Breast Surgery in Switzerland: The Complete Guide

Breast surgery covers all procedures that change the volume, shape, position or symmetry of the breasts. It is one of the most frequently performed areas of plastic surgery in Switzerland, and also one of the most varied: a young woman with asymmetrical breasts, a mother whose breasts have emptied after breastfeeding, a woman with back pain caused by heavy breasts, a man bothered by gynaecomastia and a patient reconstructed after cancer have neither the same expectations nor the same solutions. This guide presents all these procedures and explains how to choose between them, what you need to know about implants, recovery, risks, long-term follow-up, insurance coverage and where to consult in the 26 cantons. It links to our detailed pages, starting with our page on breast surgery in Switzerland.

The main breast procedures are augmentation with implants, fat transfer or a hybrid technique, a lift for sagging breasts, a reduction for overly large breasts, implant exchange or removal, correction of asymmetry or tuberous breasts, correction of gynaecomastia in men, and reconstruction after cancer. They are usually performed under general anaesthesia, with a support bra for several weeks. Breast reduction with a medical impact, reconstruction after cancer and certain malformations may be covered by insurance; cosmetic procedures are not. Budget guidelines in percentages on our page on breast surgery prices in Switzerland.

These procedures can be combined with one another, for example a lift with implants, or with other body contouring procedures, such as a tummy tuck in post-pregnancy restoration. Our detailed pages describe each of these situations.

This table gives general guidance; only an examination allows the choice to be made. Skin quality, stretch marks, desired volume and tolerance of scars count a great deal in the decision.

The breast is made of gland tissue, surrounded and interwoven with fat, lying on the pectoralis major muscle and covered by skin. The gland, organised into lobes connected to the nipple by ducts, produces milk. The proportion of gland to fat varies greatly from one woman to another and over a lifetime, which explains differences in consistency and how the breasts respond to weight changes.

Nipple sensation depends mainly on a nerve that reaches the breast from the side, at the level of the fourth space between the ribs. The vessels supplying the areola come from several directions. These landmarks guide surgeons in choosing techniques that preserve the sensation and vitality of the areola.

The beauty of the breasts is not just a matter of volume. Surgeons rely on reference points for proportions: a nipple located roughly halfway down the upper arm, between the shoulder and the elbow; an upper pole slightly less full than the lower pole, with a gentle slope; an areola in proportion to the breast; a harmonious space between the two breasts; and breasts suited to the width of the chest and shoulders.

These reference points are not norms to be imposed, but tools for achieving a natural result. Very large breasts on a petite figure, or breasts that are very round at the top on a slim woman, can look artificial. The surgeon discusses this with you based on your preferences, your figure and your activities.

Puberty

The breasts develop under the influence of hormones, sometimes asymmetrically for several years. Asymmetry often, but not always, decreases once growth is complete.

Weight changes

Breast fat follows changes in weight: weight gain increases volume, weight loss reduces it and can leave lax skin.

Pregnancy and breastfeeding

The gland develops, the skin stretches, then the breasts often empty after weaning, with a loss of volume and more or less marked descent.

Menopause

The gland is gradually replaced by fat, and the breasts become softer and tend to descend.

Age

The skin loses its elasticity and the ligaments slacken; ptosis increases.

Understanding these changes helps you choose the right time for a procedure. It is often advisable to wait until growth is complete, to have a stable weight and, if a pregnancy is planned, to think about its timing, as it can change the result of breast surgery.

During puberty, the breasts develop over several years, often unevenly. Asymmetry, tenderness, and rapid or slow development are usually normal. It is worth seeking advice if the difference between the breasts is very marked and persists after growth is complete, if the shape suggests tuberous breasts, if the breasts become very large and painful, or if there is a palpable lump.

In adolescent boys, gynaecomastia is common and often regresses. In all cases, a kind, attentive approach and clear information are essential, as these situations are often difficult to live with. Cosmetic surgery is not offered before development is complete, except in exceptional cases assessed by a specialist team.

At menopause, the mammary gland is gradually replaced by fat, and the breasts become softer, sometimes larger with weight gain, and tend to descend. Some women then wish to have a lift, a reduction or old implants removed. Breast cancer screening becomes particularly important at this age; a recent mammogram is requested before any procedure. Tissues heal a little more slowly, but results remain very satisfying.

After one or more pregnancies, many women find their breasts have changed: they are emptier, especially at the top, softer, sometimes lower; the areolas may be wider and darker, and an asymmetry may have appeared. These changes are natural and vary with genetics, skin quality, the number of pregnancies and weight changes.

It is advisable to wait at least six months after the end of breastfeeding before considering surgery, until the breasts have stabilised. Depending on the situation, augmentation with implants or fat transfer, a lift or both are proposed. If another pregnancy is planned, it may be better to wait. See our page on the mommy makeover.

After bariatric surgery or a loss of several tens of kilos, the breasts often lose a lot of volume and the very stretched skin remains lax. The breasts may look empty and very low, with folds extending towards the back. Correction generally combines a lift with gland reshaping, sometimes an implant or fat transfer, and often treatment of the lateral folds.

It is recommended to wait until weight has stabilised, generally twelve to eighteen months after bariatric surgery. These procedures are often part of a programme of reconstructive body contouring. See our guide to bariatric surgery.

The first breast reductions date back to the early twentieth century, and current techniques, which preserve the blood supply to the areola, developed after the 1960s. The first silicone breast implant was placed in 1962. Since then, implants have gone through several generations, with stronger shells and more cohesive gels, and episodes that have marked the specialty, such as the scandal of fraudulent implants from a European manufacturer revealed in 2010, or the withdrawal of certain macrotextured implants in 2019, linked to a rare lymphoma.

In parallel, breast reconstruction after cancer has made great progress, with techniques using the patient's own tissues and fat transfer. Breast fat transfer, long controversial, is now practised within a regulated framework. The specialty now places emphasis on implant traceability, patient information and long-term follow-up.

Breast implants have evolved considerably since the 1960s. The first generations had a thin shell and a liquid gel, which could seep through the shell and spread in the event of rupture. Subsequent generations strengthened the shell with several layers and introduced barriers against gel diffusion. Current implants contain a cohesive silicone gel, which is firmer and keeps its shape even if the shell ruptures.

Surfaces have also evolved: after a period when heavily textured surfaces were widely used to limit rotation and capsular contracture, their association with lymphoma led to smooth and microtextured surfaces being favoured. If you have old implants, it may be useful to review their type and condition with a surgeon, particularly if they are more than fifteen years old.

Breast augmentation aims to give more volume to breasts considered too small, underdeveloped or emptied after pregnancy. There are three approaches: implants, fat transfer and the hybrid technique, which combines the two.

The choice is made at the consultation, according to the desired volume, the thickness of the skin and gland, the fat available, the shape of the chest and expectations. See our page on breast augmentation in Switzerland.

In trans women, feminising hormone therapy leads to breast development, generally over two to three years, but often modest. When the volume remains insufficient, augmentation with implants or fat transfer can be offered. The shape of the chest, often wider, with more developed pectoral muscles and smaller areolas, guides the choice of implants, generally wider, and of the placement plane.

It is advisable to wait at least one to two years of hormone therapy before deciding, to judge natural development. Insurance coverage may be requested as part of a gender dysphoria care pathway, according to criteria examined case by case. See our page on body feminisation.

The filling

The vast majority of current implants are filled with cohesive silicone gel, which does not leak if the shell ruptures. Saline-filled implants, which are rarer, deflate if they rupture, without danger but visibly.

The shape

Round implants give more volume to the upper pole; anatomical, teardrop-shaped implants mimic the natural slope of the breast but must stay correctly oriented.

The surface

Smooth or microtextured surfaces are favoured today. Heavily textured surfaces, known as macrotextured, have been associated with a higher risk of anaplastic large cell lymphoma, and some have been withdrawn from the market.

Profile and volume

The profile, more or less projected, and the volume are chosen according to the width of the breast base and the thickness of the tissues, not just according to a desired cup size.

Choosing the volume is one of the most important decisions in breast augmentation. Too little volume disappoints; too much stretches the tissues, increases the risk of ptosis, visible edges and complications, and can be a nuisance day to day, particularly for sport. The surgeon starts from the width of the breast base and the thickness of the tissues to define a range of suitable volumes, then refines it with you according to your wishes.

• Try sizers in an unpadded bra, with close-fitting clothing.
• Think about your activities: running, yoga, swimming, carrying loads.
• Imagine yourself in ten or twenty years: the breasts change with age.
• Be wary of cup sizes, which vary from one brand to another.
• Ask to see results in women of similar build.

Several tools help you picture the result before augmentation. Sizers are placed in an unpadded bra to give an idea of the volume, ideally with close-fitting clothing in front of a mirror. 3D simulation software, used by some surgeons, models the breasts from photos or a scan of the chest and shows the effect of different implant volumes and shapes.

These tools are useful for discussion and avoiding misunderstandings, but they remain approximate: they do not account for the full complexity of the tissues, their elasticity and healing. They should be used as a basis for discussion with the surgeon, not as a promise of results. Taking the time to try several volumes, possibly over two consultations, helps you make a choice you will be happy with in the long term.

Also try on the clothes you wear most often — a blouse, a T-shirt, a fitted dress, sportswear — with the sizers: it is in these everyday situations that the chosen volume will later be judged. If your partner or a friend comes with you, their opinion can help, but the final decision is yours. An attentive surgeon will advise against a volume that, in their view, would jeopardise the long-term result, even if it matches what you want at the moment.

