This study analyzed subjective sensations caused by DBS pulse-generator and lead-extensions in relation with objectively measured parameters. In 50 patients implant-related sensations were evaluated. The pulse-generator mobility was video-analyzed. Insufficient lead-extension/pulse-generator tolerability (72%/84%) was documented. Furthermore, 54% of the patients described movement impairments and 48% cosmetic deformity. High body mass index (BMI) was associated with low lead-extension related pain (P < 0.001). High generator mobility resulted in high lead-extension related pain (P < 0.001). Compared with lead-extension type 7482, type 7495 showed less lead-extension related pain (P = 0.0138), we suppose secondary to surgical tunneling instruments with a larger tip diameter. The lead-extension path with one tissue tunnel for both lead-extensions had 36% lead-extension related pain versus 11% for the path with one single tunnel for each lead-extension. Smaller pulse-generators for better cosmetic results, surgical procedures using larger tunneling instruments and one single tunnel for each lead-extension would provide better results for patients with BMI <30.