Dr. med. Maria Wiedner

Breast surgery and breast revisions

Breast surgery is one of the most specialised areas of plastic and aesthetic surgery. Shape, volume, skin quality, tissue, the chest wall, implant position, scarring and long-term stability are all closely interlinked. Dr Wiedner supports patients through both initial procedures and complex revisions following previous operations. Her areas of expertise include breast augmentation, breast lift, breast reduction, breast revision, implant exchange, implant removal, correction of capsular contracture, asymmetry, bottoming-out, rippling, unnatural or unstable results, as well as hybrid procedures combining implants and autologous fat. Particularly in revision procedures, the aim is often not to do ‘more’. Often, the opposite is true: tissue needs to be soothed, tension reduced, and a shape restored that looks more natural and is more stable in the long term. Many patients consult Dr Wiedner because they do not want a result that looks conspicuous or artificial. Their goal is a breast that integrates naturally into the body — aesthetically, anatomically and emotionally.

Implants, autologous fat and hybrid procedures

A particular focus of her work is on biological and autologous reconstruction and volume restoration techniques. Dr Wiedner is very keen to use the patient’s own tissue and autologous fat transfer techniques whenever anatomically and medically appropriate. The focus here is not merely on volume, but above all on tissue quality, a natural appearance, smooth transitions and long-term stability. At the same time, she is by no means fundamentally opposed to breast implants. Modern implant surgery continues to play an important role and can achieve very satisfactory results in cases with suitable anatomy. However, it is crucial that the implant size, tissue quality and long-term durability are all compatible. Autologous fat techniques have advanced considerably in recent years. Thanks to modern processing and transplantation techniques, results have become more predictable, meaning that autologous fat now represents an interesting alternative or complement to implants in many situations. Individually tailored hybrid procedures are particularly important. In such cases, an implant can provide the structural foundation, whilst autologous fat creates softer transitions, harmonises implant edges, supports tissue quality and makes the breast appear more natural. Which solution is appropriate — implant, autologous fat or a hybrid procedure — always depends on the tissue composition, skin quality, existing breast shape, previous operations, the desired volume and the patient’s personal preferences.

Breast lift and augmentation mastopexy

An important aspect of her breast surgery practice is breast lifting — with or without breast augmentation. Following pregnancy, breastfeeding, weight fluctuations or natural ageing processes, the breasts often lose their shape, firmness and projection. Many patients do not necessarily want larger breasts, but rather breasts that look more harmonious, firmer and more natural again. Dr Wiedner does not view a breast lift as merely a procedure to remove skin. The key factor is the internal stabilisation of the tissue. Concepts such as the so-called ‘internal bra’ can help to support the breast in the long term, create a rounder shape and prevent further sagging, waterfall deformity or a ‘Snoopy breast’. If additional volume is desired or required, a so-called augmentation mastopexy may be appropriate — that is, a combination of a breast lift and volume augmentation. This can be achieved using implants, autologous fat or a hybrid procedure. This is precisely where the importance of individual planning becomes apparent: a lift and additional volume exert different forces on the tissue. A beautiful breast shape is therefore not achieved solely through increased volume, but through the right balance of shape, stability, tissue quality and natural proportions.

Implant removal, BII and complex breast findings

Another key area of focus is the removal and replacement of implants, as well as providing tailored advice for any concerns or uncertainties relating to breast implants. Some patients, after many years with implants, wish to return to a more natural solution. Others come in due to capsular contracture, chronic tightness, implant ageing, tissue thinning, or concerns regarding Breast Implant Illness (BII) or BIA-ALCL. Dr Wiedner takes a calm and scientifically nuanced approach to this. Not every patient requires the same solution. Some wish for complete explantation, others for smaller implants, a lift, autologous fat transfer or a hybrid approach. The decisive factor is always how the breast can be stabilised biologically and aesthetically following the removal or replacement of the implant. Explantation often involves far more than simply removing an implant. The skin, tissue, capsule, breast shape and long-term stability must all be considered together.

Body contouring and tightening procedures

In body contouring surgery, too, Dr Wiedner takes a nuanced and rather conservative approach. The focus is not on achieving the most dramatic transformation, but on proportion, tissue quality, mobility and the long-term harmony of the body. Her range of procedures includes tummy tucks, mummy makeovers, body contouring following weight loss, body lifts, upper arm lifts, thigh lifts, liposuction, fat removal, contouring and corrective procedures following previous operations. Tissue quality is particularly crucial in body-contouring procedures. Skin elasticity, scarring, lymphatic and tissue conditions, individual healing tendencies, and the question of which procedures can be sensibly combined all determine the planning. Many patients particularly appreciate the calm assessment when a smaller or gradual procedure makes more medical sense than a major surgical solution. For Dr Wiedner, body surgery does not mean removing as much skin or fat as possible. It is about restoring a silhouette that feels natural, resilient and harmonious.