The procedure takes about an hour. After the incision, the surgeon creates a pocket the size of the implant, in the chosen plane, checks haemostasis, then inserts the implant with minimal skin contact, sometimes using an insertion sleeve, to reduce the risk of contamination and capsular contracture. They check symmetry with you sitting up on the table, then close in several layers.

On waking, the chest feels tight and tense, especially if the implant is under the muscle. Pain peaks in the first two or three days and is well relieved by painkillers. Discharge home often takes place the same day. Daily life resumes gradually over a week, avoiding arm exertion.

Implants are not designed to be permanent. Many remain in place without problems for fifteen years or more, but the risk of complications increases over time: shell rupture, hardening of the capsule that forms around the implant, displacement. Further surgery during a lifetime is therefore likely for some women, to exchange, remove or correct an implant. There is no need to change an implant that is fine at a fixed date, but regular follow-up is recommended.

A woman who receives implants at twenty-five will probably wear them for several decades. Over time, the breasts change around them: the gland decreases, the skin slackens, weight varies, and pregnancies and menopause alter the tissues. An implant that seemed perfect at thirty may look too high, too large or too visible at fifty, when the natural breast has descended.

That is why many women consider further surgery at some point: a change of volume, a lift, removal. It is useful to keep this perspective in mind when making the initial choice: a reasonable volume and an implant suited to the body shape generally age better. Regular follow-up allows these changes to be anticipated rather than endured.

A distinction is made between intracapsular rupture, where the gel remains contained within the capsule formed around the implant, and extracapsular rupture, where some of the gel escapes from the capsule into the neighbouring tissues. Intracapsular rupture is often silent and discovered on MRI. Extracapsular rupture can cause distortion, nodules or lymph nodes in the armpit.

Confirmed rupture generally justifies removal of the implant, the gel and often the capsule, with replacement if the patient wishes. With current cohesive gels, silicone diffusion is limited. Manufacturers' warranties sometimes cover part of the costs; keep your implant card and make enquiries.

Fat transfer involves harvesting fat by liposuction from the abdomen, hips or thighs, preparing it and then reinjecting it into the breasts in thin layers. It allows a moderate augmentation of about one cup size per session, with a very natural feel and the advantage of slimming the donor area. Some of the fat is resorbed in the first few months, and several sessions are sometimes needed.

It is also used to correct asymmetry, tuberous breasts, irregularities after reconstruction or the visible edges of an implant. Grafted fat can leave small calcifications or cysts visible on imaging; an informed radiologist can distinguish them from suspicious lesions. See our page on breast fat transfer in Switzerland.

Harvesting

Under general anaesthesia or local anaesthesia with sedation, fat is harvested with fine cannulas from one or more areas, often the abdomen, hips or thighs.

Preparation

The fat is washed, decanted or centrifuged to remove fluid and debris and keep only viable cells.

Reinjection

It is reinjected in very fine threads, in several layers and directions, under the skin, into the gland and sometimes into the muscle, to promote its blood supply.

Recovery

Swelling of the breasts and bruising of the donor area for one to two weeks, with a compression garment on the donor area.

The result

It is judged after three to six months, once resorption is complete. A second session can complete the volume.

Some teams use an external expansion device, worn for several weeks before fat transfer to prepare the tissues and improve fat take; this demanding technique remains uncommon.

Breast fat transfer is generally well tolerated. The most common complications are partial resorption of the fat, which reduces the volume gain, and the formation of oil cysts or small hard areas, called fat necrosis, when clusters of fat have not acquired a blood supply. These nodules are benign, but they can be worrying and justify an ultrasound, or even a biopsy, to confirm their nature.

Injecting in thin layers, in a reasonable amount per session, reduces these risks. The donor area may show temporary bruising and irregularities. According to the available data, fat transfer does not increase the risk of breast cancer, but the radiologist must be informed at screening examinations.

Breast ptosis is the descent of the breast and areola, linked to pregnancy, weight changes, age and skin quality. It is classified according to the position of the nipple relative to the fold under the breast.

A breast lift, or mastopexy, raises the areola, removes excess skin and reshapes the gland to give back a round, high shape. It can be combined with an implant when the volume is insufficient. The scars vary according to the degree of correction. See our pages on the breast lift and on breast ptosis.

Stretch marks on the breasts often appear at puberty, during pregnancy or with rapid weight changes. They show that the skin has been stretched beyond its capacity. They do not disappear with surgery: a lift or reduction can remove some of the marked skin, but the remaining stretch marks stay, and an augmentation can stretch them further.

Skin quality also influences how well the result holds: thin, inelastic skin slackens more quickly after a lift and supports a large implant less well. The surgeon takes this into account when choosing the technique and volume, and may advise a more moderate implant or fat transfer.

The periareolar lift

A scar only around the areola, for mild ptosis. It allows the areola to be raised by a few centimetres and its diameter reduced, but reshapes the gland very little.

The vertical lift

A scar around the areola and vertically down to the fold. It reshapes the gland, narrows the base and raises the breast. It is the most widely used technique for moderate ptosis.

The inverted-T lift

A scar around the areola, vertical and horizontal in the fold. It is reserved for significant ptosis with a lot of skin to remove.

Auto-augmentation

The surgeon uses part of the gland from the lower breast to fill the upper part, which improves upper volume without an implant.

Combining a lift and an implant makes it possible to raise sagging breasts while restoring volume in the upper part. It is a more demanding procedure than either on its own, as the two goals pull in opposite directions: the implant stretches the skin, the lift tightens it. The surgeon must find a balance to avoid tension on the scars and preserve the blood supply to the areola.

The revision rate is higher than after augmentation or a lift alone. Some surgeons prefer to perform the two procedures in two stages, starting with the lift, particularly when ptosis is significant or skin quality is poor. A moderate implant volume and good support after the procedure promote a lasting result.

Very large breasts can cause back, neck and shoulder pain, strap marks, irritation under the breasts, difficulty with sport or finding clothes, and psychological distress. Breast reduction removes part of the gland, fat and skin, raises the areola and restores a harmonious shape. It is one of the plastic surgery procedures with which patients are most satisfied.

The scars, around the areola and vertical, sometimes in an inverted T, are the price of a significant correction. Areola sensation and the ability to breastfeed may be affected. When the breasts cause documented medical problems, insurance coverage may be requested. See our page on breast reduction in Switzerland.

All reduction techniques share one principle: the areola remains attached to a pedicle, a strip of gland containing its vessels and nerves, while the excess gland, fat and skin around it is removed. The pedicle can be superior, inferior, medial or lateral; the choice depends on the volume, the distance the areola must be raised and the surgeon's practice. The scar is vertical or an inverted T depending on the excess skin.

For very large breasts, known as gigantomastia, a free nipple graft, in which the areola is detached and then repositioned, is sometimes necessary. It compromises breastfeeding and areola sensation but allows a large reduction to be performed safely. Additional liposuction of the sides of the chest refines the figure.

Very large breasts weigh on daily life: neck, back and shoulder pain, grooves from bra straps, irritation and fungal infections under the breasts in summer, difficulty running, finding clothes or sleeping on your front, staring and remarks. These problems are often minimised, including by the women themselves.

Physiotherapy, a suitable bra and muscle strengthening provide partial relief. But when discomfort persists, breast reduction often brings dramatic relief, both physical and psychological, with one of the highest satisfaction rates in plastic surgery. Documenting your symptoms, treatments and their duration helps build the insurance file.

Some adolescents and young women develop very large breasts, sometimes rapidly, known as juvenile hypertrophy. It can cause pain, difficulty with sport, teasing and significant distress. Generally, surgery waits until the volume stabilises, but when the discomfort is major, a reduction can be considered earlier, after careful assessment by an experienced team. Recurrence is possible if the breasts continue to develop, and future breastfeeding is part of the discussion.

Surgery on implants already in place may be prompted by a complication, such as rupture or capsular contracture, a wish to change volume, or the desire to live without implants. There are many options: replacing the implants, changing their size or plane, removing the capsule surrounding them, or removing them permanently, with or without a lift or fat transfer to restore shape.

After implant removal, the breasts may look emptied and lax, all the more so if the implants were large and old. A combined lift, immediately or at a later stage, and fat transfer make it possible to regain a harmonious shape. See our pages on breast implant replacement and implant removal with a breast lift.

More and more women are choosing to have their implants removed, for various reasons: a complication, symptoms they attribute to the implants, fear of long-term risks, the wish for a more natural body or a change of priorities with age. Explantation can be performed with or without removing the capsule; complete capsule removal is recommended in cases of rupture, capsular contracture or suspected lymphoma, and is discussed in other cases.

The aesthetic result depends on skin quality, the volume of the implants and how long they have been in place. Emptied, descended breasts can be reshaped with a lift, immediately or after a few months, and volume can be added with fat transfer. Many women say they feel relieved after explantation, even when their breasts are smaller.

Slight asymmetry between the breasts is the rule. When it is marked, in volume, shape or areola position, it can be a source of significant distress, particularly in adolescence. Correction uses the same tools as other breast surgery: an implant or fat transfer on the smaller side, a reduction or lift on the larger side, or a combination.

