in a personal consultation Dr. Klöppel addresses all your individual concerns.
Callback Service
6. Advantages of endoscopic breast augmentation
3-chip cameras
An important milestone in this process of improving axillary breast augmentation is the use of modern, digital 3-chip cameras, which provide brilliant images of the implant pocket and a precise optical representation of, for example, muscle tissue or blood vessels.
HD magnification
HD magnification provides the surgeon with an exceptionally clear view of the interior of the breast. With this technology, the detailed view of the implant pocket on the HD monitor is significantly superior to that of conventional breast augmentation performed through the inframammary fold.
Brilliant lighting
The use of high-tech cold light sources allows for brilliant and intense illumination of the interior of the implant pocket.
Precise placement
An experienced surgeon can place the implants exactly where they create the ideal balance between the upper and lower poles of the breast—namely, a 40:60 ratio—for a perfectly shaped and beautifully proportioned female breast.
All available implants
This method allows for the routine placement of all available implants—whether round or teardrop-shaped—up to a size of 800 ml, preferably under the pectoral muscle, but in some cases also over the pectoral muscle.
Sterile administration
The use of the Keller Funnel allows the implants to be inserted without coming into contact with the outer skin or the sweat glands surrounding the incision. The implants therefore do not come into contact with the outer skin at all, enabling sterile insertion.
Take advantage of our many years of professional expertise and let us guide you on your journey to achieving your dream bust.
BREASTetics stands for the highest level of expertise, premium quality, high-tech methods, and the best service for your endoscopic axillary breast augmentation.
7. Implants
Which implant size for which cup increase?
For an increase of two cup sizes – for example from cup A to cup C – implants of approximately 300 to 350 cc are typically used. The exact size depends on chest width, tissue quality and the desired look and is determined together with the surgeon during the personal consultation.
| Cup increase | Typical implant volume | Recommended implant diameter |
| A to B (one cup size) | 220–280 cc | 10–11.5 cm |
| A to C (two cup sizes) | 300–350 cc | 11.5–12 cm |
| A to D (three cup sizes) | 370–450 cc | 12.5–13 cm |
Cubic centimetres (cc) and millilitres (ml) are identical units – an implant of 300 cc contains exactly 300 ml.
Runde Implantate
Runde Implantate für eine weibliche wohlproportionierte Brust und ein schönes, leicht gewölbtes Dekolleté.
Anatomische Implantate
Anatomische bzw. tropfenförmige Implantate für einen besonders natürlichen Look mit geradem Dekolleté und vollerem unteren Brustpol.
XTRA Implantate
Mentor MemoryGel® XTRA Implantate – für mehr Fülle, mehr Projektion und eine weiche, natürliche Haptik.
MENTOR Promise
Ihr MENTOR Promise Schutzplan:
- Kostenlose & automatische Teilnahme
- Kostenloser lebenslanger Ersatz bei Ruptur
- Bis zu 1.000 € finanzielle Unterstützung bei Ruptur
- Kostenloser Ersatz des Produkts im Fall einer Kapselkontraktur (Baker III/IV), Doppelkapsel oder bei später Serombildung (bis 10 Jahre)
- Kostenloses kontralaterales Implantat auf Anfrage Ihres Chirurgen
Mentor Qualität
Bereits seit über 30 Jahren erweist sich Mentor als ein weltweit führender Hersteller von qualitativ höchstwertigen, auslaufsicheren Brustimplantaten, die strengsten Testverfahren unterliegen. Mentor legt größten Wert auf Forschung und beste Entwicklungs- und Prüfstandards, damit die Patientinnen sich auch langfristig wohlfühlen.
Auch BREASTetics ist von der erstklassigen Mentor Qualität und Sicherheit der Implantate überzeugt und bietet den Patientinnen daher lediglich diese CE-zertifizierten und FDA-zugelassenen Silikongelimplantate an.
Runde Implantate
Runde Implantate für eine weibliche wohlproportionierte Brust und ein schönes, leicht gewölbtes Dekolleté.
Anatomische Implantate
Anatomische bzw. tropfenförmige Implantate für einen besonders natürlichen Look mit geradem Dekolleté und vollerem unteren Brustpol.
XTRA Implantate
Mentor MemoryGel® XTRA Implantate – für mehr Fülle, mehr Projektion und eine weiche, natürliche Haptik.
MENTOR Promise
Ihr Schutzplan:
- Kostenlose & automatische Teilnahme
- Kostenloser lebenslanger Ersatz bei Ruptur
- Bis zu 1.000 € finanzielle Unterstützung bei Ruptur
- Kostenloser Ersatz des Produkts im Fall einer Kapselkontraktur (Baker III/IV), Doppelkapsel oder bei später Serombildung (bis 10 Jahre)
- Kostenloses kontralaterales Implantat auf Anfrage Ihres Chirurgen
Mentor Qualität
Bereits seit über 30 Jahren erweist sich Mentor als ein weltweit führender Hersteller von qualitativ höchstwertigen, auslaufsicheren Brustimplantaten, die strengsten Testverfahren unterliegen. Mentor legt größten Wert auf Forschung und beste Entwicklungs- und Prüfstandards, damit die Patientinnen sich auch langfristig wohlfühlen.
