Method
1. Consultation & preparation
What is the initial consultation process?
A detailed individual consultation and examination in our practice clinic is always the first step on your way to your desired breast without any visible scars. During this conversation, you will get to know your surgeon and get the opportunity to address all outstanding questions. You will be advised in detail about the different breast implant forms and sizes as well as about the optimal implant placement (subglandular or submuscular) and you will get the chance to try on the implants with a special bra top, in order to get a feeling how your new breast could look like. Furthermore, you will learn more about the surgical procedure, potential risks and advantages and disadvantages of the endoscopic breast augmentation.
After the first consultation, we recommend that you take your time to think thoroughly about a possible surgery. When you are completely sure that you want to have the surgery and the relationship of trust feels right, then we will determine together a surgery appointment. Of course, we will advise and support you during your decision-making.
What is there to keep in mind before the surgery?
- Preliminary examination, just as a small blood count including the coagulation level
- Mammography in cases of a Mamma-Ca in the family
- Written detailed information about the surgery and the risks in the practice
- No blood thinning drugs and food 2 weeks before the surgery
- Resting ECG by a general practitioner, internist or gynecologist
- Medical advice with a certificate of the surgical suitability
- Making of photos of the breast before the surgery
- No nicotine consumption at least 2 weeks before the surgery
- Breast cancer screening with ultrasound of the breast by a gynecologist
- Anesthetic interview with the anesthetist of the private clinic
- Taking measure and customizing the medical bra including breast strap
- If necessary, conclusion of a follow-up costs assurance
2. Surgical procedure
What is the breast augmentation procedure?1. Consultation
Before the surgery will begin Dr. Klöppel personally welcomes the patients, discusses the single steps as well as the important questions and marks the places for implant insertion and placement.
2. Anesthesia
In the operating room, the anesthetist ensures a peaceful sleep while the surgery is done which lasts approximately between 70 and 75 minutes. The anesthesia will be a so-called TIVA, a modern form of anesthesia that is very well tolerated and gentle.
3. Incision
The incision of only 3-4 cm (1-2 inches) to insert the implant will be made in the natural crease of the armpit. Due to the very thin skin localized in the armpit and the naturally occurring folds, the scar heals better than average and is barely visible after about 6-8 months.
4. Preparation of the implant pocket
The path from the armpit to the breast is well prepared with the endoscope together with the arch-shaped retractor (an instrument for keeping the surgical area open) and electric scalpel in order to optimally prepare the implant pocket under the pectoralis major muscle. The high-resolution imaging of the HD-3 chip camera with cold light source and suction device allows the surgeon to see precisely the inside of the breast for correct positioning of the silicone gel implants. Both round and teardrop-shaped (anatomical) implants up to 600 ml can be placed above or preferably below the pectoral muscle.
5. Insertion of the implant
Then Dr. Klöppel inserts the silicone implant with the so-called ‘Keller Funnel’-technique. The ‘Keller Funnel’ is a form of funnel-shaped, stable plastic bag in order to insert the implant more gently without any skin contact through a small opening. In using this method from the USA, the risk of infection and therefore the risk of a capsular fibrosis are reduced.
6. Suture closure
As soon as the implants are in the perfect position, both incisions will be closed with sutures that dissolve under the skin. Finally, the patient's breast will be fixed with adhesive bandages and the medical bra along with the ‘Stuttgart belt’ so that the implants can not shift.
After the surgery the patient will normally wake up without having any pain and will be brought to her room for recovery and observation. The patient will be monitored for one night in the hospital and can leave the clinic on the following day after the doctor’s visit with an accompanying person. The follow-up examinations take place in our practice clinic.
3. Breast implant exchange & removal
Is an implant exchange or removal via the armpit possible?
It is often said that an implant exchange or removal via the armpit is not possible. This statement is simply false. For many years now, Dr. Klöppel performs implant exchanges or removals via the armpit by using the endoscopic transaxillary method, so that the breasts will remain scar-free. Especially patients – often from Asian countries – who underwent many years ago a transaxillary breast augmentation, ask for a replacement using this method and come in some cases from far away to our practice clinic.
An implant exchange can be deemed clinically necessary, for example on one hand in cases of an advanced capsular fibrosis or older generation implants that have a limited lifetime of between 10 – 15 years. On the other hand, it is possible that the optic of the enlarged breasts will alter and a change of shape and size is desired. Even in case of capsular fibrosis, the capsule with the implant can be completely removed and replaced with new implants.