Tuberous breasts are a developmental malformation: the breast base is narrow, the inframammary fold high, the breast has an elongated or tubular shape and the areola is often wide and bulging. Correction combines reshaping the gland, lowering the fold, reducing the areola and often adding volume with an implant or fat transfer. Depending on its severity, this malformation may be the subject of a request for coverage.

Tuberous breasts appear at puberty, often with asymmetry. Several forms are distinguished, from simple narrowing of the lower pole to an entirely tubular breast with a herniated areola. The distress is often significant in young women, who hide their breasts. Correction is generally performed after development is complete, in one or two stages.

The surgeon releases the constricted gland with internal incisions, lowers the fold under the breast, reduces the areola, then adds volume with an implant, fat transfer or both. Results are good, but perfect symmetry is difficult. Insurance coverage may be requested for marked forms, documenting the malformation.

Poland syndrome is a rare congenital malformation that combines partial or total absence of the pectoralis major muscle on one side, often an underdeveloped or absent breast on the same side, and sometimes hand abnormalities. Other chest deformities, such as pectus excavatum, can also change the appearance of the breasts.

Correction uses the techniques of breast and chest wall surgery: custom implants, fat transfer in several sessions, muscle flaps. It is generally planned after growth is complete, by experienced teams. As congenital malformations, these situations may be covered by disability insurance (AI/IV) or compulsory health insurance according to the conditions in force.

Gynaecomastia is development of breast gland tissue in men. It is common at puberty, when it often disappears on its own, and can also appear later, linked to a hormonal imbalance, certain medicines, anabolic steroids, alcohol or illness. It must be distinguished from pseudogynaecomastia (adipomastia), a simple excess of fat linked to being overweight. A medical assessment is useful to look for a cause.

When it persists and is bothersome, correction combines liposuction of the fat and removal of the gland through a small incision at the edge of the areola. Results are generally excellent. Insurance coverage may be discussed in certain situations. See our page on gynaecomastia in Switzerland.

Glandular forms, in which firm gland tissue can be felt under the areola, are distinguished from fatty forms, linked to excess weight, and mixed forms, which are the most common. The medical assessment aims first to look for a treatable cause. Recent, painful or one-sided gynaecomastia, or gynaecomastia associated with a hard lump, must be examined promptly.

The procedure generally takes one to two hours, under general anaesthesia or local anaesthesia with sedation, often as day surgery. The surgeon begins with liposuction of the chest fat, then removes the remaining gland through a small incision at the lower edge of the areola. If there is a lot of excess skin, after major weight loss for example, skin excision is necessary. A compression vest is worn for four to six weeks. Results are generally stable, unless there is significant weight gain or renewed exposure to a hormonal cause, such as anabolic steroids.

In men, chest surgery mainly concerns gynaecomastia. Some men also want more pronounced pectoral definition, with solid silicone pectoral implants placed under the muscle, or with fat transfer. These procedures fall under male cosmetic surgery and are presented on our page on pectoral implants for men.

After a mastectomy for breast cancer, or preventively in a woman carrying a high-risk genetic mutation, reconstruction can be offered, immediately or later. It is part of treatment and is covered by compulsory insurance, including procedures to achieve symmetry of the other breast.

Reconstruction is decided with the oncology team and the plastic surgeon, taking into account the treatments, body shape and the patient's wishes. Some women choose not to have reconstruction; this is an equally legitimate choice. Certified breast centres in Switzerland offer a multidisciplinary approach.

Immediate reconstruction, performed during the same operation as the mastectomy, avoids living for a period without a breast and often gives a better cosmetic result, as the skin can be preserved. It is not always possible, particularly when radiotherapy is planned or when health or the stage of the disease means cancer treatment must take priority. Delayed reconstruction, performed months or years later, allows time to complete treatment and think calmly. Both options give good results; the choice is made with the breast centre team.

It is also possible to start with one stage and complete it later: for example, placing an expander at the time of the mastectomy, then choosing the definitive technique once treatment is complete. This flexibility allows reconstruction to be adapted to how your situation and wishes develop.

Abdominal flap reconstruction uses skin and fat from the lower abdomen, taken with their vessels and then connected to the chest vessels by microsurgery. It gives a soft, warm breast that changes with weight like a natural breast, and requires no implant. It also has the effect of a tummy tuck on the abdomen.

It is a long procedure, lasting several hours, performed by specialist teams, with a hospital stay of a few days and careful monitoring of the flap's circulation. Recovery takes several weeks. It is particularly suitable for women who have had radiotherapy and have enough abdominal tissue.

When the skin remaining after a mastectomy is not enough to accommodate a definitive implant directly, the surgeon first places an expander, a shell that is gradually inflated in the consulting room every one to two weeks by injecting saline through the skin. Once the volume is reached, the expander is replaced by a definitive implant during a second operation.

This technique is less demanding than a flap, but it requires several stages and gives a firmer breast that does not change over time like a natural breast. It is less suitable after radiotherapy, which increases complications. In some cases, a definitive implant can be placed directly at the time of the mastectomy.

Reconstruction of the areola and nipple is often the final stage of breast reconstruction, performed a few months after the breast has been reconstructed. The nipple can be recreated from a small local skin flap or a graft from part of the nipple on the other side. The areola is usually recreated by medical tattooing, which reproduces the colour and, with three-dimensional techniques, the impression of relief.

Some women choose an artistic tattoo instead of the areola, or decide not to reconstruct the areola. These choices are personal. Medical tattooing is generally covered as part of the reconstruction.

After reconstruction, the reconstructed breast and the remaining breast may differ in volume, shape or position. A procedure on the other breast, such as a reduction, lift, augmentation or fat transfer, restores symmetry. In Switzerland, this symmetrisation is part of the reconstruction and is covered by compulsory insurance. It is often performed during the second stage of reconstruction.

Not every woman wants reconstruction after a mastectomy. Some prefer to live with a flat chest; others use an external prosthesis placed in a suitable bra. External prostheses are available in silicone, in various shapes and sizes, sometimes adhesive, as well as lightweight versions for sport and swimming. Specialist shops and advisers help with the choice.

Disability insurance (AI/IV) or compulsory insurance generally contributes to the cost of external prostheses after a mastectomy, according to the conditions in force; ask the breast centre. The choice not to have reconstruction is respected, and delayed reconstruction remains possible years later.

Radiotherapy, common in the treatment of breast cancer, permanently changes the skin and tissues: they become firmer, less elastic and less well supplied with blood. It increases the risk of capsular contracture around an implant and of healing complications. That is why, when radiotherapy is planned or has taken place, surgeons often favour reconstruction using the patient's own tissues or add fat transfer, which improves the quality of irradiated tissues.

Some women carry a genetic mutation that greatly increases the risk of breast cancer, for example in the BRCA1 or BRCA2 genes. After a genetic counselling consultation, several options are available: enhanced surveillance with MRI and mammography, or a preventive mastectomy, often with immediate reconstruction. This weighty, personal decision is made with a specialist team, taking the time needed. Preventive mastectomy with reconstruction is covered by insurance when the criteria are met.

Several short procedures concern the areola and nipple: reduction of wide areolas, correction of an inverted nipple, that is, one turned inwards, and reduction of a large nipple. They are often performed under local anaesthesia. Correcting an inverted nipple may sever some milk ducts and compromise breastfeeding on that side; this must be discussed before the procedure.

Several procedures are often combined. A lift with implants, or augmentation-mastopexy, corrects both descent and lack of volume. A reduction combined with liposuction of the flanks or back refines the figure. After pregnancies, a restoration combining breast surgery and a tummy tuck is common. Combining procedures limits the number of anaesthetics but lengthens the procedure and recovery. See our pages on breast augmentation with liposuction and the mommy makeover.

In many women, excess fat on the sides of the chest and near the armpit, sometimes called an axillary roll, weighs down the figure, especially in a bra or swimsuit. Liposuction of these areas, performed alone or during a reduction, lift or augmentation, refines the contour and improves harmony. The fat harvested can sometimes be used for breast fat transfer. See our page on liposuction in Switzerland.

Emma, 26

Underdeveloped breasts since adolescence, firm skin. Augmentation with round implants in a dual plane, through the inframammary fold.

Sophie, 38

Two pregnancies, emptied and slightly descended breasts. Augmentation with implants, without a lift, as the nipple remains above the fold.

Nadia, 45

Marked ptosis after significant weight loss. Lift with a vertical scar, complemented by fat transfer to the décolleté.

Claire, 52

Very heavy breasts, back pain and irritation for years. Breast reduction with an inverted-T scar, covered by insurance after a cost approval request.

Léa, 19

Tuberous, asymmetrical breasts. Gland reshaping, lowering of the fold and fat transfer, in two stages.

Monique, 61

Implants twenty-five years old, troublesome capsular contracture. Explantation, capsule removal and lift; she chooses to live without implants.

Thomas, 24

Gynaecomastia persisting since puberty. Liposuction and removal of the gland through an incision at the edge of the areola.

Isabelle, 47

Mastectomy for cancer. Delayed reconstruction with an abdominal flap, then areola reconstruction.

"Implants have to be changed every ten years"

False. They are not permanent, but they are not changed at a fixed date: they are monitored, and surgery is performed if there is a problem.

"You can't breastfeed after breast surgery"

Not necessarily. Breastfeeding is often possible after an augmentation, sometimes partially after a reduction.

"Implants prevent mammography"

False. Mammography remains possible with an adapted technique.

