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Split Muscle Breast Augmentation



Dr. Drik Kremer's Split Muscle Technique. Note the natural projection of the lower part of the breasts but superior part of implant well hidden under the muscle. Also, this procedures is less painfull than under the muscle completely. 

Split Muscle Breast Augmentation

Split Muscle Technique By Dr. Kremer

The split pectoral muscle technique Learnt in Los Angeles, Dr Kremer perfected this groundbreaking technique at his clinic in Munich.


Traditionally implants are either placed on top of the chest muscle(supra pectoral) or underneath (sub pectoral); this new procedure sees the muscle split just wide enough to cover the top part of the round implant leaving the lower part lying on top of the muscle yet still under the skin and breast tissue. The outline of the implant is hidden under muscle whilst the fullness in the lower part is accentuated. The success of this procedure relies a great deal on the skill of the surgeon as accurate placement of the cut is vital to the overall result, avoiding breasts that are too close together or too wide apart.

Read More About The Split Muscle Technique On Our Blog Click Here

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Female Breast Surgery

What breast surgery actually entails


Breast surgery is a highly individualized procedure – Permanent breast enhancement can only be achieved surgically. There is currently no medical treatment of any kind for breast enhancement with the proven results and satisfaction of breast augmentation. Adult woman of any age can benefit from breast augmentation to enhance small breast size or restore fullness. However it is recommended that breasts be fully developed prior to breast augmentation. You should also be aware that breast augmentation does not generally interfere with a woman's ability to breastfeed. Good candidates for the procedure are defined as:

  • Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
  • Non-smokers
  • Individuals with a positive outlook and specific goals in mind for improving their body image
For additional detailed information regarding the safety of breast implants, please visit


Where do I begin?


A consultation with your plastic surgeon is the first step to learn how breast augmentation can enhance your breasts' appearance and improve your body image. A consultation is designed to fully educate you about breast augmentation in a non-pressured environment and will include:

  • A discussion of your goals and an evaluation of your individual case
  • The options available in breast augmentation surgery ( eg. Type of breast implant, size, and position)
  • The likely outcomes of breast augmentation and any risks or potential complications as well as any guarantees in place by the manufacturers for such complications.
  • The course of treatment recommended by your plastic surgeon according to your needs and suitability.
  • Pictures of previous clients who have given permission will be used in order to illustrate the types of results to expect.cosmedocs operating theatre


What can breast surgery achieve?


A consultation with your plastic surgeon is the first step to learn how breast augmentation can enhance your breasts' appearance and improve your body image. A consultation is designed to fully educate you about breast augmentation in a non-pressured environment and will include:

  • Breast Enlargement
  • Breast Uplift
  • Asymmetry Reduction
  • Breast Implant Revision
  • Inverted Nipple Correction


Who can benefit from breast surgery?


Breast size is important to many women. Some individuals feel that small breasts not only limit their fashion choices, but can also cause dissatisfaction with body image. Breast augmentation to increase fullness and projection of the breasts improves the balance in a woman's figure and can enhance her self-image and self-confidence.

Breast augmentation is the surgical placement of breast implants to increase fullness and projection of the breasts or to improve symmetry of the breasts. Clinically referred to as augmentation mammaplasty.
The procedure is used cosmetically to:

  • Enlarge a naturally small breast, most commonly the result of heredity
  • Restore breast volume lost following pregnancy, as a result of breast-feeding or due to weight loss
  • Achieve better symmetry when breasts are moderately disproportionate in size and shape
Breast augmentation does not however correct sagging breasts. In cases where a woman desires to enhance breast fullness and at the same time improve the position and shape of sagging breasts, a breast lift may be performed in conjunction with breast augmentation.


Realistic expectations


Breast augmentation does not however correct sagging breasts. In cases where a woman desires to enhance breast fullness and at the same time improve the position and shape of sagging breasts, a breast lift may be performed in conjunction with breast augmentation.


