Breast development is highly individual. Changes in size, shape, sagging of the tissue or increased weight can lead to an unsatisfactory body image.

With the help of today's plastic and aesthetic surgery and the latest surgical techniques, treatment options are available that lead to greater satisfaction and self-confidence. The Clinical Department of Plastic, Aesthetic, Hand and Reconstructive Surgery at Hannover Medical School offers you all treatment methods at the cutting edge of science and professional expertise to achieve your individual ideal state.

This includes

• Corrective shaping using implants and autologous tissue
• breast augmentation
• Breast reduction
• Breast lift

Corrective shaping with implants

Lateral imbalance, underdevelopment of the breasts, malformations, volume reduction and sagging can be surgically corrected using silicone implants. The procedure is determined together with the patient in a personal consultation according to her wishes and individual appearance and the position of the skin incision and the choice of implant in terms of size and shape is selected and the position (above/below the pectoral muscle) of the implant is decided.

The breast implants we use are high-quality and approved medical products. The implant shell has a coarse-pored structure and thus reduces the risk of capsular fibrosis. The gel-like structure of the implant protects against silicone leakage, even if the implant shell is damaged.

However, we would like to point out to our patients that material fatigue can occur, meaning that the silicone implants may need to be replaced after 15 to 20 years.

Breast augmentation

The female breast plays a key role in a woman's body image, as it represents the gender characteristic "female" to the outside world. For this reason, women who suffer from very small breasts often experience a disturbance in their emotional well-being. In our experience, breast augmentation can therefore help to restore self-confidence, which has a lasting positive impact on patients' lives.

The surgical procedure is determined together with the patient, taking into account her wishes and individual appearance.

The different shape and size of the implant as well as the position (above/below the breast muscle) are important parameters for the desired result.

Publication in the European Journal of Plastic Surgery
Implant-based multiplane breast augmentation-a personal surgical concept for dynamic implant-tissue interaction providing sustainable shape stability
DOI 10.1007/s00238-021-01816-2
Publication Date 2021-04-23

Breast reduction

After growing during puberty, the female breast undergoes changes in the course of life due to pregnancy and breastfeeding, weight fluctuations and loss of tissue elasticity.

Aims of breast reduction:

• Reduction of the breast
• Symmetry
• Creating a shape that fits the patient's body silhouette
• Short scars that are as inconspicuous as possible
• Preservation of blood circulation and nipple sensitivity
• Preservation of the ability to breastfeed

In plastic surgery, breast reduction is a good example of a procedure that belongs to both the reconstructive and aesthetic spectrum. The aim of breast reduction, in addition to tissue reduction, is to create a breast shape that is in harmony with the existing body proportions. If the breasts increase disproportionately in size and weight, this can lead to health problems, usually affecting the spine. Furthermore, fungal infections can settle in the "underbust fold" due to increased sweating, which is accompanied by severe itching. Many patients complain of painful cutting of the bra straps due to the heaviness of the breasts.

The hormonal balance during puberty and childbirth also play a decisive role in the development of the female breast. This leads to a reduction in glandular tissue and thus to a loss of elasticity, especially in mothers who have already breastfed.

Each operation is preceded by a detailed consultation with our specialized specialists, anamnesis, examination and measurement of the breast as well as breast imaging diagnostics. Breast reduction significantly reduces the weight of the breast, which means that the complaints can be treated sustainably. The result is a significantly improved cosmetic result and freedom from discomfort.

If the indication for surgery is confirmed, the costs may be covered by your health insurance.

Please do not hesitate to contact us!

Breast lift

In so-called "sagging breasts", there is a disproportion between the skin mantle and breast tissue in favor of the skin mantle. The result is sagging of the breasts. During a breast lift (mastopexy), the sagging breasts are lifted back into a natural shape. The existing glandular body, including the nipple, is moved upwards to restore the breast shape and the surrounding skin is tightened.