"Fat transfer can double breast size"

False. It gives a moderate augmentation per session.

"A breast lift leaves no scars"

False. The scars vary according to the degree of ptosis, but they always exist.

"Breast reduction is purely cosmetic"

False. It often relieves real pain and may be covered by insurance.

Breast surgery results abound on social media. Be wary of retouched photos or photos taken in flattering conditions, very large volumes presented as natural, promises of invisible scars and promotional offers that push you to decide quickly. A reputable surgeon shows varied results, some time after surgery, in patients with different body shapes, and talks about limitations and risks.

Breast surgery can considerably improve the harmony of the figure, comfort and self-confidence. It does not create perfectly symmetrical breasts, does not remove scars and does not freeze the result: the breasts will continue to change with time, weight, pregnancies and menopause. Implants require follow-up and further surgery is likely during a lifetime.

Talking concretely with the surgeon about what you expect, what can be achieved with your body shape and what will remain visible allows you to approach the procedure calmly and judge the result fairly.

The breasts hold a particular place in body image, linked to femininity, motherhood, sexuality and how others see us. Breasts considered too small, too large, sagging or asymmetrical can weigh on self-confidence, choice of clothing, intimate life and sport. These feelings are legitimate.

Surgery can bring lasting well-being when the plan is personal and expectations are realistic. It does not resolve deeper distress about body image; when the preoccupation seems disproportionate, an attentive surgeon will suggest talking to a psychologist. It is also important to remember that breasts are enormously diverse, and that the "ideal" breasts conveyed by retouched images do not exist.

• It does not stop the breasts from ageing.
• It does not remove stretch marks.
• It does not guarantee perfect symmetry.
• It does not replace breast cancer screening.
• Implants are not permanent.
• It does not on its own resolve distress about self-image.

Satisfaction studies place breast reduction among the most beneficial procedures in plastic surgery, with a clear improvement in pain, physical activity and quality of life. Breast augmentation is also associated with improved body image and self-confidence in most patients. Reconstruction after cancer improves the psychological well-being of many women, without the absence of reconstruction being a failure for those who choose it.

Long-term studies on implants confirm that a proportion of women will have further surgery over the years, hence the importance of information and follow-up. These data help approach each plan with fair expectations.

1. Name what bothers you

Volume, descent, asymmetry, the weight of the breasts, the shape of the areolas.

2. Choose the right time

Growth complete, stable weight, thoughts about future pregnancies.

3. Consult a qualified surgeon

Examination, measurements, explanation of the options and their trade-offs.

4. Understand the consequences

Scars, recovery, implant follow-up, breastfeeding, coverage.

5. Decide calmly

Reflection period, second opinion if needed, organising recovery.

Reflection

Often months, or even years, before daring to make an appointment. Reading, discussions with those close to you, first questions.

The first opinion

An opinion based on photos or a first consultation to understand the options and orders of magnitude.

The in-depth consultation

Examination, measurements, choice of technique, implant sizers, quote or coverage request.

The reflection period

A few weeks to let the decision mature, sometimes a second opinion.

Preparation

Stopping smoking, tests, buying bras, arranging help and time off work.

The procedure and recovery

A few weeks of precautions, then a gradual return to activities.

Follow-up

Check-ups in the first year, then regular follow-up if implants have been placed.

This journey often takes several months between the first consultation and a stabilised result. The time taken at each stage is a guarantee of satisfaction: patients who have let their plan mature, understood the trade-offs and prepared their recovery generally judge their result more calmly.

• What exactly bothers me, and since when?
• Is this my plan, or someone else's?
• Do I plan to have children or lose weight?
• Am I prepared to accept scars?
• Have I understood that implants require follow-up and possible further surgery?
• Can I arrange a few weeks of recovery?

Your expectations

The surgeon asks what bothers you, what you want and why now. Photos of breasts you like or dislike can help with mutual understanding, provided they are used as reference points rather than models.

Your medical history

Pregnancies, breastfeeding, plans for children, weight changes, family history of breast cancer, previous mammograms and ultrasounds, treatments, smoking.

The examination

Measurements of the breast base, the distance between the areola and the fold, tissue thickness, assessment of skin quality, symmetry, the chest and the spine.

Tests

Depending on age and history, an ultrasound or mammogram may be requested before the procedure.

The proposal

Technique, scars, volume, recovery, risks, expected results, long-term follow-up, then a quote and a reflection period.

Note what bothers you, since when, and what you hope for. Gather your recent breast examinations, your personal and family history of cancer, the list of your treatments and, if you already have implants, their card and the operative report. A few photos of breasts you like or would not want can help express your preferences. Prepare your questions in writing, and feel free to bring someone with you.

Before proposing a technique or volume, the surgeon measures the breasts precisely. These measurements make the examination objective and guide the choices.

These measurements are compared side to side to assess asymmetry. They also allow changes in the result to be checked after the procedure. They explain why two women who want the same cup size may receive implants of very different volumes.

• Do you hold the specialist title in plastic, reconstructive and aesthetic surgery?
• How many breast procedures of this type do you perform each year?
• Which technique, implant and plane do you recommend for me, and why?
• Where will the scars be?
• What long-term follow-up do you offer?
• What happens if there is a complication or an unsatisfactory result?
• Who is the implant manufacturer, and will you give me the implant card?

Check the surgeon's title in the federal MedReg register. A good surgeon helps you choose a volume suited to your body shape rather than following an unrealistic request, and explains the trade-offs of each option.

• Which manufacturer and model do you propose, and why?
• Which surface: smooth or microtextured?
• What follow-up do you recommend, and how often?
• What warranty does the manufacturer offer in the event of rupture?
• Will you give me the implant card and a copy of the operative report?
• What will happen if I want them removed one day?

A second opinion is useful if you are hesitating between several techniques, if the volumes proposed differ greatly from one surgeon to another, or if you are offered a more extensive procedure than expected, for example a lift when you were thinking of a simple implant. Bring your photos, test results and questions. Two concurring opinions are reassuring; two different opinions deserve an explanation.

Before the procedure, you sign a document specifying the technique, the scars, the type and volume of implants where applicable, the risks, follow-up and the limits of the result. For implants, it mentions in particular their limited lifespan, capsular contracture, rupture, associated lymphoma and the need for follow-up. Read it at home, ask your questions and keep a copy.

In Switzerland, any procedure requires your free and informed consent, after clear information about the nature of the procedure, its risks, alternatives and costs. You have the right to ask all your questions, to take time to think, to ask for a second opinion and to withdraw from the procedure at any time before it takes place.

You also have the right to access your medical file and obtain a copy, in particular the operative report and information about the implants. For cosmetic procedures, a detailed written quote must be given to you before the procedure. In the event of a dispute, patient associations and cantonal mediation bodies can advise you.

Breast surgery is performed in clinics and hospitals with an operating theatre, anaesthesia and post-operative monitoring. Check the facility's cantonal licence, the presence of an anaesthetist, the possibility of staying overnight if necessary and how emergencies are handled. For reconstructions, favour a facility that is part of a breast centre.

Smoking

Stopping for several weeks before and after clearly reduces healing complications, particularly for lifts and reductions.

Medicines

Mention your treatments; blood thinners and some supplements are often suspended on medical advice. The contraceptive pill may be discussed according to the risk of thrombosis.

Screening

Bring your breast cancer screening up to date according to your age and history.

The bra

Get one or two support bras, without underwiring, in the size indicated by the surgeon.

Organisation

Arrange help for the first few days, especially if you have young children you will not be able to carry.

Diabetes, an autoimmune disease, corticosteroid treatment or heart disease do not necessarily contraindicate breast surgery, but they require careful assessment. Poorly controlled diabetes increases the risk of infection and healing problems, particularly after a lift or reduction. The surgeon and anaesthetist coordinate preparation with your GP so that the procedure takes place in the best conditions.

• Quote signed or insurance approval received.
• Informed consent read and signed.
• Breast screening up to date.
• Stopped smoking several weeks ago.
• Support bras bought.
• Clothes that fasten at the front.
• Help arranged for the first few days.
• Prescription collected from the pharmacy.

Autumn and winter are often preferred: covering clothes hide the support bra, the heat is less and it is easier to avoid exposing scars to the sun. Summer means giving up swimming for several weeks. Also take account of your family and work commitments: you will not be able to carry loads or children for several weeks.

Most breast procedures are performed under general anaesthesia. Some, such as areola correction, minor gynaecomastia or limited fat transfer, can be done under local anaesthesia with sedation. Nerve blocks around the chest reduce pain after the procedure. The anaesthesia consultation assesses your risks and preferences.

You arrive having fasted, usually in the morning. The surgeon makes the markings with you standing, as sitting or lying changes the shape of the breasts. The procedure takes from one hour for an implant augmentation to three or four hours for a large reduction or a reconstruction. On waking, a dressing and support bra are in place, sometimes drains. Depending on the procedure, you go home the same day or after one or two nights.

The support bra is worn day and night for four to six weeks. Swelling decreases within a few weeks, but the final shape becomes clearer over three to six months, longer after a reduction or lift. Implants may look high and firm at first, then gradually settle and soften.

Sleeping

On your back, upper body slightly raised, for a few weeks.

Raising your arms

Overhead movements are limited for the first few days; prefer clothes that button at the front.

Showering

Generally after forty-eight hours, depending on the dressing and instructions.