Different breast surgery procedures


Breast Uplift (Mastopexy)
Over time breasts, just like the rest of the body can sag and become droopy. Pregnancy, breast feeding and weight-loss can give the breast a deflated appearance and many woman become very conscious of how their breast look especially in fashionable clothes and on the beach. If you desire a breast uplift surgery with no increase in size then this is the right procedure for you. The aim of surgery is to reposition the nipple, pull up the breast tissue and reduce the amount of skin. The design of the procedure is based on a breast reduction.

CosmeSurg surgeons' are experts in breast uplifts, so you know you will be in safe hand throughout all stages of your breast uplift. We provide before and after care so our patients reap the maximum and according to their satisfaction results.


All women have some degree of size difference between their breasts; asymmetry refers to an obvious inequality. It is caused by the lack of full development of the breast on one side. There are several options for treatment but the most simple is usually the insertion of different size breast implants in each side in order to create a balanced and even look. In severe cases where there is a large difference in nipple-areola shape and size additional surgery such as breast uplift may be necessary.

The risks include scars, infection, hematoma, capsular contracture, implant replacement and secondary surgery to name the most common. But lesser degrees of asymmetry often persist. Additional scarring for nipple-areola correction may take a little longer to fully settle.

Breast Implant Revision
A women's breast do not remain static in shape, size or volume throughout different stages of their life, particularly pregnancy and lactation. Breast Augmentations are not considered fixed or permanent and 'maintenance' surgery is often required at some stage.

Common causes are droopiness (ptosis), especially with very large implants, implant failure and the most common reason worldwide capsule formation. The procedure then depends on the cause and will vary from simple implant replacement, capsule removal or uplift (mastopexy). All secondary operations take longer to perform, require longer recovery, carry a slightly greater risk of complications and generally leave larger scars. Results are less predictable and surgical experience is vital.

Recovery may require the use of drains, overnight stay and there is a greater risk to nipple sensitivity. Hence, in order to ensure your quick recovery with a successful procedure CosmeSurg will allow only very experienced breast surgeons to operate on such cases requiring a very high level of expertise and care.

All women have some degree of size difference between their breasts; asymmetry refers to an obvious inequality. It is caused by the lack of full development of the breast on one side. There are several options for treatment but the most simple is usually the insertion of different size breast implants in each side in order to create a balanced and even look. In severe cases where there is a large difference in nipple-areola shape and size additional surgery such as breast uplift may be necessary.

Inverted Nipple Correction
Most cases of inverted nipples are congenital – some people are just born that way. However, some nipples become inverted after breastfeeding when scar tissue builds in the milk ducts. Nipples that become inverted after birth are usually caused by one of three things:
  • Not enough skin at the base of the nipple
  • Constricted milk ducts
  • Scarring of the milk ducts due to breastfeeding.
An inverted nipple may appear flat or as a hole or slit-like depression. Nipple correction surgery can restore the nipple to a naturally-projecting appearance.

“Puffy” areola (also known as Protuberant Areola) puts a cone–like cap on the breasts that some women find unattractive. CosmeSurg can perform a simple, routine procedure to flatten the areola and beautify the breasts.


Male Breast Reduction

What causes enlarged breast in males


Gynaecomastia is an excessive enlargement of the male breast. It may affect one or both breasts. For some teenage boys and adult men, it can be a normal occurrence at a certain stage of life. Although men and boys who have gynaecomastia find it embarrassing, it is a common condition.

Excess breast tissue in men with gynaecomastia is composed of fatty tissue and mammary gland tissue. Some male breasts contain mainly fatty tissue while others contain mainly glandular tissue or they may be made up of both. Extra skin can also make breasts look larger. After an examination, your surgeon may require further tests such as a mammogram or ultrasound to determine the make-up of breast tissue to plan the best surgical approach. These investigations will also check for the presence of breast cancer which is highly unlikely.


Treatment options


Some patients respond to non-surgical management if an underlying cause has been identified. These modalities can include medications to regulate hormonal imbalances and irradiation. Medical therapy has only met with limited success.Surgical treatment is based on the degree of breast tissue that is present as well as the element of 'drooping' of the breast. A convenient grading system is useful in planning surgical options.