Aims of the breast lift:

• Lifting of the breast
• Symmetry
• Restoration of a shape that fits the patient's body silhouette
• Maintaining blood circulation and nipple sensitivity
• Preservation of the ability to breastfeed
• Short scars that are as inconspicuous as possible

After the breast lift, the new shape gains in contour and can also appear larger as a result. The additional insertion of silicone implants to increase volume is also possible (augmentation mastopexy).

After pregnancies and severe weight loss, there can be a disturbing excess of skin and tissue in the abdominal region, which cannot be reduced even through sporting activities. Excess tissue can be surgically removed by abdominoplasty (tummy tuck). However, the long-term results depend on the patient's behavior, as the tightened skin can easily stretch due to weight gain or new pregnancies.

The skin incision is made horizontally in the area of the pubic hairline so that it can be concealed by wearing underwear or swimwear. If the abdominal wall muscles are also thinned by the severe stretching or if there is even a hernia in the abdominal wall, the muscular abdominal wall is reconstructed. After removing the excess tissue, it is usually necessary to reposition the navel in order to achieve a good tightening result.

The operation is performed under general anesthesia. The inpatient stay is approximately 3-7 days.
In some cases, costs may be covered after consultation with your health insurance provider.

Body lift

Significant weight loss can lead to large, hanging flaps of skin, which can be very annoying in everyday life. Fungal infections often occur in the skin folds.

Clothes are difficult to find due to the hanging and bulging skin flaps and do not fit, so that patients are often still unhappy about their body image despite significant weight loss.

The body lift can be performed as a supplement to a tummy tuck or in a single procedure and removes excess skin from the abdomen, flanks, buttocks and therefore also from the thighs.

Other operations such as an upper arm lift and thigh lift are also required after significant weight loss.

The typical patient who benefits from a skin tightening procedure suffers from excess soft tissue on the extremities (arms/legs), which has been caused by severe weight loss.

Weight gain is usually a slow but steady process under which the skin can adapt. However, the soft tissue of the skin is not able to adapt to this extent to a significant reduction in weight, so that excess soft tissue of the skin develops, particularly in the abdomen (see abdominoplasty), upper arms and thighs, which can be cosmetically unpleasant.

Shaping surgery removes excess soft tissue, resulting in a tighter and smoother shape. The skin incision is made on the inner thigh, for example, up to the crotch area and its extent depends on the individual findings.

You will be advised in detail about your treatment options in our aesthetics consultation.
The operation is performed under general anesthesia.

The typical patient who benefits from a skin tightening procedure suffers from excess soft tissue on the extremities (arms/legs) due to severe weight loss.

Weight gain is usually a slow but steady process under which the skin can adapt. However, the soft tissue of the skin is not able to adapt to this extent to a strong weight reduction, so that an excess of soft tissue is created, particularly in the area of the abdomen (see abdominoplasty), upper arms and thighs, which can be cosmetically unpleasant.

Shaping surgery removes excess soft tissue, resulting in a tighter and smoother shape. The skin incision is made on the inner thigh, for example, up to the crotch area and its extent depends on the individual findings.

You will be advised in detail about the treatment options in our aesthetics consultation.
The operation is performed under general anesthesia.

The ideal, individual face is characterized by balance, harmony and harmonious proportions. However, the facial skin loses elasticity, water content and tone with age due to a variety of factors (in addition to smoking, alcohol, etc.), making it appear thinner and wrinkled. However, the versatility of the appearance of people of the same age makes it clear that chronological age is not necessarily the same as biological age.

Surgical lifting of the facial skin lifts and contours the cheeks, smoothes the facial skin and thus rejuvenates the external appearance of the face without impairing natural facial expressions. The incision is made in the invisible area of the hairy scalp, the temples, behind the ears and in the natural crease in front of the ear. Correction of the eyelids, forehead and neck can complement the operation.

The operation can be performed under local or general anesthesia.

The patient's improved self-confidence and the personal satisfaction resulting from this procedure lead to a lasting gain and psychological well-being for the patient.

Forehead lift

The forehead lift smoothes the forehead, lifts the eyebrows and thus also enlarges the eyes.

The incision is made invisibly in the area of the hairy scalp so that no scars are visible after the operation.