Driving

After one to two weeks, when turning the steering wheel and wearing the seat belt are no longer painful.

Children

Avoid carrying young children for several weeks; arrange help.

In the first few weeks, sleep on your back, with your upper body slightly raised on two pillows or a wedge cushion, which limits swelling and avoids pressure on the chest. Keep the support bra on at night. A pillow under the knees relieves the lower back in this unusual position. Sleeping on your side is generally allowed after two to three weeks, and on your front after four to six weeks, depending on the procedure and the surgeon's instructions.

Day 0

Dual-plane implants placed through the fold, a one-hour procedure. Home in the evening, chest tight, moderate pain.

Days 1 to 3

Peak tightness, difficult to raise the arms. Regular painkillers, rest, sleeping on the back.

Day 7

Check-up: scars clean. The implants look high and firm. Back to working from home.

Week 3

The implants are starting to settle. Daily walks, no sport yet.

Week 6

Night-time support bra no longer needed, back to running with a sports bra.

Month 4

Natural shape, implants softened. The scars are still pink.

One year

Pale scars. First annual implant check-up.

Day 0

Reduction with an inverted-T scar, a three-hour procedure. Drains removed the next day.

Day 2

Discharged from the clinic. Moderate pain but already less weight on the shoulders.

Week 2

Check-up: small wound breakdown where the scars meet on one side, local care.

Week 3

Back to office work. No more neck pain.

Week 8

Back to sport, running for the first time in years.

Month 6

Shape stabilised, areola sensation almost back. She says her daily life has been transformed.

Day 0

Removal of the implants and capsules, vertical lift, a two-and-a-half-hour procedure. Drains in place.

Day 1

Drains removed, discharged. The breasts look small but light; a feeling of relief.

Week 2

Check-up: healing is fine. Back to office work.

Week 6

Night-time support bra no longer needed, back to yoga.

Month 4

The shape has rounded out; the breasts look more natural than she had imagined.

Month 9

Additional fat transfer is discussed to fill the upper breasts; she finally decides to do without.

Day 0

Liposuction and gland removal, an hour and a half, as day surgery. Compression vest put on in theatre.

Days 1 to 3

Swelling and bruising, moderate pain. Working from home.

Day 7

Check-up, back to work at the office, vest worn day and night.

Week 4

Back to sport without pectoral exercises, vest worn during the day only.

Week 6

Back to full weight training.

Month 3

Flat chest, discreet scars at the edges of the areolas. He goes back to the swimming pool without a T-shirt.

This is possible after an augmentation or a minor procedure, provided someone takes you home and, ideally, you are not alone on the first night. Place everyday items within easy reach, prepare simple meals and choose clothes that are easy to put on. After a reduction or reconstruction, help in the first few days is strongly advised.

Keep your phone charged and within reach, with the team's number saved, and let someone close to you know so they can come round quickly if needed, day or night, throughout the first week after the procedure.

In the first few days, help is invaluable for tasks that involve the arms: carrying shopping, looking after children, reaching for things up high, getting dressed. Those close to you need to know the warning signs, such as one breast suddenly swelling, fever or breathlessness. Their support also matters when the result does not appear straight away, during the period of swelling.

For many women, breast surgery changes their relationship with swimwear: finally choosing the top they like, swimming without a reinforced sports bra, enjoying a day at the lake without worrying about their breasts. Swimming resumes after complete healing, generally four to six weeks. Recent scars must be protected from the sun for at least a year, with high-factor sunscreen or a swimsuit that covers them.

If a scar remains visible at the edge of the swimsuit, a swimsuit with wider straps or a top that covers the line of the fold protects it while letting you fully enjoy the summer. After gynaecomastia surgery, men often rediscover with pleasure the freedom of swimming bare-chested, once healing is complete and the compression vest has been set aside.

After breast surgery, a well-fitted sports bra is essential for resuming physical activity, particularly running and high-impact sports. It limits breast movement, protects the scars and implants, and improves comfort. In the long term, good support during sport helps preserve the result of a lift or augmentation by limiting tissue stretching.

For athletes, the choice of implant volume and plane is important: an implant under the muscle can move when the pectorals contract, which bothers some activities such as weight training or climbing. Talk to the surgeon about your activities before deciding.

Weight training does not enlarge the breasts, which are made of gland tissue and fat, not muscle. Strengthening the pectorals may slightly lift the appearance of the breasts by developing the underlying muscle, but it does not correct ptosis or a lack of volume. Conversely, significant weight loss due to sport can reduce breast volume. After submuscular implants, intense pectoral training can move or distort the implant when the muscle contracts; discuss it with the surgeon if you train in this way.

After the post-operative support period, the question of bras arises. After an augmentation or reduction, the cup size has changed, and it is advisable to be measured again in a shop a few months after the procedure, once the shape has stabilised. A good bra supports the breasts without compressing the scars, with wide straps and a band that does not ride up.

Underwiring can be worn with the surgeon's agreement, often at around six weeks, provided it sits well in the fold and does not press on the scar. For sport, a high-support sports bra remains essential. Wearing suitable support day to day helps preserve the result of a lift or reduction.

For office work, a return is often possible after five to ten days for an augmentation, one to two weeks for a lift and two to three weeks for a reduction. Jobs that involve raising the arms, carrying loads or lifting patients require four to six weeks. The sick note does not mention the nature of the procedure.

Jobs that involve lifting loads, repeatedly raising the arms or moving people, such as care work, childcare, logistics or crafts, require a longer recovery, often four to six weeks before a full return. After a submuscular augmentation, arm exertion directly strains the operated area. Plan the procedure accordingly and discuss a gradual return or temporary adjustment of your duties with your employer.

General risks

Haematoma, infection, delayed healing, thick scars, thrombosis, reactions to anaesthesia.

Sensation

Temporary decrease or increase in areola sensation is common; lasting loss is possible but rarer.

Scars

They fade over one to two years but remain visible close up; some may thicken.

Asymmetry

Slight asymmetry is common; marked asymmetry may justify a touch-up.

Healing complications

After a reduction or lift, a small wound breakdown where the scars meet is common and heals within a few weeks. Compromised blood supply to the areola is rare.

Fever, increasing pain, sudden swelling of a breast, redness or discharge from a scar require prompt contact with the team; in an emergency, call 144. Swelling of a breast that appears years after an implant has been placed must always be examined.

After breast surgery, sensation in the areola and breast skin is often altered: reduced, numb or, on the contrary, hypersensitive, with tingling or shooting sensations. These sensations are linked to stretching or cutting of small nerves and generally evolve over several months, up to a year or more.

For many women, the breasts and nipples play a role in intimacy. A temporary change in their sensation after surgery can be disconcerting. In most cases, it improves over the months. If preserving sensation is important to you, discuss it before the procedure: the choice of approach and technique can take it into account. After a large reduction or reconstruction, a lasting decrease is more common, and support can help you live with this change.

Talking with your partner also helps: explaining that some areas are temporarily less sensitive, or on the contrary more sensitive, avoids misunderstandings during the recovery period.

Scars go through several phases. During the first few weeks, they are thin and pink. Between the second and sixth months, they may become redder, slightly thick and itchy: this is the normal inflammatory phase. Beyond that, they gradually pale and soften, becoming white and thin after one to two years in most women.

• Gently massage the scars once the skin has closed, for a few minutes a day.
• Use silicone gel or sheets if the surgeon advises.
• Protect them from the sun for at least a year.
• Avoid tension on the scars, particularly arm exertion in the first few weeks.
• Report a scar that thickens noticeably or becomes painful: early treatment is more effective.

Darker skin and certain family predispositions carry a greater risk of thick scars and keloids. Mention this before the procedure, so that the surgeon can adapt the technique and follow-up.

Darker skin carries a higher risk of thick scars, keloids and changes in scar pigmentation. This does not contraindicate breast surgery, but it calls for techniques that limit scar length, closing the skin without tension and closely monitoring the scars in the first few months. Preventive treatments, such as silicone sheets or injections into the scar, may be offered. Mention any previous thick scars at the consultation.

The causes of capsular contracture are not fully known; minor bacterial contamination of the implant, a haematoma or radiotherapy encourage it. Current techniques, such as inserting the implant without contact with the skin and placing it under the muscle, reduce its frequency. Treatment involves removing the capsule and replacing the implant, often changing the plane. Recurrence remains possible.

A few weeks after breast surgery, a hard and sometimes painful cord may appear under the skin, below the breast or towards the abdomen. This is inflammation of a small superficial vein, called Mondor's disease. It is benign and generally disappears within a few weeks, with anti-inflammatories and warmth if the doctor recommends them. It should nevertheless be shown to the surgeon to confirm the diagnosis.

Most pain after breast surgery disappears within a few weeks. A minority of patients keep pain for longer: tightness around a submuscular implant, nerve-type pain, burning or shooting sensations, a tender scar, pain linked to capsular contracture. An examination allows the cause to be found. Treatments range from physiotherapy to medicines for nerve pain and, more rarely, revision surgery, for example to change the plane of an implant or treat capsular contracture.

• Are the swelling and the position of the implants developing normally?
• When can I stop wearing the support bra?
• When can I resume sport, raising my arms, weight training?
• How should I care for my scars?
• Will the asymmetry I notice diminish?
• What long-term follow-up is needed for my implants?

