Breast implants

For many women, beautifully shaped breasts are an important part of their femininity and play a major role in their self-esteem. If they feel they are too small, are bothered by an asymmetrical shape or simply do not meet their expectations, their satisfaction and self-esteem suffer. Women often no longer feel comfortable in their own skin and hide their cleavage.
With breast augmentation, modern plastic and aesthetic surgery offers the possibility of adapting the size and shape of the natural breasts to individual wishes. The aim is for you to feel comfortable and feminine in your body and to be able to wear your favorite clothes to your heart’s content.
However, breast augmentation – whether with implants or autologous fat – requires a great deal of expertise to ensure that your breasts blend harmoniously into your silhouette. You are in the best hands with Dr. Nichlos. The experienced plastic surgeon regularly performs the operation and will be happy to advise you on the options for augmentation in your case without obligation.
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More InformationIn breast surgery, breast augmentation is primarily used to increase breast volume in the case of breasts that are perceived as too small or sagging, as well as to even out breasts of different sizes. However, it can also be used to remodel the shape of the breasts and give the patient a new body image with a more feminine silhouette.

Dr. Emmanouil Nichlos has specialized in breast augmentation for over 17 years and has extensive experience in aesthetic breast surgery.
With a keen sense of proportion and natural forms, Dr. Nichlos achieves aesthetic and harmonious results. During the recovery phase, patients who have recently undergone surgery receive personalized care, and Dr. Nichlos is available at any time, even around the clock, if needed.
The reasons for wanting breast augmentation are very diverse. By far the most common is that women simply feel their breasts are too small and therefore desire a fuller, more feminine bust that creates a voluptuous décolletage and eliminates the need for aids such as push-up bras.
Sometimes, however, breasts that have become saggy or droopy due to significant weight loss or pregnancy prompt women to explore breast augmentation and/or a breast lift more closely.
Other reasons include asymmetry between the two breasts, which can often be effectively corrected with breast augmentation. Even after breast surgery (such as tumor removal), breast augmentation offers the opportunity to restore lost volume and return the breast to its feminine shape.
For breast augmentation, we use two methods that have proven effective in plastic surgery: implants and autologous fat. Both procedures have their own specific advantages. Which method is best for you depends, among other things, on the degree of augmentation you desire.
With this method, we insert silicone implants (usually under the pectoral muscle). Depending on the breast shape or size you desire, we can use different types of implants. In addition to round implants, an increasing number of patients are opting for teardrop-shaped implants, as these create a very natural and feminine breast shape.
The use of implants is particularly suitable for women with small breasts who desire significantly more breast volume and/or a defined breast shape. Even for those with a very slender figure and little body fat, we can fulfill the desire for larger breasts using this method.
Breast augmentation with silicone implants takes about 1–2 hours and is performed exclusively under general anesthesia at the Berger Clinic. Before administering the anesthesia, Dr. Nichlos first marks the areas to be operated on. Once you are asleep, the actual procedure begins. The specialist first makes the incisions to insert the implants into your breast. There are various approaches or types of incisions: Most commonly, the incision is made in the inframammary fold. The advantage is that the incision is barely visible later on. For smaller-volume implants, an incision at the edge of the nipple is also possible. A third alternative is an incision in the armpit.
Regardless of the type of incision, a pocket is created in the breast tissue during the breast surgery into which the implants are inserted. These can be placed either under or over the pectoral muscle. Placement under the pectoral muscle has the advantage that the implants are less palpable later on and allows for a more natural shape. Placement above the muscle is associated with a shorter healing time but is only possible if there is sufficient breast tissue.
Dr. Nichlos then inserts the implants under sterile conditions and carefully checks their position and symmetry. Finally, he closes the incision with dissolvable sutures and applies a bandage and a compression bra.
Alternatively, volume can be increased using the body’s own fat tissue. This is harvested from areas such as the abdomen, hips, or thighs, processed, and then injected directly into the breast. The resulting breast looks and feels natural. A practical side effect: harvesting fat tissue from other areas automatically improves their appearance as well.
Lipofilling is suitable for women who desire a small adjustment in volume and prefer not to have foreign material introduced into their bodies.
Learn more about breast augmentation with autologous fat
Breast augmentation using autologous fat takes about 1–2 hours, depending on the extent of the procedure, and is performed at our clinic on an outpatient or inpatient basis under general anesthesia, depending on the individual case.