As an alternative procedure, an endoscopic forehead lift is possible, in which the surgical instruments are only inserted under the skin through tiny incisions.

To support the post-operative result, the eyelids can be corrected and, if necessary, injected with botulinum toxin.

The tightening correction of the eyelids known as blepharoplasty involves the removal of excess skin from the upper and/or lower eyelid. Bags under the eyes can also be corrected. This creates the desired effect of a younger facial appearance. General anesthesia is not required for this procedure; a local anesthetic is sufficient.

Ectropion of the upper/lower eyelid can also be surgically corrected. This is, for example, the pathological "outward and downward" inclination of the lower lid ectropion, which can lead to conjunctivitis of the eye if left untreated.

The shape, size and symmetry of the nose have a decisive influence on the aesthetics of the face. For this reason, rhinoplasty is one of the most sought-after procedures in cosmetic surgery, as a nose correction can give the patient a "new profile".

However, it is often obstructed nasal breathing that can cause patients to visit the doctor, particularly in the case of upper respiratory tract infections and allergic hypersensitivity reactions. In addition to a curvature of the nasal septum, this functional impairment of nasal breathing is usually also due to a deformity of the external nose, meaning that in most cases a functional improvement is only possible by simultaneously correcting the external nose. The costs of the procedure, known as functional septorhinoplasty, are usually covered by statutory health insurance on request. This is particularly possible for congenital and acquired deformities such as crooked nose, saddle nose, humped nose or changes in shape caused by accidents.

The most common procedure on the auricle is otoplasty. In this procedure, if the angle between the pinna and the skull is greatly increased (>30°), the "protruding ear" is reattached to the head at a natural angle. The cartilage is sculpted using a special surgical technique, resulting in a permanent correction. The operation is performed from the back of the auricle so that no scars are visible after the operation.

In children, correction should ideally be carried out before they start school between the ages of 5 and 6 in order to avoid psychological stress from the environment.

The costs for otoplasty in children are covered by statutory health insurance.
Corrective otoplasty can be performed on adults at any time.

Patients who have suffered a loss of the outer ear or patients with malformations of the external auditory canal can be reconstructed using localized procedures or a free tissue transfer, depending on the defect.

Wrinkle injections

Injecting wrinkles in the facial area is a gentle procedure to rejuvenate the appearance of the face.

We only use hyaluronic acid, which can be broken down by the body, to avoid permanent hardening and deformities.
Wrinkle injections are particularly indicated when wrinkles appear in the skin even without muscle activation.

However, this procedure is only effective for a limited time.
It can be refreshed from time to time at your own discretion.

Botox

Admission

At the beginning of 2006, the drug Vistabel® (Allergan) was granted admission in Germany for the treatment of forehead wrinkles. This confirms years of good clinical experience with regard to efficacy and patient safety. The admission of the other preparations (Botox®/Allergan, Dysport®/Ipsen, Xeomin®/Merz) containing botulinum toxin A is limited to the treatment of muscle cramps or spasticity.

Corrections after cosmetic surgery

After previous cosmetic surgery, results may occur that are considered unaesthetic and unsatisfactory for the individual. A possible complication-prone course can result in shape disorders or unfavorable scars that make further surgical interventions necessary. Changes in shape or implant-related complications that can be addressed surgically can also occur over the long term, e.g. after breast augmentation with implants. The rare BIA-ALCL (breast implant-related anaplastic large cell lymphoma) must be ruled out as a possible reaction to silicone implants in the event of any noticeable change in shape after breast augmentation by means of standardized diagnostics, as in our Clinical Department.

As a second opinion center, we are also available for an assessment, consultation and, if necessary, surgical corrections in the case of previous external operations.

Examples of shape disorders or complications

• Breast asymmetry (after enlargement or reduction)
• Scar irregularities
• Contour irregularities of the skin after liposuction
• Chronic pain
• Implant-related complications (capsular fibrosis, slippage, implant rupture, pain, unaesthetic changes in shape over time)
• BIA-ALCL (breast implant-related anaplastic large cell lymphoma)