Compare photos taken before the procedure and at six months or one year, from the front and in profile, under the same conditions. Go back to the goals you set: volume, shape, symmetry, comfort, freedom in choosing clothes, relief of pain after a reduction. Small asymmetries and scars that are still visible in the first year are part of the normal course. If a flaw persists after a year, talk to the surgeon.

A touch-up can be useful for persistent asymmetry, a widened scar, an unsatisfactory implant position, a small irregularity or a volume that does not suit. It is discussed once the result has stabilised, generally six months to a year after the procedure. The touch-up rate varies between procedures; it is higher after a lift with implants or correction of tuberous breasts.

The financial conditions of a touch-up — free of charge, a contribution or full billing — should be known before the first procedure and set out in writing. A well-indicated touch-up often clearly improves the result; repeating touch-ups for minor details, on the other hand, is rarely beneficial.

• Choosing an implant volume solely according to a desired cup size.
• Neglecting to stop smoking before a lift or reduction.
• Wearing an underwired bra too early.
• Resuming pectoral training too quickly.
• Losing your implant card.
• Ignoring late swelling of a breast.
• Forgetting breast cancer screening.

Women with implants benefit from regular follow-up, at least a clinical examination every one or two years, and imaging if in doubt or according to their surgeon's recommendations. MRI is the most reliable test for detecting silent rupture. Keep your implant card, which shows the manufacturer, model, volume and batch number: it is essential in the event of a medical device safety alert or further surgery.

Implants do not replace breast cancer screening. Mammography remains possible, with adapted views that displace the implant; mention it to the radiology centre. After fat transfer or a reduction, small changes on imaging are common; pass your reports on to the radiologist.

The gynaecologist and family doctor carry out breast cancer screening, regular clinical breast examinations and prescribe imaging tests. They are often the first to notice a problem related to an implant or a scar. Send them the operative report and a copy of your implant card, and inform them of any breast surgery, even long ago.

In Switzerland, breast implants are medical devices monitored by Swissmedic. Serious incidents must be reported, and the authorities can issue alerts or withdrawal measures if there is a problem with a model. The traceability of each implant, through the card given to the patient and the facility's records, allows the people concerned to be identified.

Keep your implant card and operative report with your important documents, and give a copy to your family doctor. If you move house or change doctor, these documents go with you. If an alert is issued about an implant model, you can quickly check whether you are concerned and contact your surgeon.

Breast implant-associated anaplastic large cell lymphoma is a rare cancer of the immune system that develops in the fluid or capsule around the implant, not in the breast itself. The risk is mainly linked to implants with a macrotextured surface; it is much lower with smooth or microtextured surfaces. It occurs on average several years after placement.

The most common sign is significant, rapid swelling of one breast, due to fluid accumulation, sometimes a lump. Diagnosis relies on ultrasound, aspiration of the fluid and its analysis. Diagnosed at an early stage, it is cured in the vast majority of cases by removing the implant and the entire capsule. The authorities do not recommend removing implants without symptoms, but careful follow-up.

Some women with implants describe a set of diffuse symptoms: fatigue, joint and muscle pain, difficulty concentrating, sleep disturbance, skin rashes. This picture is sometimes called breast implant illness. Studies have not shown a clear cause-and-effect link, and these symptoms can have many other causes.

These complaints nevertheless deserve to be taken seriously. A medical assessment looks for other causes. When the patient wishes, explantation can be offered; some women report an improvement after removal, but it is not possible to predict who will benefit. The decision is made after honest information about what is known and what is not.

Always mention your breast surgery to the radiologist and bring your previous examinations: comparison is essential for interpreting images after surgery.

In many cantons, particularly in French-speaking Switzerland, organised screening programmes invite women from the age of fifty to have a mammogram every two years, covered by basic insurance. In other cantons, screening takes place on the initiative of the woman and her doctor. Women at high risk, because of family history or a genetic mutation, receive adapted follow-up, starting earlier and sometimes with MRI.

Breast surgery never exempts you from screening. A recent examination is often requested before any procedure. After an augmentation, reduction or fat transfer, mention your surgery to the screening centre, which will adapt the technique and the interpretation of the images.

Implants do not increase the risk of breast cancer, but a woman who has them can, like any other, develop cancer. Screening remains effective with adapted techniques, and clinical examination can even be easier when the implant is under the muscle, as it pushes the gland forward. If cancer occurs, treatment follows the usual recommendations; depending on the case, the implant may be kept, removed or replaced during surgery, and reconstruction is adapted accordingly.

Informing the oncology team of the presence of implants, their type and how long they have been in place makes planning easier. Radiotherapy increases the risk of capsular contracture around an implant; this question is discussed with the specialists.

Pregnancy after breast surgery is possible, but it may change the result, particularly after a lift or augmentation. If a pregnancy is planned soon, it may be better to wait; this is discussed with the surgeon.

If you have had breast surgery and want to breastfeed, inform your midwife and, if possible, a lactation consultant from pregnancy onwards. Early and frequent feeding stimulates milk production. Monitor the baby's weight gain, particularly after a reduction or areola correction, where production may be partial. Mixed feeding is a perfectly satisfactory solution when production is insufficient.

Implants do not prevent breastfeeding and do not pass into the milk. If you have pain, redness or fever while breastfeeding, seek advice promptly, as any breastfeeding woman should: mastitis is easily treated when caught early.

Compulsory health insurance reimburses treatment of an illness, malformation or accident and their consequences when it is effective, appropriate and economical. Purely cosmetic breast surgery is not reimbursed.

For breast reduction, insurers generally take into account the symptoms, their duration, treatments already tried such as physiotherapy, the amount of tissue to be removed relative to body shape and sometimes body mass index. The surgeon prepares the file. Wait for the written reply before setting the date if coverage is a condition of your plans.

Cosmetic breast surgery is offered in most medium-sized towns. Reconstructions after cancer take place in breast centres that bring together oncologists, radiologists, surgeons and plastic surgeons, found in the major hospitals.

Geneva

Many plastic surgeons, a university breast centre and private clinics. Point of comparison for prices.

Vaud

Lausanne has a university breast centre and clinics; La Côte, the Riviera and northern Vaud also have plastic surgeons.

Neuchâtel and Jura

Plastic surgeons and a regional breast centre in Neuchâtel; Delémont also looks to Basel.

Fribourg

Plastic surgeons and a cantonal breast centre, bilingual consultations.

Valais

Sion, Martigny and Monthey for cosmetic surgery; cantonal breast centre. Upper Valais also looks to Bern.

Bern and Solothurn

University centre and many practitioners in Bern; Biel/Bienne, Thun and Solothurn for local provision.

Basel

University centre and private clinics, accessible from Jura and Aargau.

Zurich and surroundings

The widest provision in German-speaking Switzerland, including complex flap reconstructions.

Central and Eastern Switzerland

Lucerne, Zug and St. Gallen offer cosmetic surgery and breast centres; Zurich for certain reconstructions.

Graubünden and Ticino

Chur, Lugano and Bellinzona offer cosmetic surgery and breast centres; consultations in Italian in Ticino.

If you choose a distant surgeon, organise your journey home in advance, ideally accompanied, and possibly a night nearby. Combine check-ups, ask whether some can be done by photo, and identify a local doctor or emergency department. For implants, long-term follow-up can also be provided by a surgeon close to home, provided you give them all your documents.

In French-speaking Switzerland, consultations take place in French. In the major German-speaking cities, many plastic surgeons see patients in French or English; mention this when booking. In Ticino, consultations take place in Italian. To choose an implant, a volume or a technique, it is essential to fully understand every explanation.

For 42 cities, this table shows provision for cosmetic breast surgery, access to a breast centre for reconstructions and the price difference usually observed compared with Geneva for non-reimbursed procedures.

For breast surgery, several check-ups are planned in the first few weeks, followed by long-term follow-up for implants. Proximity to the clinic is therefore a real advantage, as are the surgeon's experience and the content of the quote.

We express prices as relative indices, which allow procedures to be compared with one another without amounts that vary between facilities.

Details by city appear on our page on breast surgery prices in Switzerland.

For a cosmetic procedure, a deposit is often requested at booking, expressed as a percentage of the quote, partly because the implants are ordered in advance. Ask about the conditions for postponement if there is a medical problem and the conditions for cancellation, and ask for them in writing.

Often added are support bras, medicines, scar creams or gels, days off work and, in the long term for implants, check-up examinations and a possible exchange procedure. Manufacturers sometimes offer warranties covering part of the costs in the event of rupture; ask about their conditions.

Mastopexy: Breast lift.

Ptosis: Descent of the breast and areola.

Submuscular plane: Implant placed under the pectoralis major muscle.

Dual plane: Implant partly under the muscle.

Capsular contracture: Hardening of the capsule around an implant.

Inframammary fold: Fold under the breast.

Tuberous breasts: Malformation with a narrow base and an elongated breast.

Gynaecomastia: Development of breast gland tissue in men.

Flap: Tissue transferred with its blood vessels for reconstruction.

• Breast surgery covers very different procedures depending on needs.
• The choice between implants, fat transfer and the hybrid technique depends on body shape and expectations.
• Implants are not permanent and require follow-up.
• Lifts and reductions leave scars that fade over time.
• Reconstruction after cancer is covered by insurance.
• Reduction for hypertrophy may be covered on request.
• Breast cancer screening remains essential.

Medespoir Suisse helps you clarify your plans, understand the options and their trade-offs, and find an experienced plastic surgeon in your region and your language. We also help you read quotes and prepare any coverage request.