Once anesthesia has taken effect, Dr. Nichlos first injects a special tumescent solution into the area selected for fat harvesting (e.g., abdomen, hips, thighs). This solution has an anesthetic effect and simultaneously loosens the fat cells, making them easier to extract via liposuction. We then process the harvested fat in a special device until only the pure fat cells remain.
Dr. Nichlos then injects this purified fat into the breast in several layers using very fine cannulas, shaping it until the desired form is achieved. If necessary, additional treatments may be required after some time to achieve the optimal volume. The major advantage: This type of breast augmentation does not require large incisions; small puncture sites are usually sufficient. After the procedure, you will receive compression garments, which you should wear consistently over the following weeks.
Implant or autologous fat? Sometimes the best solution is to combine both procedures. In hybrid breast augmentation, Dr. Nichlos first inserts the silicone implant. This provides the desired shape and volume. He then sculpts the finer details by injecting fat tissue that has been harvested from the donor site and processed, thereby concealing visible implant edges, for example. The advantages over pure implant surgery:
Of course, a prerequisite for this method is that sufficient donor fat is available. Dr. Nichlos assesses this prior to surgery and discusses with you what the best solution is for you.
This is by far the most common approach used in breast augmentation—and for good reason. The incision, which is only about 3–4 cm long, runs virtually invisibly along the natural crease beneath the breast. Through this clearly visible surgical field, Dr. Nichlos can place the implant within the breast with millimeter precision. The milk ducts and nipple nerves remain unaffected, so breastfeeding is still possible and sensation in the nipple is preserved.
With this approach, Dr. Nichlos makes a semicircular incision along the lower edge of the areola. If healing proceeds without complications, the scar will be barely visible later on. However, with this approach, it is unavoidable that some of the breast tissue will be cut through. This increases the risk of sensory disturbances. Breastfeeding ability may also be affected. Dr. Nichlos therefore recommends this approach only in specific cases, such as when the areola also needs to be reduced and the patient has completed her family planning.
With the transaxillary incision technique, the breast itself remains completely scar-free. Here, Dr. Nichlos makes the incision in the axillary crease to gain access. He guides the implant to the correct position through a small tunnel. This technique is technically very demanding, but routine for Dr. Nichlos. However, when replacing an implant, access often must be created via the inframammary fold. The transaxillary approach is ideal for women with very small breasts who lack a distinct inframammary fold and for patients who, for aesthetic reasons, desire a completely scar-free breast.
Implants can be positioned in the breast in various ways. The position that is best for you depends on various factors, such as your body type, the thickness of your breast tissue, whether and how intensely you exercise, and your aesthetic preferences.
In this procedure, Dr. Nichlos places the implant above the pectoral muscle and directly beneath the breast gland (subglandular). Since the muscle is not involved in this surgery, healing occurs more quickly and there is less pain afterward. The implant’s position offers another advantage: for athletic patients, it does not deform as easily during intense chest workouts, since it lies above rather than below the muscle, which means the muscle does not exert pressure on the implant.
This placement is less suitable for slender women with little natural breast tissue, as the edges of the implant may be visible and palpable. In such cases, a hybrid breast augmentation can provide a solution (see above under Breast Augmentation Methods).
This is currently the most commonly used technique in breast surgery and is suitable for most patients. In this procedure, Dr. Nichlos places the upper part of the implant beneath the pectoral muscle, while the lower part lies beneath the breast tissue. This creates a very natural transition with no visible implant edges and a beautiful curve in the lower part of the breast.
In this approach, the implant is placed entirely beneath the pectoral muscle (submuscular) and is completely enveloped by it. As a result, the implant and its edges are virtually invisible. The risk of capsular contracture is also lowest with the submuscular placement. However, the surgery is more complex and the healing period is correspondingly longer. Dr. Nichlos recommends this placement for patients who desire a particularly natural-looking result and do not engage in intense strength training, as this can cause the implant to deform.
Before your breast augmentation, you will come to our practice in Frankfurt for a thorough examination, where you will have a detailed consultation with Dr. Nichlos in a relaxed atmosphere.
The specialist in plastic and aesthetic surgery will want to know why you have decided to have a breast augmentation and what you hope to gain from the operation. You will discuss the extent of your breast augmentation and whether the use of implants or autologous fat is the most suitable method for you. Dr. Nichlos can also show you before and after pictures of breast augmentations that have already been carried out.
Depending on which option you choose, the breast surgery procedure will change, which Dr. Nichlos will of course explain to you as well as the possible risks and complications and what you should pay attention to before and after the breast surgery.
Of course, you will also want to know what the costs of breast augmentation will be. As a rule, it is not possible to give you a fixed price. However, we will provide you with a customized quote in which you will find a clear list of all costs.