Liposuction, lipoedema and three-dimensional body contouring

Dr Wiedner does not view liposuction as a simple ‘suction’ procedure, but rather as precise body contouring. Key factors include proportions, transitions, skin quality, the lymphatic system and long-term tissue stability. A particular focus is placed on water-assisted liposuction (WAL). This procedure allows for particularly gentle removal of fatty tissue and plays a key role, particularly in cases involving sensitive tissue, large-scale contouring and the functional treatment of lipoedema. Lipoedema is not a classic form of weight gain, but a chronic disorder of fat distribution that is often associated with pain, tenderness, a feeling of heaviness and a reduced quality of life. In lipoedema surgery, the focus is therefore not on aggressive contouring, but on reducing the pathologically altered tissue in a manner that is as gentle on the tissue as possible and preserves the lymphatic vessels. A clear medical distinction is important here: pathologically altered lipoedema tissue is not used for lipofilling or regenerative autologous fat procedures. For aesthetic body contouring, Dr Wiedner also uses modern 3D analyses. These help to assess volume distribution, asymmetries, contour deficiencies and proportions more precisely. This allows for better planning of where tissue should be reduced, where transitions should be harmonised and where, if necessary, autologous fat or regenerative procedures can be usefully supplemented.

Regenerative medicine, microfat and nanofat

A key focus of Dr Wiedner’s work is on regenerative procedures using the body’s own tissue. This is not about traditional volume restoration, as with conventional fillers, but primarily about the biological improvement of skin quality, tissue structure, elasticity and long-term regeneration. Micro- and nano-fat procedures, in particular, play a key role here. They are used specifically to naturally improve fine skin changes, thinning tissue, scars, loss of volume or perioral wrinkles, without artificially altering or weighing down facial features. Particularly when it comes to fine lines around the mouth and face, Dr Wiedner often sees advantages in regenerative autologous tissue procedures over purely volumising fillers or more aggressive surface treatments. These procedures complement Dr Richter’s structural facial surgery in a unique way: whilst surgical procedures reposition and stabilise tissue, regenerative approaches improve the quality and biological regeneration of the tissue itself. This often results in a particularly natural and long-lasting, harmonious form of facial rejuvenation.

Minimally invasive procedures and skin quality

Not every change requires surgery. That is why Dr Wiedner incorporates minimally invasive procedures where they can usefully complement other treatments — for example, to improve skin quality, to enhance surgical results, or to provide a gentle rejuvenation without structural changes. These procedures include, in particular, radiofrequency, RF microneedling, microneedling, PRP, MCT-PRP and regenerative treatment approaches aimed at improving skin and tissue quality. Here, too, her guiding principle applies: not every available treatment is automatically the right one. The key factor is whether a procedure is appropriate for the diagnosis, the quality of the tissue and the desired outcome.

Research and international teaching

In addition to her clinical work, Dr Wiedner has been actively involved for many years in the academic and international training of plastic surgeons. Her work focuses in particular on regenerative procedures, biological approaches to tissue rejuvenation, autologous fat transfer, breast surgery, body contouring, liposuction and modern minimally invasive procedures. She is regularly invited to speak and deliver keynote addresses at international specialist conferences and plays an active role in the scientific exchange within her field. In addition, she is deeply committed to the training of young plastic surgeons. Within the International Society of Aesthetic Plastic Surgery, she is responsible for international training programmes and supports young specialists on their path into aesthetic surgery. This teaching role also shapes her own work: calm, precise, thoughtful and focused on the long term.

Your role at the UNIQ Institute

Together with Dr Dirk F. Richter, Dr Wiedner has developed a deliberately complementary approach at the UNIQ Institute. Whilst Dr Richter specialises in facelift surgery, eyelid surgery, orbital surgery and complex facial revisions, Dr Wiedner complements this structural surgery with breast and body surgery, liposuction, autologous fat and tissue grafting techniques, regenerative procedures and minimally invasive treatments to improve skin and tissue quality. Both approaches are interlinked — not as a passing trend, but as a well-thought-out, comprehensive medical concept. Structure, function, tissue quality and regeneration are not viewed in isolation, but are understood as interconnected aspects of modern plastic surgery.

Personal approach

Dr Wiedner does not view cosmetic surgery as a race to achieve the most dramatic transformation. Her aim is a result that suits the patient’s anatomy, personality and life circumstances. In breast and body surgery in particular, achieving a natural look is often more challenging than making the most drastic changes. It requires experience, an understanding of tissue, restraint and a keen sense of when doing less is the better decision in the long term. “It’s not about changing as much as possible. It’s about understanding what really suits a person.”

Consultancy

Are you looking for a well-founded, honest assessment? A consultation with Dr Wiedner begins with a detailed analysis of your anatomy, tissue quality, previous treatments, personal expectations and long-term resilience. The aim is to provide a realistic assessment of which treatments are appropriate — and which are not. Book a discreet consultation at the UNIQ Institute at Bensberg Castle.