Enlarging, lifting, reducing, harmonising or reconstructing: breast surgery offers solutions suited to every situation, with results that are often very satisfying when the plan is well prepared. Taking the time to understand the options, choose an experienced surgeon and know about long-term follow-up is the best guarantee of a lasting result. For the budget, see our page on breast surgery prices in Switzerland.

Budget

Price differences between cities and cantons, the quote breakdown and ways to save are detailed on our page Breast surgery guide: prices in Switzerland.

All pages in this section

• Breast surgery in Switzerland
• Gynaecomastia in Switzerland

Related procedures

• Breast lift in Switzerland
• Breast ptosis in Switzerland
• Breast augmentation in Switzerland
• Breast reduction in Switzerland
• Breast fat transfer in Switzerland

Our guides

• Cosmetic surgery in Switzerland

Answers to the most frequent questions about breast surgery in Switzerland.

General questions

What is breast surgery? It covers all procedures that change the volume, shape, position or symmetry of the breasts: augmentation, lift, reduction, implant exchange or removal, correction of asymmetry or tuberous breasts, correction of gynaecomastia in men, and reconstruction after cancer.

Which procedure suits my situation? It depends on what bothers you: a lack of volume points to augmentation, sagging breasts to a lift, breasts that are too heavy to a reduction, and emptied, sagging breasts to a lift with implants. The surgeon helps you choose after an examination.

What is the minimum age for breast surgery? Generally, surgery waits until breast development is complete, at around eighteen. A reduction for very troublesome hypertrophy or correction of a severe malformation can sometimes be considered earlier, after careful assessment. Cosmetic augmentations are not performed on minors.

Is there a maximum age? No. Women aged sixty and over benefit from lifts, reductions or implant removal. General health and tissue quality are more decisive than age.

Do I need to have finished having children? It is not mandatory, but a pregnancy can change the result, especially after a lift or augmentation. If a pregnancy is planned soon, it may be better to wait. The surgeon discusses this with you.

Does my weight need to be stable? Yes, ideally. Significant weight gain or loss after the procedure changes the volume and shape of the breasts. If you plan to lose weight, do so beforehand.

Is breast surgery risky? Like any surgery, it carries risks, generally low in a healthy person: haematoma, infection, healing problems, changes in sensation, asymmetry. Implants also have their own risks. Good preparation and an experienced surgeon reduce them.

How long does the result last? The result is lasting, but the breasts continue to age and change with weight, pregnancies and menopause. Implants are not permanent; further surgery during a lifetime is likely for some women.

Implants

What types of implants are there? Most are filled with cohesive silicone gel; some with saline. They come in round or anatomical shapes, with smooth or more or less textured surfaces, and in different profiles and volumes, chosen according to your build.

Round or anatomical implant? A round implant gives more volume in the upper breast and poses no problem if it rotates. An anatomical implant mimics the natural slope of the breast but must stay correctly oriented. The choice depends on your build and the desired result.

Should the implant be placed under the muscle? When the tissues are thin, placement under the muscle or in a dual plane covers the implant better and makes its edges less visible. When the tissues are thick, placement in front of the muscle prevents the implant from moving when the muscle contracts. The surgeon chooses according to your situation.

How is the implant inserted? Usually through an incision in the fold under the breast. Other approaches exist, at the edge of the areola or in the armpit. Each has its advantages; the inframammary approach offers the best control.

How is the volume chosen? Volume is chosen according to the width of your breast base, the thickness of your tissues and your figure, more than according to a cup size. Trying sizers in a bra or using simulations helps you picture the result.

Can implants rupture? Yes, the shell can crack over time, often without symptoms. With a cohesive gel, the silicone largely stays in place. Rupture is diagnosed by imaging, preferably MRI, and justifies replacement or removal.

What is capsular contracture? The body naturally forms a capsule around the implant. When it thickens and contracts, the breast becomes hard, sometimes distorted and painful. This is called capsular contracture. It is treated by removing the capsule and changing the implant, often to another plane.

What is implant-associated lymphoma? It is a rare lymphoma that develops in the capsule around the implant, mainly with macrotextured implants. It generally shows as late swelling of one breast. Diagnosed early, it is usually cured by removing the implant and its capsule.

Should textured implants without symptoms be removed? Health authorities generally do not recommend routinely removing textured implants that cause no problems. Regular follow-up and a consultation if swelling occurs are enough. Discuss it with your surgeon.

Do implants cause systemic illness? Some women report diffuse symptoms, such as fatigue or pain, which they attribute to their implants. Studies have not established a clear link, but some of these women feel better after implant removal. These complaints must be listened to and assessed.

Do implants need changing every ten years? No. There is no fixed date. Implants are monitored and changed if there is a problem or if the patient wishes. The risk of complications does, however, increase over the years.

What is the implant card? It is a document showing the manufacturer, model, volume and batch number of your implants. Keep it safe: it is essential in the event of a safety alert or further surgery.

Are implants compatible with MRI and security checks? Yes. Breast implants contain no metal and pose no problem for MRI or security checks. Some tissue expanders used in reconstruction have a metal valve; mention them.

Fat transfer and hybrid techniques

Can fat transfer replace implants? For a moderate augmentation, of about one cup size per session, yes. For a larger augmentation, several sessions or a hybrid technique are needed. You also need enough fat to harvest.

Does the injected fat stay? Some of it is resorbed in the first few months, often around a third to a half depending on the technique and the patient. The part that takes is lasting and then follows changes in weight.

Does fat transfer interfere with cancer screening? It can leave small calcifications or cysts visible on imaging, which radiologists can generally distinguish from suspicious lesions. Always inform the radiologist of the procedure and pass on your reports.

What is hybrid augmentation? It is the combination of an implant and fat transfer. The implant provides the volume, the fat softens the contours and covers the edges of the implant, for a more natural result, particularly in women with thin tissues.

Lift and reduction

How do I know if I need a lift? If the nipple is at or below the fold under the breast, or points downwards, a lift is generally needed. If the sagging is slight, an implant or fat transfer may be enough. The surgeon assesses the ptosis at the examination.

Does a breast lift leave scars? Yes. Depending on the degree of ptosis, the scar goes around the areola, runs vertically down to the fold, or even extends along the fold in an inverted T shape. They fade over one to two years.

Does a breast lift last? The result is lasting, but the skin continues to age and the breasts gradually descend again, especially if they are heavy. A stable weight and good support prolong the result. Combining it with an implant can help maintain volume in the upper breast.

Is breast reduction painful? Pain is generally moderate and well relieved by painkillers. Many women notice relief from their back and shoulder pain from the first few days.

How much tissue can be removed? It depends on the breasts and the figure. The surgeon aims for proportionate breasts, keeping enough tissue for a good blood supply to the areola. The planned amount is often part of the insurance file.

Can I breastfeed after a reduction? Some women can, often partially. Current techniques preserve the gland and ducts as much as possible. If breastfeeding is important to you, discuss it before the procedure.

Is nipple sensation preserved? It is often temporarily altered after a lift or reduction. It returns in most women, but a lasting decrease is possible, more common after large reductions.

Particular situations

Can significant asymmetry be corrected? Yes, by combining as appropriate an implant or fat transfer on one side and a reduction or lift on the other. Perfect symmetry is not possible, but the improvement is often dramatic.

What are tuberous breasts? It is a developmental malformation in which the breast base is narrow, the fold high and the areola wide and bulging. Correction combines reshaping the gland, lowering the fold, reducing the areola and adding volume.

Can implants be removed without replacing them? Yes. Implant removal is often combined with a lift and fat transfer to restore a harmonious shape, especially if the implants were large or old.

Is reconstruction after cancer always possible? In the vast majority of cases, yes, immediately or later. The technique depends on the treatments, particularly radiotherapy, the patient's build and wishes. Choosing not to have reconstruction is also a legitimate choice.

What is a preventive mastectomy? It is the preventive removal of the breasts in women at very high risk of cancer, particularly carriers of certain genetic mutations. It is often accompanied by immediate reconstruction and is decided with a specialist team.

Can an inverted nipple be corrected? Yes, with a small procedure under local anaesthesia. However, it may sever some of the milk ducts and compromise breastfeeding on that side; this should be discussed beforehand.

Can areolas that are too large be reduced? Yes, through an incision around the areola that reduces its diameter, on its own or during a lift or augmentation. The scar lies at the junction between the areola and the skin.

Gynaecomastia

What is gynaecomastia? It is development of breast gland tissue in men, on one or both sides. It is common at puberty, when it often regresses, and can appear later in connection with hormones, medicines, anabolic steroids or illness.

Are tests needed before operating on gynaecomastia? Yes, especially if it is recent, painful or one-sided. A medical assessment looks for a hormonal or drug-related cause or another illness. A hard lump on one side must be examined promptly.

Does sport make gynaecomastia disappear? Sport and weight loss reduce fat, but not gland tissue. When the gland is developed, only surgery removes it.

Does gynaecomastia correction leave scars? A small scar at the lower edge of the areola and a few small liposuction openings. Large gynaecomastia with excess skin may require longer scars.

Before the procedure

Is a mammogram needed before the procedure? Depending on your age and history, a recent mammogram or ultrasound is often requested before breast surgery, to ensure there is no lesion and to have a reference examination.