Breast augmentation with silicone implants takes about 1-2 hours and is performed by us at the Berger Klinik exclusively under general anesthesia. Before inducing the anaesthetic, Dr. Nichlos will first mark out the areas for the operation. As soon as you are asleep, the actual operation begins. The specialist will first make the incisions to insert the implants into your breast. There are different approaches and types of incision: the incision is most commonly made in the underbust crease. The advantage of this is that the incision is barely visible later on. For implants with a smaller volume, an incision can also be made at the edge of the nipple. A third alternative is an incision in the armpit.
Regardless of the type of incision, a pocket is formed in the breast tissue during breast surgery into which the implants are inserted. These can be placed either under or over the pectoral muscle. Placement under the pectoral muscle has the advantage that the implants are less palpable later on and allows for a more natural shape. Placement above the muscle is associated with a shorter healing time, but is only possible if there is sufficient breast tissue.
Dr. Nichlos then inserts the implants under sterile conditions and checks their exact position and symmetry. Finally, he closes the wound with self-dissolving sutures and applies a bandage and compression bra.
In the first few days after your operation, you may experience slight swelling, bruising, tightness and pain in the area of your breast. However, this is completely normal in the first few days and usually subsides within 1-3 weeks.
It is important that you wear a compression bra or support bra after the insertion of implants and that you wear compression garments at the donor sites as continuously as possible after the insertion of autologous fat. The purpose of the compression garment is to support the healing process and help stabilize the results of the operation. Initially, please sleep on your back and do not exert any pressure on the breast.
Make sure that you do not lift or carry anything heavy for the first 6 weeks and refrain from physical exertion (including sport). Be sure to attend the regular follow-up appointments at our practice in Frankfurt am Main.
Every surgical procedure involves certain risks, and this also applies to breast augmentation – both with autologous fat and with traditional silicone implants. However, breast surgery is a very frequently performed routine procedure and complications only occur in very rare cases due to the fact that the surgical area is limited to the skin, tissue and muscles. However, they can never be completely ruled out.
The general risks and complications during and after breast augmentation include the usual risk of anesthesia, post-operative bleeding, wound healing disorders and infections. Injuries to individual nerves or the pectoral muscle are also possible, but very rare. However, these risks can be minimized if the procedure is carried out professionally by an experienced specialist such as Dr Nichlos and the strictest hygiene guidelines are adhered to.
One of the long-term risks of breast surgery with implants is capsular fibrosis. This causes the tissue around the implant to harden. The reason for this is that the body perceives the implant as a foreign body and tries to isolate it with a solid capsule. In the worst case scenario, the implants need to be replaced. However, the risk of developing capsular fibrosis is very low thanks to the use of modern implants.
Other very rare complications of breast augmentation can include
In rare cases, breast augmentation with autologous fat can also lead to hardening and lumps. It is also possible that the inserted fatty tissue heals irregularly, which means that the volume is no longer uniform.
Many patients want to know the costs associated with breast augmentation before undergoing treatment. Since each procedure is planned individually, the exact price may vary depending on the method and the patient’s initial condition.
At our practice in Frankfurt, the cost of a breast augmentation typically starts at:
The exact costs depend, among other things, on the chosen method, the extent of the surgery, and your individual circumstances. Following a personal consultation, Dr. Nichlos will create a personalized treatment and cost plan that transparently lists all services.
The total cost of breast augmentation consists of several components. These typically include:
In addition, breast augmentation involves anesthesia costs and clinic fees, as the procedure is performed under general anesthesia in a specialized clinic.
For breast augmentation with implants, a compression bra is also part of the post-operative care. An overnight stay at the clinic can be arranged additionally, depending on your individual recovery or personal preference.
To help you plan your desired treatment flexibly, you have the option to finance your breast augmentation conveniently in monthly installments.
Financing is provided by an experienced financing partner and can be individually tailored to your financial situation. This means you do not have to cover the costs all at once, but can pay for the treatment in monthly installments.
We would be happy to inform you about the requirements and the financing process during a consultation.
Two established procedures are available for breast augmentation: the use of silicone implants and autologous fat transplantation (lipofilling). While implants provide significantly more volume, treatment with the patient’s own fat ensures a particularly natural look and feel. Both procedures are regularly performed by Dr. Nichlos in Frankfurt.
Breast augmentation is suitable for women who feel their breasts are too small, who suffer from a loss of volume after pregnancy or weight loss or who want a more harmonious shape. Asymmetrical breasts can also be balanced out with the right method. Which technique is suitable depends on body type, tissue and the desired result.