Auch BREASTetics ist von der erstklassigen Mentor Qualität und Sicherheit der Implantate überzeugt und bietet den Patientinnen daher lediglich diese CE-zertifizierten und FDA-zugelassenen Silikongelimplantate an.
See for yourself our results
Only when our patients are happy with the result of their endoscopic breast augmentation in Munich are we happy too. Take a look at some of our results.Results in a bra: this is how the breasts look in everyday life after an endoscopic breast augmentation via the armpit with Dr. Klöppel. For each patient you will find the starting point, the implant and when the photo was taken.
36 years · 405 ml · 9 months after surgery
Patient detailsHide details
- Age 36, 167 cm, 59 kg
- Starting point: the breasts had lost volume after two pregnancies and breastfeeding (involutional atrophy)
- Round implant, Mentor Moderate Plus Profile XTRA, 405 ml
- Placed under the pectoral muscle, endoscopically via the armpit
- Photo 9 months after the procedure
36 years · 350 ml · 2.5 years after surgery
Patient detailsHide details
- Age 36
- Starting point: loss of volume after two pregnancies and breastfeeding, plus breasts of different sizes (asymmetry)
- Round implant, Mentor Moderate Plus XTRA, 350 ml
- Placed under the pectoral muscle, via the armpit with an HD endoscope
- Photo and video 2.5 years after the procedure
20 years · 270 ml · 3 months after surgery
Patient detailsHide details
- Age 20, 154 cm, 46 kg
- Starting point: very small breasts (micromastia) with a slightly tubular shape (tuberous breast)
- Round implant, Mentor Moderate Plus XTRA, 270 ml
- Placed under the pectoral muscle, endoscopically via the armpit
- Photo 3 months after the procedure
22 years · 370 ml · 3 months after surgery
Patient detailsHide details
- Age 22
- Starting point: breasts of different sizes (asymmetry) and a tubular breast shape (tuberous breast)
- Round implant, Mentor Moderate Plus Profile, 370 ml
- Placed under the pectoral muscle, endoscopically via the armpit
- Photo 3 months after the procedure
33 years · 405 ml · 3 years after surgery
Patient detailsHide details
- Age 33
- Starting point: loss of volume after breastfeeding twice (involutional atrophy)
- Round silicone gel implant, Mentor Moderate Plus XTRA, 405 ml
- Placed under the pectoral muscle, endoscopically via the armpit
- Photo 3 years after the procedure
10 years after surgery, two pregnancies in between
Patient detailsHide details
- Two pregnancies with breastfeeding between the procedure and the photo
- Implant under the pectoral muscle, inserted endoscopically via the armpit
- Photo and video 10 years after the procedure
Results without a bra from cup size A to B, each with age, body measurements and implant.
24 years · 250 ml · round
Patient detailsHide details
- Age 24, 163 cm, 49 kg
- Round implants, 250 ml
- Placed under the pectoral muscle (submuscular)
23 years · 325 ml · round
Patient detailsHide details
- Age 23, 175 cm, 57 kg
- Round implants, 325 ml
- Placed under the pectoral muscle (submuscular)
25 years · 300 ml · round
Patient detailsHide details
- Age 25, 176 cm, 62 kg
- Round implants, 300 ml
- Placed under the pectoral muscle (submuscular)
Results without a bra from cup size A to C, each with age, body measurements and implant.
42 years · 330 ml · anatomical
Patient detailsHide details
- Age 42, 168 cm, 58 kg
- Anatomical (teardrop-shaped) implants, 330 ml
- Placed under the pectoral muscle (submuscular)
27 years · 350 ml · round
Patient detailsHide details
- Age 27, 162 cm, 49 kg
- Round implants, 350 ml
- Placed under the pectoral muscle (submuscular)
32 years · 350 ml · round
Patient detailsHide details
- Age 32, 174 cm, 56 kg
- Round implants, 350 ml
- Placed under the pectoral muscle (submuscular)
Results without a bra from cup size A to D, each with age, body measurements and implant.
27 years · 445 ml · anatomical
Patient detailsHide details
- Age 27, 172 cm, 56 kg
- Anatomical (teardrop-shaped) implants, 445 ml
- Placed under the pectoral muscle (submuscular)
20 years · 400 ml · round
Patient detailsHide details
- Age 20, 170 cm, 53 kg
- Round implants, 400 ml
- Placed under the pectoral muscle (submuscular)
19 years · 545 ml · round
Patient detailsHide details
- Age 19, 173 cm, 65 kg
- Round implants, 545 ml
- Placed under the pectoral muscle (submuscular)
Results without a bra from cup size B to C, each with age, body measurements and implant.