4. Aftercare
What is there to keep in mind after the surgery?- Coming to the regular follow-up examinations in the practice, on patient's request at any time
- Taking the analgesics and anti-inflammatory as prescribed
- Regular cooling of the chest after the surgery
- After 2 weeks cutting of the thread ends, the suture under the skin is self-dissolving
- Wearing the medical bra up to six weeks after the surgery
- Practising daily the lateral arm abduction up to 90 degrees
- For between four and six weeks sauna, solarium, sports and heavy physical activity are forbidden
- For four weeks avoiding to sleep in prone position
- Scar care for approximately six months
5. Possible risks
Risks rarely occur, but can not be completely excluded. Our aim is to keep the risks as low as possible to ensure our patients the optimal result: an enlarged and well-proportioned breast with no obvious scar and signs that surgery was done. Studies of our patients who have received a breast augmentation with this method over the last 10 years show above average low complication rates. The number of capsular fibrosis, secondary bleeding and implant dislocation are far below the average compared to the worldwide statistical complication rates of the conventional breast augmentation method with the IMF approach.
Short-term risks
- Secondary bleeding (immediately) after the surgery
- Thrombosis and sudden blocking of important arteries (for example in the legs)
- Poor circulation & vertigo resulting from a low blood pressure
Medium-term risks
- Wound infections by inflammation of the tissue/implant, even four to six weeks after the surgery
- Shifting of the implants when the after care instructions after the surgery were not fulfilled
Long-term risks
- Capsular fibrosis due to the continuous strengthening of the connective tissue capsule around the implant
- A defect or rather a rupture of implants
- Poor scarring due to, for example wound healing disorder
6. Advantages of the endoscopic breast augmentation
3-chip camera
An important milestone in the improvement process of the transaxillary breast augmentation is the use of the modern, digital 3-chip camera with brilliant pictures of the implant pocket and the precise optical display of muscular tissue, nerves and vessels.
HD-enlargement
The HD-enlargement provides an extraordinary good display of the breast interior for the surgeon. With this technique is the detailed display of the implant pocket on the HD-monitor far superior in comparison to the classic inframammary breast augmentation.
Brilliant illumination
The use of high-tech cold-light sources allows a brilliant and intensive illumination of the interior of the implant pocket.
Very precise placement
The experienced surgeon can place the implants exactly at the place where the right relation between upper and lower chest pole is created, namely 40:60 for a perfectly shaped and well-proportioned female breast.
All available implants
With this method, all available implants can be inserted, from round to teardrop-shaped, up to a volume of 600 ml, preferably under the pectoral muscle, but in individual cases also over the muscle.
Sterile insertion
The use of the ‘Keller Funnel’ enables a non-contact insertion of the implants with the surrounding skin and the sweat glands that surround the incision. Therefore, the implants have no contact with the outer skin and a sterile insertion is possible.
Benefit from our long-lasting experience, our expert knowledge and allow us to accompany you on your way to your dream breast.
BREASTetics stands for the highest level of competence, premium quality, high-tech methods and the best service around your endoscopic axillary breast augmentation.
7. Implants
Round implants
Round implants for a female, well-proportioned breast and a beautiful slightly rounded décolleté.
Anatomical implants
Anatomically shaped or rather drop-shaped implants for a particularly natural look with an upright décolleté and a fuller lower chest pole.
XTRA Implantate
Mentor MemoryGel® XTRA implants – for more volume, more projection and a soft, natural haptic.MENTOR promise
Your protection plan:
- free & automatic participation
- free lifetime replacement in cases of a rupture
- up to 1.000 € financial support in cases of a rupture
- free replacement of the product in cases of a capsular contracture (Baker III/IV), double capsule or late seroma formation (up to 10 years)
- free contralateral implant on request of your surgeon
Mentor quality
For more than 30 years now, Mentor is a world-leading manufacturer of high-quality, leak-proof breast implants that are subject to stringent inspection and rigorous testing to ensure quality and performance. For Mentor, research as well as test and development standards are of great value so that the patients feel good in the long term.
BREASTetics is also convinced of the first-class Mentor quality and the safety of the implants and therefore only offers its patients these CE-certified and FDA-approved silicone implants.
Round implants
Round implants for a female, well-proportioned breast and a beautiful slightly rounded décolleté.Anatomical implants
Anatomically shaped or rather teardrop-shaped implants for a particularly natural look with an upright décolleté and a fuller lower chest pole.
XTRA Implants
Round Mentor MemoryGel® XTRA implants – for more volume, more projection and a soft, natural haptic.
MENTOR promise
Your protection plan
- free & automatic participation
- free lifetime replacement in cases of a rupture
- up to 1.000 € financial support in cases of a rupture (within 10 years after implantation date)
- free replacement of the product in cases of a capsular contracture (Baker III/IV), double capsule or late seroma formation (up to 10 years)
- free contralateral implant on request of your surgeon
Mentor quality
For more than 30 years now, MENTOR is a world-leading manufacturer of high-quality, leak-proof breast implants that are subject to the highest quality standards and the most stringent testing procedures. Added to this are decades of experience, first-class product quality and intensive research and development work.
BREASTetics is also convinced of the first-class MENTOR quality and the safety of the implants and therefore only offers its patients these CE-certified and FDA-approved silicone implants.