With implants, volume is created using dimensionally stable silicone cushions – ideal if a significant enlargement or specific shape is desired. With lipofilling, fat is removed from the abdomen, hips or thighs, processed and injected into the breast. This method is particularly suitable for moderate augmentation and offers a natural tactile sensation – without any foreign bodies.
Experience has shown that breast augmentation by half a cup to a whole cup size is realistic when using autologous fat. More is only possible with repeated autologous fat treatments or in combination with the use of implants. Dr. Nichlos will be happy to advise you on this in a personal consultation.
Find out more about the right cup size
I explain what really matters when choosing a breast size in the blog article “Which cup size suits me?“. Find out more now.
The procedure takes about 1 to 1.5 hours and is performed under general anesthesia at the Berger Klinik. The implant is inserted above or below the pectoral muscle through a small incision (e.g. in the underbust crease). The breast is then sutured, bandaged and a compression bra is applied. In most cases, the patient can leave the clinic on the same day – an overnight stay is only required if necessary.
❌ According to the Therapeutic Products Advertising Act (HWG), the public presentation of before-and-after images for aesthetic plastic surgery procedures such as breast augmentation is not permitted.
✅ During a personal consultation, you have the opportunity to view anonymized image documentation from previous treatments. This will give you a realistic impression of possible results and give you a better idea of the process. You are also welcome to bring your own sample images with you to discuss your ideas with us and tailor the planning to your individual wishes.
Modern implants are long-lasting and do not need to be replaced routinely if the procedure is free of complications. Breast augmentation with autologous fat also offers long-lasting results – around 60-80% of the injected fat remains for the long term. How long the result remains visible also depends on age, skin elasticity and lifestyle.
Thanks to general anesthesia, the operation itself is painless. In the days following the operation, you may experience a feeling of tension or slight tenderness – especially if the implant is placed under the pectoral muscle. This discomfort can be easily treated with painkillers. Most patients are fit for social life again the following day.
Yes, with breast augmentation you have the choice between the classic round and the newer teardrop-shaped breast implants. The latter are designed to give the breasts a particularly natural look thanks to their anatomically correct shape. However, body proportions should be taken into account when deciding for or against one of the implants.
No, with modern silicone gel implants, such as those we use in our practice, replacement is generally no longer necessary. It used to be said that breast implants lasted around 10 to 15 years and should then be replaced. However, this no longer applies to today’s breast implants. As long as there are no complaints, they can last a lifetime. Nevertheless, it makes sense to have them checked regularly.
The incision is usually made in such a way that scars remain as inconspicuous as possible – e.g. in the underbust crease. The stitches dissolve by themselves. With good care, the scars fade over time. With the autologous fat method, there are only tiny puncture marks, which usually heal completely.
Your breasts will hardly feel any different after an augmentation than before. Especially not if we use your own fat. Since in this case no foreign body in the form of an implant is inserted into the breasts, they continue to feel very soft and natural. If implants are to be inserted, Dr. Nichlos uses special surgical techniques to position them in such a way that they are neither visible nor palpable. Only in the case of naturally very slim women with implants that are large in relation to the mammary gland tissue can they be felt in rare cases.
Yes, in most cases breastfeeding is still possible after breast augmentation. Implants are placed behind the mammary gland or the pectoral muscle and do not usually affect the ability to breastfeed. Breast function is also preserved after augmentation with autologous fat.
As with any surgical procedure, there are also risks associated with breast augmentation, e.g. wound healing disorders, bruising or infections. In rare cases, capsular fibrosis can occur with implants. Uneven volume distribution or hardening is possible with the autologous fat procedure. Dr. Nichlos will inform you in detail about all possible risks during your consultation.
You should avoid physical exertion for at least 4 to 6 weeks after the operation. You may experience swelling, tightness or slight pain in the first few days. It is important to wear the compression bra consistently for a period of six weeks. Follow-up appointments and lymphatic drainage if necessary support the healing process.
Dr. Emmanouil Nichlos, MD, is a board-certified specialist in plastic and aesthetic surgery in Frankfurt and has specialized in breast augmentation and other aesthetic procedures involving the breasts for over 17 years.
The content of this page has been personally reviewed by him and is in line with current medical knowledge and the professional standards of plastic and aesthetic surgery.
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Are you unhappy with your breast size or shape and would like to make a change? During a consultation in our practice, Dr. Nichlos will be happy to show you the options for breast augmentation in Frankfurt without obligation. Simply submit your request for an initial consultation online using our form.
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