38 years · 375 ml · anatomical
Patient detailsHide details
- Age 38, 164 cm, 55 kg
- Anatomical (teardrop-shaped) implants, 375 ml
- Placed under the pectoral muscle (submuscular)
25 years · 450 ml · round
Patient detailsHide details
- Age 25, 167 cm, 65 kg
- Round implants, 450 ml
- Placed under the pectoral muscle (submuscular)
28 years · 420 ml · anatomical
Patient detailsHide details
- Age 28, 172 cm, 55 kg
- Anatomical (teardrop-shaped) implants, 420 ml
- Placed under the pectoral muscle (submuscular)
Results without a bra from cup size B to D, each with age, body measurements and implant.
39 years · 525 ml · anatomical
Patient detailsHide details
- Age 39, 160 cm, 60 kg
- Anatomical (teardrop-shaped) implants, 525 ml
- Placed under the pectoral muscle (submuscular)
30 years · 420 ml · anatomical
Patient detailsHide details
- Age 30, 172 cm, 64 kg
- Anatomical (teardrop-shaped) implants, 420 ml
- Placed under the pectoral muscle (submuscular)
28 years · 450 ml · round
Patient detailsHide details
- Age 28, 171 cm, 57 kg
- Round implants, 450 ml
- Placed under the pectoral muscle (submuscular)
The implant size is determined individually during the consultation; every result is different.
Travelling from further away? We are happy to answer your questions about the first consultation by email or phone before you book: info@breastetics.de · +49 89 122 896 338
What our patients say on Google
Real reviews from our Google profile. Most of our patients write in German, so we have translated these reviews into English. You can read every review in its original language on Google.
I travelled from Mexico to Dr Klöppel for a breast augmentation, and it was the best decision I could have made. The augmentation was done via the armpit with 600 cc, and my breasts look very natural and symmetrical. Three months have now passed since the surgery, I feel very well and fully recovered. The medical team and the surgeon are highly qualified and professional. I highly recommend them if you are looking for a natural, beautiful and elegant result. The scar in the armpit is almost invisible and fades more every week. My arm mobility is excellent and I can already exercise again. […]
Yessenia MartinezAugust 2025 · Google · translated from Spanish
I had my operation in January 2026. Everything was explained to me in detail, including the procedure. Dr Klöppel and his team took very good care of me and I felt in very good hands. Whenever I had questions, I could call or write an email at any time and got a prompt answer. Every day I enjoy a new feeling for my body. It gave me back my soul and even more self-confidence than before. Everyone is very nice, friendly and attentive. My gut feeling was right once again. Thank you so much for everything.
Miroslava JordanApril 2026 · Google · translated from German
Many thanks to Dr Klöppel and his team for the empathetic advice and support during my breast augmentation! The result is beautiful and even surprised me. I had my first consultation with Dr Klöppel in December. Until then I had no experience at all with plastic surgery and many prejudices and fears. Dr Klöppel took away all my doubts with great sensitivity and his detailed explanations convinced me to take the step of an endoscopic breast augmentation. I have not regretted it! I had the operation in March and was looked after professionally from start to finish. After the operation, too, the practice team was always there for my questions and worries. The result is truly natural and beautiful. I have regained a piece of quality of life. Thank you
KätheJuly 2026 · Google · translated from German
I can wholeheartedly recommend Dr Klöppel and the entire BREASTetics team! From the first consultation through the preparation to the operation and the comprehensive aftercare, I always felt in very good hands and professionally looked after. I was particularly impressed by the detailed and honest advice. At all times I felt that my wishes and needs were addressed individually. Now, three to four months after my breast augmentation, I am overjoyed with the result. It turned out exactly as I had imagined: natural, aesthetic and simply perfect for me. I could not have made a better decision and would take this step again in exactly the same way. Thank you very much for the great care and the wonderful result! An absolute recommendation with a clear conscience!
Laura HeumannApril 2026 · Google · translated from German
I had my breast augmentation with Dr Klöppel in December 2025 and I am absolutely thrilled with the result! From the very first consultation I felt in very good hands at the practice. Dr Klöppel won me over from the start with his warm manner and his many years of expertise in breast augmentation. In the consultation he took plenty of time for my questions and considered my individual wishes and circumstances to find the right implant for me. I was particularly convinced by the endoscopic axillary method that Dr Klöppel uses, because the incision is made in the armpit and there are no scars on the breast. The operation went smoothly and everything has healed very well. The many follow-up appointments, which were always very thorough and answered all my open questions, also helped. Many thanks also to Dr Klöppel's whole team, who were always very helpful and polite and took a lot of time for my concerns. I am more than satisfied with the result. It is exactly what I imagined and has clearly boosted my self-confidence. I would choose surgery there again at any time and can recommend Dr Klöppel and his team 100 %.
LeticiaApril 2026 · Google · translated from German
A very beautiful practice with a lot of competence and expertise. I was informed really well, have a great result and received excellent aftercare. I can only recommend it and would choose this practice again at any time. Thank you for everything.
Nikola ZekovaMay 2026 · Google · translated from German