Should I stop the pill? Not routinely. For a long procedure or in the presence of other risk factors for thrombosis, the doctor may suggest stopping it temporarily or strengthening prevention. Follow their instructions.

Can I have surgery during my period? Yes, menstruation is not a contraindication. Simply mention it to the team on the day of the procedure.

Do I need to stop smoking? Yes, ideally several weeks before and after. Smoking greatly increases healing complications, particularly after a lift or reduction, where the blood supply to the areola is under strain.

Should I lose weight before a reduction? If you are overweight and plan to lose weight, it is better to do so beforehand, as weight loss will also reduce breast volume. Some insurers take body mass index into account for coverage.

How can I picture a new volume? Sizers placed in a bra, photo or 3D simulations and comparison with result photos of women of similar build help you choose. These tools remain indicative.

How long between the consultation and the procedure? A reflection period of several weeks is usual for a cosmetic procedure, often with a second consultation. For a covered reduction, the timing also depends on the insurer's response.

Can I ask for a second opinion? Yes, it is a normal step, useful if you are hesitating between several options or if the proposals you have received differ. Bring your photos, test results and questions.

What should I buy before the procedure? One or two support bras in the indicated size, clothes that fasten at the front, an extra pillow to sleep propped up, and the prescribed medicines.

Can breast surgery be combined with a tummy tuck? Yes, this is common after pregnancies. The combination limits the number of anaesthetics, but lengthens the procedure and recovery and slightly increases the risks. The surgeon assesses whether it is reasonable in your case.

Practical questions

Can I shower after the procedure? Generally after forty-eight hours, depending on the dressing and instructions. Pat the scars dry. Baths wait until healing is complete.

How should I dress in the first few weeks? In loose clothes that fasten at the front, to avoid raising your arms. The support bra is worn at all times.

Can I carry a backpack? Avoid heavy bags and straps that press on the chest for a few weeks. A light bag carried in the hand or a trolley is preferable.

Can I work from home quickly? Yes, often from a few days after an augmentation, provided you limit arm movements and take breaks. Computer work is generally well tolerated.

Can I travel after the procedure? Travel within Switzerland is possible after a few days, avoiding carrying heavy luggage. Remain available for the first check-ups.

Can I expose my scars to the sun? Avoid it for at least a year, or protect them with very high-factor sunscreen and clothing. The sun can pigment them permanently.

When can I resume intimacy? Generally after two to three weeks, avoiding pressure on the chest for four to six weeks. The support bra can be kept on.

Can I wear an underwired bra? After about six weeks, with the surgeon's agreement. Underwiring worn too early can hinder healing of the fold and the position of the implants.

Do implants change how the breasts feel to the touch? Depending on the plane, the volume and the thickness of the tissues, the implant may be more or less palpable, especially at the sides and lower part of the breast. Implants under the muscle and hybrid techniques reduce this.

Can I go diving or to high altitude with implants? Yes. Pressure changes have no significant effect on silicone gel implants. High-altitude activities and recreational diving are possible after recovery.

How many check-ups should I plan for? Usually a check-up after one week, another after four to six weeks, then at three or six months and at one year, before more widely spaced follow-up for implants.

What if a scar opens slightly? This is common where scars meet after a reduction or lift. Show it to the surgeon; local care is generally enough and healing occurs within a few weeks.

Can I go swimming again? After four to six weeks, once the scars have closed. Start with breaststroke or backstroke, which are gentler on the pectorals, before front crawl.

Should I massage my breasts after augmentation? Some surgeons recommend massage to help the implants settle and prevent capsular contracture, others do not, depending on the type of implant. Follow your surgeon's instructions.

Can the breasts be asymmetrical at first? Yes, swelling and implant position can develop differently on each side in the first few weeks. Asymmetry is judged after three to six months.

Whom should I call at night if there is a problem? The on-call number given by the team, to be saved before the procedure. In the event of sudden swelling of one breast, breathlessness or heavy bleeding, go to the emergency department or call 144.

Can I smoke after the procedure? Smoking is strongly discouraged for at least four weeks after the procedure, and ideally you should stop for good. Smoking reduces tissue oxygenation and increases the risk of wound breakdown, infection and compromised blood supply to the areola.

Should I tell my family doctor? It is useful, particularly for implant follow-up and screening. Send them the operative report and a copy of the implant card.

Do implants interfere with breastfeeding? Usually not, especially if they were placed through the inframammary fold. Milk is not contaminated by the implants. The amount of milk depends mainly on the gland tissue preserved.

Does pregnancy change the result? Often, yes: the breasts enlarge and may then empty and descend after breastfeeding. A touch-up can be considered afterwards if the result no longer suits.

Recovery

How long should the support bra be worn? Generally four to six weeks, day and night at first. It limits swelling, supports the tissues and stabilises the implants. Underwired bras wait for the surgeon's agreement.

When can I sleep on my front? Generally after four to six weeks, once the tissues and implants have stabilised. In the first few weeks, sleep on your back, with your upper body slightly raised.

The implants look high at first: is this normal? Yes. After augmentation, especially under the muscle, the implants often look high and firm in the first few weeks. They gradually settle and soften over a few weeks to a few months.

When can I drive again? After one to two weeks, when turning the steering wheel and wearing the seat belt are no longer painful.

When can I go swimming? After complete healing, generally four to six weeks. Hot baths and saunas also wait.

How should I care for my scars? Once the skin has closed, gentle massage, silicone gel or sheets if advised, and strict sun protection for at least a year. A scar that thickens should be shown to the surgeon.

When will I see the final result? After three to six months for an augmentation, often longer for a lift or reduction, until the swelling has gone and the shape has stabilised.

Are drains needed? Sometimes, especially for large reductions, gynaecomastia or reconstructions. They are generally removed after one to three days.

Can I raise my arms after the procedure? Gentle movements are encouraged, but wide overhead movements and exertion are limited for two to three weeks, longer after a submuscular augmentation.

When can I resume weight training? Leg training can resume after three to four weeks. Upper body training waits six to eight weeks, longer for the pectorals after a submuscular implant.

Follow-up and screening

What follow-up is needed after implants? Regular clinical check-ups, at least every one to two years, and imaging if in doubt or according to recommendations. MRI is the most reliable test for detecting rupture.

Can I have a mammogram with implants? Yes, with an adapted technique that displaces the implant to better see the gland. Mention your implants to the radiology centre. An ultrasound often complements the examination.

Does breast surgery increase the risk of cancer? Implants do not increase the risk of breast cancer. A rare lymphoma associated with implants exists, distinct from breast cancer. Breast reduction might on the contrary slightly reduce the risk, as breast tissue is removed.

What should I do if one breast swells late? See your surgeon or doctor promptly. Swelling that appears years after an implant has been placed must be investigated by ultrasound and sometimes aspiration, to rule out implant-associated lymphoma.

What should I do if there is a safety alert about an implant model? Check on your implant card whether you are concerned and contact your surgeon. Recommendations are issued by the authorities, in Switzerland by Swissmedic, and specify what to do.

Price and insurance

How much does breast augmentation cost in Switzerland? It serves as the reference for our comparisons, at an index of 100. Fat transfer is around 80 to 120, hybrid augmentation around 120 to 150 and a lift with implants around 140 to 180. Differences between cities appear on our price page.

Is breast reduction reimbursed? It may be when the breasts cause documented medical problems, such as back pain or persistent skin irritation, after a prior cost approval request. Insurers examine each case; wait for the written reply.

Is reconstruction after cancer reimbursed? Yes, it is part of treatment and is covered by compulsory insurance, including procedures to achieve symmetry of the other breast and reconstruction of the areola.

Is implant exchange reimbursed? If it is due to a complication of implants placed for reconstruction, it is generally covered. For cosmetic implants, the situation varies; an exchange for personal preference remains at the patient's expense.

Is gynaecomastia reimbursed? Coverage may be discussed in certain situations, for example significant, persistent gynaecomastia with an impact on daily life. A prior cost approval request is necessary.

Is Geneva more expensive? Geneva serves as the point of comparison and is among the most expensive cities, along with Zurich. Elsewhere, fees are often 5 to 20% lower. Choosing an experienced surgeon matters more than the price difference.

Do manufacturers offer a warranty? Some manufacturers offer warranties covering implant replacement and sometimes part of the costs in the event of rupture for a given period. Ask your surgeon about the warranty conditions for the chosen implants.

Where to consult in Switzerland

Who performs breast surgery in Switzerland? Surgeons holding the specialist title in plastic, reconstructive and aesthetic surgery, in practices, clinics and hospitals. Reconstructions are carried out in liaison with breast centres. Check the title in the MedReg register.

Where can I have reconstruction after cancer? At a breast centre, often certified, which brings together oncologists, radiologists, surgeons and plastic surgeons. Major hospitals in every region have one.

Can I consult in French in German-speaking Switzerland? Often, yes, in the major cities. Mention it when booking. To choose an implant or technique, it is essential to fully understand the explanations.

Should I have surgery close to home? It is an advantage for check-ups in the first few weeks and long-term implant follow-up. If you choose a distant clinic, organise the check-ups and identify a local doctor.

Can Medespoir guide me? Yes. Send us front and side photos and a few words about your plans. A plastic surgeon will give you a first opinion and an estimate, and we will direct you to experienced practitioners in your region and your language. Free and without obligation.

Send us front and side photos, along with a few words about your plans. A plastic surgeon will give you a first opinion and an estimate. Free and without obligation.