Balancing Desire and Surgical Safety
As a plastic surgeon performing breast surgeries here in Istanbul, Turkey, I often encounter patients seeking breast lift (mastopexy) with simultaneous implant placement. While this combination can be an excellent option for some, it's crucial to understand that it's *not* universally suitable. In cases of significantly large, dense, and sagging breasts, adding implants can actually compromise the health and long-term outcome of the procedure. I, Dr. Cem Berkay Sinaci, believe in prioritizing patient safety and realistic expectations, which sometimes means advising against implants in certain situations.
The Risks of Implants in Large, Ptotic Breasts
When breasts are already substantial in size, dense in tissue composition, and exhibiting significant ptosis (sagging), attempting to insert an implant during a breast lift can create a cascade of potential complications. The primary concern revolves around the delicate blood supply to the nipple-areola complex (NAC).
Don't forget to visit our breast lift with implant (mastopexy augmentation) information page !
Nipple Ischemia and Necrosis
In cases where the nipple needs to be elevated more than 6-7 centimeters, inserting an implant significantly increases the risk of compromising blood flow to the NAC. This can lead to nipple ischemia (insufficient blood supply) and, in severe cases, nipple necrosis (tissue death).
Pedicle Tension
The surgical technique used to lift the breast relies on a "pedicle" – a bridge of tissue that maintains blood supply to the NAC. When breasts are large and dense, the lift itself creates significant tension on this pedicle. Adding an implant further exacerbates this tension, jeopardizing circulation.
Incompatibility with Safer Lift Techniques
The safest and most reliable breast lift techniques for large, ptotic breasts are often those that *don't* readily accommodate implants. Central pedicle and inferior pedicle techniques are excellent for preserving blood supply and achieving a stable, long-lasting result. Altering these techniques to accommodate an implant can introduce unacceptable risks.
Increased Pressure and Wound Healing Problems
Dense breast tissue, combined with the tension from the lift and the added pressure of an implant, can lead to poor wound healing. This can manifest as wound dehiscence (opening of the surgical incision), fat necrosis (death of fat tissue), and an increased risk of infection.
Why Implants Aren't Always the Answer: A "Prosthesis in the Arm" Analogy
In my practice, I believe that inserting an implant into a large, dense breast when it's not truly indicated is akin to "cutting off an arm and inserting a prosthesis." It's an unnecessary intervention that carries significant risks when a more natural and safer alternative exists.
The Power of Auto-Augmentation: Breast Lift with Your Own Tissue
When a patient has sufficient breast volume, the healthiest and most predictable approach is to perform a breast lift using their own breast tissue. This is often referred to as "auto-augmentation" or using an "internal bra" technique.
How Auto-Augmentation Works
During the breast lift, excess breast tissue is strategically repositioned to create upper pole fullness and enhance the overall shape and projection of the breast. This eliminates the need for a foreign object (the implant) and minimizes the risks associated with it.
-Natural Results: Auto-augmentation provides a more natural-looking and feeling result compared to implant-based augmentation. The breast maintains its natural consistency and movement.
-Reduced Complications: By avoiding implants, we significantly reduce the risk of capsular contracture (scar tissue formation around the implant), implant rupture, infection, and other implant-related complications.
-Long-Lasting Results: When performed correctly, auto-augmentation can provide long-lasting results that are stable and aesthetically pleasing.
Central Pedicle and Inferior Pedicle Techniques: Preserving Blood Supply
The central pedicle and inferior pedicle techniques are my preferred methods for breast lift in patients with large, ptotic breasts. These techniques prioritize the preservation of blood supply to the NAC, minimizing the risk of nipple complications. They allow for significant reshaping and lifting of the breast while maintaining a robust and reliable blood supply.
When Are Implants Appropriate?
It's important to emphasize that implants *do* have a role in breast lift surgery. They are most appropriate in patients who: -Have insufficient breast volume to achieve the desired fullness with auto-augmentation alone.
-Desire a significant increase in breast size beyond what can be achieved with their own tissue.
-Have good skin elasticity and a healthy blood supply to the NAC.
Don't forget to visit our breast augmentation with silicone implants information page !
The Importance of Realistic Expectations and Open Communication
The key to a successful breast lift, with or without implants, lies in realistic expectations and open communication between the surgeon and the patient. During your consultation, I will thoroughly assess your breast anatomy, discuss your goals, and explain the risks and benefits of all available options. It's my responsibility to provide you with the information you need to make an informed decision that is best suited to your individual needs and circumstances.
Conclusion: Prioritizing Safety and Natural Beauty
When it comes to breast lift surgery, particularly in patients with large, dense, and sagging breasts, it's essential to prioritize safety and natural-looking results. While implants can be tempting, they are not always the best choice. Auto-augmentation, using your own breast tissue, offers a safe and effective alternative that can achieve beautiful and long-lasting results. If you're considering a breast lift, I encourage you to seek a consultation with a board-certified plastic surgeon who has extensive experience in breast surgery and who prioritizes patient safety above all else. Together, we can create a personalized treatment plan that will help you achieve your desired outcome while minimizing risks and maximizing your long-term satisfaction.
Watch our real patient stories in Turkey !
-See Nina's breast lift with implant in Istanbul from Germany
-Watch Dany's breast augmentation from Australia to Istanbul, Turkey
