Your breasts – identify your issue and see how we can help you.
Every woman's breasts are different. Whether you are dealing with a loss of firmness after breastfeeding, disproportion, or asymmetry, find out which surgical solution is right for you.
Sunken and inverted nipples
Are your nipples inverted? Are you worried that you will never be able to breastfeed your child? Perhaps you have never experienced the pleasure that nipple stimulation can provide and would like to know what it feels like? Or maybe it simply makes you feel self-conscious? An inverted nipple is most often a congenital condition; it is not uncommon, affecting between 1.8% and 3.3% of all women. The issue manifests in various forms, ranging from nipples that are retracted but easily protrude with manual stimulation to those permanently retracted due to shortened, fibrotic milk ducts.
Mildly inverted nipples can sometimes be drawn out by continuously wearing a piercing or a shaping device for at least six months. However, this is a tedious, often painful method with limited effectiveness. Paradoxically, surgery is a much simpler solution, especially since the procedure is performed on an outpatient basis under local anesthesia. The more severely inverted the nipple, the more likely it is to require direct correction.
As an alternative to this so-called "direct nipple correction," a similar effect can be achieved by inserting a high-projection breast implant. Such an implant pushes the entire breast gland forward, indirectly forcing the nipple outward. In most cases, the ability to breastfeed is preserved after the procedure.
Uneven breasts, or asymmetry
Breast asymmetry affects the majority of women, and slight differences in volume or positioning are entirely natural. Since no one is perfectly symmetrical, variations in the structure and alignment of the ribs on the left and right sides naturally result in differences in breast placement. Asymmetry is further pronounced in cases of congenital muscle defects—such as Poland syndrome—or abnormalities in the connective tissue supporting the breast gland, as seen in tubular (or tuberous) breasts. Furthermore, differences in breast volume can develop following pregnancy or breastfeeding. Naturally, breast surgeries—such as the removal of benign or malignant tumors—can also lead to significant size discrepancies. Beyond aesthetic concerns, marked asymmetry causes uneven weight distribution on the spine, potentially leading to spinal degeneration and curvature.
If you are troubled by breast asymmetry, uneven posture, or back pain, or if you struggle to find well-fitting lingerie, plastic surgery offers a range of lasting solutions to achieve balanced, beautiful breasts.
Macromastia and Gigantomastia – When Breasts Are Too Large
Many women suffer from having overly large breasts. A heavy bust sags, looks unattractive, and places a strain on the spine. Spinal pain resulting from degenerative changes can be severe enough to serve as a sufficient indication for the procedure. Another medical reason for such surgery may be an inability to breastfeed; excessively long milk ducts can become blocked, making nursing impossible. Furthermore, large breasts will inevitably begin to sag over time. In such cases, if the skin of the lower breast pole rests directly against the skin of the inframammary fold, thermoregulation and glandular secretion are impaired, potentially leading to bacterial accumulation or fungal infections.
Breast reduction procedure
Sagging breasts
Have your breasts lost their firmness and begun to look empty or saggy? It may be of some small comfort to know that you are not alone—many women struggle with this issue. Breast sagging occurs when the skin stretches to the point where it loses its elasticity. This can have a genetic basis; some women develop heavy breast tissue that puts a strain on the skin, causing it to stretch permanently. However, the greatest enemies of breast firmness are obesity and significant weight fluctuations. Frequent weight loss and gain cause the skin all over the body—not just on the breasts—to stretch and lose elasticity. This is why breasts often appear to sag after weight loss. Excess weight can also stretch the skin so severely that it permanently loses its elasticity. A similar mechanism applies after pregnancy or breastfeeding: heavy breast tissue stretches the skin, and the breast does not return to its original state.
In cases of mild sagging—such as Grade 1 ptosis on the Regnault scale—simply filling the breast with an implant is often enough to restore a beautiful appearance. Ideally, this procedure is performed using an endoscopic method to avoid scarring.
More severe degrees of sagging require mastopexy (breast lift). This can be performed with an implant (augmentation-mastopexy) or without one (standard breast lift), and in some cases, via a minimally invasive procedure semi-videoscopic breast lift with implant.
Breasts after pregnancy
So, you decided to take on one of life’s greatest challenges and became a mother. Your body has made—and continues to make—you keenly aware that you have given birth and that your identity has changed forever. You have also noticed changes in your breasts since pregnancy. Do you feel they have lost their former vitality? Does your bust area feel heavy and sagging, making you feel unattractive and undermining your self-confidence? Do you suffer from recurring neck and back pain, or struggle to find clothes that fit properly? Do you find it difficult to maintain proper hygiene or good posture due to the shape and size of your breasts? If the answer to any of these questions is yes, then breast reduction may be the right choice for you. Breast reduction is always accompanied by a breast lift; this means that after the procedure, your breasts—while smaller—will appear fuller, firmer, and, above all, positioned higher. Together, we can help you regain your self-confidence and restore the youthful appearance you long for. In most cases, implants are not required, ensuring a completely natural-looking result.