Prior to the operation, the patient is marked in the upright position and the extent of all the fat is marked out. The operation involves essentially sucking out fat with a rigid, blunt metal tube through a small cut in the outer lower portion of the chest. The wound is closed with and a pressure garment is worn thereafter.



Frequently Asked Questions


How long does the surgery take?
The surgery will take up to 1-3 hours depending on the individual patient. Most patients can go home on the same day after the surgery; however some will stay in the hospital for a couple of days.

What can I expect from a Gynaecomastia?
As long as your expectations are realistic, the chances are you will be pleased with the results. You will have a flatter, better-contoured chest that is more pleasing to yourself.

What will happen in the recovery period?
There will be some swelling and bruising of the treated area. To help reduce this you will wear a firm Lycra garment which is worn for 3 weeks. The worst of your swelling will go down in the first few weeks however, it may be a couple of months before the full effect of the breast reduction surgery is apparent. Most patients can resume full activity including exercise in about a month following surgery for Gynaecomastia.

What is the recovery time from male breast reduction surgery?
Recovery is normally between two to three weeks, however 1-2 days after surgery you should be on your feet. It is important not to carry out vigorous activities for the first five days after the surgery. You can return to work and resume most normal activities after three weeks and begin exercise after six weeks.

Note: It is important to wear a compression vest 24 hours a day for 4 weeks and at night for a further 4 weeks.


Before Afters


Our Surgeons Keep A Complete Portfolio Of Their Before & After Pictures Which Will Be Available For You In Clinic.


Female Breast Surgery:

  1. Can saline-filled breast implants harden?
    1. Yes. Capsular contracture, which occurs when scar tissue forms around the implant, can occur with both saline-filled and silicone-gel-filled breast implants. Learn more about the risks and treatment in our comprehensive article on capsular contracture.
  2. What are the differences between smooth and textured mammary implants?
    1. The surface of the outer shell of breast implants can be either smooth or textured. Textured implants have a sandpaper-like surface, while smooth implants have a balloon-like surface. There are pros and cons to each. Smooth implants move about freely in their pocket and usually have thinner shells than their textured counterparts. The thinner shell allows smooth implants to feel more natural. Implants with smooth surfaces are also less likely to ripple. Textured implants were designed to lower the risk of capsular contracture, but this has not been proven. One type of implant shape — known as the anatomical or tear-shaped implant — is only available with a textured surface, because this surface helps keep these contoured implants in position. What´s more, textured breast implants may take longer to drop into a more natural position than smooth implants, resulting in breasts that appear higher on the chest. Some of the differences in the implant surface characteristics depend on what they are filled with — saline or silicone gel. Discuss your concerns with your surgeon.
  3. What are the differences between round and contoured breast implants?
    1. Breast implants come in a variety of shapes, but the two major types are round and contoured (also called shaped, anatomical or tear drop). Contoured implants were designed to create a more natural-looking breast shape. They are flatter on top than the bottom, so if the implant rotates, a revision surgery may be needed. Some teardrop implants are textured to avoid this rotation. By contrast, round implants — circular mounds that are flat on the back and round on the front — do not change their shape when you move. It is a matter of taste. If you like and want the rounded, sharper-edged, "Victoria´s Secret" model look, go with round implants. If you're looking for the most natural result, talk to your surgeon about the contoured implant. In the future, a teardrop silicone-gel-filled implant may be available in the U.S.; this will give more fullness in the upper part of the breast and will likely provide a more natural result.
  4. How long do breast implants last?
    1. The Institute of Medicine estimates that breast implants last an average of 16 years. Breast implant manufacturers such as Allergan and Mentor offer conditional guarantees for their implants. Each breast implant is numbered by lot and has a serial number for identification. You will most likely receive the serial number stickers as part of your postoperative information packet. In general, such warrantees protect you in case an implant rupture occurs. They cover the replacement cost of the implant itself, which is only part of the cost of breast augmentation surgery. You may also purchase additional coverage with the implant company.
  5. Can fungus grow in a saline-filled breast implant?
    1. This is an extremely rare occurrence. The saline in saline implants is sterile, and plastic surgeons now employ a closed technique to fill the implant. These efforts help stave off contamination with fungus. In the past, when the implant was filled using an open technique, there were cases of fungal infection. During the open technique, the saline comes in contact with air. The closed technique allows the saline to be injected directly from the bag into the implant without being exposed to air. If the saline breast implant is sterile when it is inserted, it should not become contaminated within the body.
  6. What are my breast implant options?
    1. The Food and Drug Administration (FDA) has approved two types of breast implants: silicone-filled and saline-filled. Both types of implants are basically shaped envelopes made of silicone that are filled with silicone gel or salt water (saline). Other types of breast implants are now being studied. This includes cohesive gel implants, also known as form-stable or "gummy bear" implants due to their consistency. These implants are available everywhere but in the United States.
  7. Are silicone-gel-filled breast implants safe?
    1. Yes. Though the Food and Drug Administration (FDA) did remove silicone-filled breast implants from the market in 1992 after lawsuits alleged they increased a woman´s risk of autoimmune and connective tissue diseases, a subsequent FDA investigation could not find any link between silicone breast implants and these diseases. As a result, they re-approved silicone-gel-filled implants in 2006.
  8. How many cubic centimeters make a cup size?
    1. Breast implant volume or size is measured in cubic centimeters (cc).One study found that an average of 189 cc of saline was needed to go up one bra cup size. Increasing an A cup to a C cup required a total of 391 cc, or 196 cc per cup. Moving from a B cup to a D cup required a total of 448 cc, or 224 cc per cup. The largest change, an A cup increasing to a D cup, required 437cc, or 145 cc per cup. Remember, bra cup sizes are not standardized. A Victoria's Secret C is not the same as a Warner's C, for example.
  9. What is overfilling?
    1. Overfilling involves adding more saline to the breast implant than the manufacturer says is the maximum amount. This is only an option with saline breast implants, as they are filled after implantation. Saline implants come in a wide range of sizes, and all of them have both a minimum and maximum fill amount. Overfilling may make the implant feel firmer, but will not affect its size. Overfilling may also increase the risk of deflation, and may void your warranty.
  10. What are expandable breast implants?
    1. Expandable saline-filled breast implants can be adjusted in size by adding more saline through a special valve, or port. Originally, this type of implant was primarily used for women undergoing breast reconstruction after breast cancer surgery, but they may also have a role in cosmetic breast augmentation. Here's how they work: A surgeon uses a syringe to either inject saline into — or draw saline out of — the implants through a port that is placed beneath the skin where the implant was originally inserted. This can allow a woman room to experiment with breast size, without undergoing revision breast augmentation.
  11. Can I get "gummy bear"implants in the United States, UK?
    1. Cohesive gel or "gummy bear" implants are under investigation, and are only available to women who enroll in a clinical trial. These implants are made of silicone gel, but the gel has the consistency of a gummy bear, meaning if you cut it in half, it will not leak.
  12. What is the "Ideal" implant?
    1. This is a brand name for an implant that purports to have the best qualities of both saline and silicone-gel-filled implants. As such, its manufacturers refer to it as a "hybrid" implant. It looks like a saline implant on the outside, but the edges are lowered so it may contour better to the chest wall. On the inside, there are a series of additional implant shells that are nested together to reduce bouncing, and reduce the risk of rippling. It is not yet available outside of clinical trials.
  13. Can breast implants rupture during a mammogram?
    1. Yes, an implant can rupture during mammography. This occurs when the pressure on the breast weakens the implant. The older a breast implant is, the more susceptible it is to trauma. This is not a reason to avoid mammograms. Tell the mammography technician that you have breast implants, and he or she will take special care not to cause a rupture. Please see our Mammogram and More section for more information on this important issue.
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Have now been to Cosmedocs three times, twice for botox and once for filler. Fantastic service and discussed filler to great lengths to make sure i was happy with the choice of filler. Amazing results on top lip, wow, very subtle but everyone can notice i now have a top lip lol. Also had filler in the nasal lines, from nose to mouth, again i couldn't be happier. Had this done at another surgery before and was not happy with the outcome. Again Cosmedocs have excelled for me. Great service, great doctor and great prices.
SL - London




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