Endoscopic Breast Augmentation: Methods, Procedure & Costs
A special procedure of the Forum Clinic in Cologne. Precise, gentle, nearly invisible scar: Through a fine incision in the armpit, we form an exact pocket under the large pectoral muscle under endoscopic view and place the implant without contact.
Overview of the treatment
The most important facts
Operation Duration: approx. 60–120 min. (depending on findings/implant)
Anesthesia: General anesthesia
Stay: outpatient or 1 night inpatient
Aftercare: Support bra for 4–6 weeks; protect the armpit, gentle exercises as instructed
Suitable if...
If you wish for a breast augmentation without visible scars on the breast.
If you prefer a precisely shaped, naturally appearing result with submuscular placement.
If you want to primarily enlarge or plan a gentle correction after a pre-op.
If you are healthy, non-smoker, and suitable for the surgery.
Relatively unsuitable …
in case of significantly sagging breasts, when no lift is planned (often a breast lift is then advisable).
after previous surgeries in the armpit or when the implants cannot be securely placed under the muscle (we clarify this on a case-by-case basis).
Process – 4 Steps
Consultation & Planning
Detailed medical history, clinical examination, if necessary imaging diagnostics (e.g., mammography/ultrasound), discussion of implant choice, realistic goals, and possible alternatives. Information about the procedure, risks, and aftercare.
Preparation
Precise marking of the axilla fold and the planned implant location. Surgery planning, selection of implants, discussion of the "No-Touch" technique using Keller Funnel. Instructions regarding fasting, medication, and aftercare/compression bra.
Surgery (under general anesthesia)
– Short incision at the highest point of the armpit along the skin fold.
– Non-traumatic access between the major and minor pectoral muscles; no severing of the axillary lymphatic pathways.
– Endoscopic preparation of the implant pocket under direct visualization: precise shaping, partial release of the lower pectoralis attachment for harmonious projection.
– Touch-free insertion of the implant using Keller-Funnel; alignment check.
– Drainage only if needed; skin closure with fine sutures, scar in the natural axillary fold.
Aftercare & Return to Daily Life
Postoperative monitoring, instructions for arm rest (short-term lifting/stretching restrictions), cooling of the axillary region, support bra, and possibly axillary girdle for 4–6 weeks. Follow-up appointments (e.g., after 1 week and 6 weeks). Daily activities usually return after a few days, with sports gradually starting after 2–3 weeks.
Result & Durability
The result is natural and harmonious: The breast receives additional projection, while the skin of the breast remains intact. The submuscular position offers stable shape and for many patients a particularly soft, discreet wearing sensation. As with any implant enlargement, changes in the body or connective tissue over the long term may necessitate a check-up or later implant exchange – we will advise you transparently on this.
Risks & Safety
In the short term, swelling, bruising, a feeling of tension, or temporary numbness can occur in the armpit/upper arm area; these usually subside within a few weeks. Endoscopic procedures mean tissue-preserving work under vision – structures of the armpit, especially lymph vessels, are not cut. Drains are only needed in exceptional cases.
General surgical/anesthesia risks (e.g., infection, postoperative bleeding, seroma, thrombosis/embolism) exist. Specifically, capsule fibrosis (rare, reduced by modern implants and sterile “no-touch” technique), implant displacement or temporary dependence of breast muscle movement are possible. With our expertise established since 2004, ISO-certified hygiene processes, cotton-free work and the Keller-Funnel technique, we reduce risks according to the state of science. If any abnormalities occur, we are available around the clock.
Combinations & Alternatives (optional)
Liposuction of the lateral breast/axilla for contour refinement
Aureole correction (shape/size)
Pure tightening (mastopexy), if mainly the shape is the issue and not the volume