Not all women experience breast enlargement after pregnancy. In some cases, glandular tissue atrophies while the skin and fascia lose elasticity, causing the breasts to sag. Is this the case for you? If you are satisfied with your breast volume but they have lost their shape, a mastopexy would be a suitable solution. Mastopexy refers to a breast lift procedure, which can be performed using various techniques.
Furthermore, breastfeeding can lead to breast asymmetry. This is more likely if you primarily nursed from one breast. Mastopexy can resolve this issue and restore symmetry to your breasts.
Conversely, if your breasts took on a beautiful shape during pregnancy, you might feel disappointed when they shrink significantly after you stop breastfeeding. Many women miss the firm, full breasts they had during the nursing period. In such cases, you can opt for breast augmentation using implants. There are various breast augmentation methods - such as incisions made in the armpit, around the areola, or in the inframammary fold - utilizing ultra-light or polyurethane-coated implants. I describe all these methods in separate subsections. Minor adjustments to volume and shape can also be achieved through fat transfer from other parts of the body.
Undersized breasts, or micromastia
Have you always dreamed of having beautiful, firm breasts? Do you desire a sensual, full décolletage like the one seen on the alluring heroines in movies? Have your breasts lost their fullness due to pregnancy, breastfeeding, or the relentless passage of time, and you wish for them to look round and youthful again? Perhaps you were born with small breasts—something that has unfortunately always made you feel self-conscious? Or maybe you simply want your breasts to be larger?
You can make your dream of breast enlargement a reality. A wide range of implants on the market, combined with potential additional procedures such as fat grafting or mastopexy, allows us to give your breasts the shape and size you desire - ranging from a youthful, natural look to a full, highly prominent appearance.
There are many methods of breast augmentation; they differ in the surgical approach, the type of implant used, and the type of pocket created for the implant. Each method has its advantages and disadvantages, but above all, the choice should be tailored to the individual patient. In the following subsections, I will present the techniques I use most frequently: transaxillary augmentation, augmentation with polyurethane-coated implants, augmentation with ultra-light implants, the trans-nipple approach, fat grafting, and variations of these methods.
Hypertrophy of the nipple papillae
Many women suffer from—and feel self-conscious about—significantly enlarged, elongated, and drooping nipples, often unaware that this is a relatively common condition. Factors such as breastfeeding or genetics can cause the nipple to increase in circumference and elongate to 2–3 cm. While this condition primarily affects women of Southeast Asian descent, it also occurs among women in Latin America and Europe. Nipple reduction surgery offers a solution to this problem.
Nipple reduction procedureBreast deformity after implants and ruptured implants
Have your breasts—once beautiful, firm, and lifted thanks to implants—changed shape over the years? There are many possible reasons for this, the most common being capsular contracture. This involves the connective tissue capsule—a sheath the body creates to isolate the foreign object (the implant). If this capsule contracts severely or becomes overgrown, it can cause breast deformity and sometimes even pain. A less common issue is a rupture of the implant shell, which can lead to the contents leaking into the surrounding pocket. An extreme—and fortunately extremely rare—problem is BIA-ALCL, a type of lymphoma.
If you notice any implant-related deformity, I recommend visiting the surgeon who performed the original procedure or consulting a plastic surgeon for diagnosis and treatment.
In most cases, I can determine the cause through a clinical examination and recommend the appropriate corrective procedure: either replacing the implants or removing them combined with breast reshaping surgery.
It is worth noting that not every breast deformity is caused by the implant itself; over many years, our tissues undergo a natural aging process and may sag below the implant—a condition known as "Waterfall Deformity." Implant removal is not always necessary in such cases; sometimes, a mastopexy (breast lift) or fat grafting is sufficient.
Conversely, implants can "slide" downward, or the breast tissue may enlarge due to hormonal changes; both scenarios can lead to deformities such as "double bubble" or "bottoming out." In these situations, implant replacement would be advisable for aesthetic reasons.
Tubular breasts
If one or both of your breasts have had unnaturally large, "puffy" areolas or a tubular, drooping shape since puberty, you may have a developmental condition known as tubular breasts. This condition results from the underdevelopment of the connective tissue that gives normally developed breasts their attractive shape. Breastfeeding may be difficult in such cases.
Fortunately, plastic surgery offers a solution through the correction of tubular breasts.
Chest asymmetries and deformities
Asymmetries and abnormal chest shapes are most often congenital defects - such as Poland syndrome, *pectus carinatum* (pigeon chest), *pectus excavatum* (funnel chest), or spoon-shaped chest—though they can also develop due to spinal curvature during early growth, resulting in a chest that is sunken on one side. A separate category consists of secondary defects acquired through accidents or oncological resections. While the treatment of internal thoracic organs and functional spinal repair falls within the purview of thoracic surgeons, orthopedists, and potentially neurosurgeons, the aesthetic aspect belongs to the field of plastic surgery.
Take the first step towards self-confidence
The consultation is a time for your questions and a thorough assessment of treatment options.
