Breast Lift Combined with Implants: Balancing Aesthetics and Function
Why Combine Mastopexy and Implants?
Breast lift (mastopexy) combined with implant placement is one of the most sophisticated procedures in aesthetic breast surgery. This operation not only increases volume, but also repositions the breast tissue, corrects the skin envelope and restores natural anatomical contours. It is especially preferred when sagging develops due to pregnancy, breastfeeding, weight fluctuations or aging, and when neither implant alone nor lift alone is sufficient.
The fundamental goal of surgical planning is to meet aesthetic expectations while preserving breast function and tissue health. Therefore, mastopexy–implant combination requires advanced experience, precise tissue assessment and strong aesthetic perception.
Breast Anatomy and the Mechanism of Sagging
Breast tissue consists of adipose tissue, glandular tissue and supportive ligaments. Sagging occurs when:
● Cooper’s ligaments lose elasticity
● Skin envelope becomes loose
● Glandular tissue loses volume
During pregnancy and breastfeeding, the breast enlarges, then loses volume in the involution period, resulting in a deflated and downward positioned breast with a lower nipple level.
Sagging severity is classified according to nipple position relative to the inframammary fold. Mild cases may be managed with implants alone, whereas advanced ptosis requires lifting.
Indications for Mastopexy–Implant Combination
This combined surgery is ideal in the following situations:
● Significant sagging with volume deficiency
● Desire for fuller and rounder upper pole
● Aim to achieve both lift and volume in a single procedure
● Need for youthful, projected and symmetrical breast contour
● Long-term stable volume within anatomical safety limits
Because both projection and lifting are targeted simultaneously, it requires meticulous planning and expert tissue management.
Personalized Surgical Planning
This combination is not performed the same way for every patient. Success depends on evaluating general body proportions, breast base width, skin quality and existing breast volume.
Key planning criteria include:
● Breast base width and chest wall anatomy
● Skin elasticity and connective tissue quality
● Amount of existing glandular tissue
● Nipple position and degree of ptosis
● Desired upper pole fullness
● Implant size, profile and shape (round vs anatomical)
The aim is to create long-lasting, natural-looking breasts without excessive tissue tension.
Implant Position: Over or Under the Muscle?
Implant placement plane is selected according to tissue characteristics and surgical goals.
Dual-Plane / Submuscular Placement
● Smoother and more natural transition
● Recommended for thin-tissue patients
● Better control of upper pole fullness
Subglandular / Subfascial Placement
● Suitable if there is adequate breast tissue
● Provides natural movement and feel
● Recovery may be more comfortable
Choosing the correct plane is essential for long-term stability and natural appearance.
Mastopexy Techniques
Technique selection depends on ptosis degree:
● Periareolar (donut)
● Vertical (lollipop)
● Inverted-T (anchor)
All techniques aim to reshape tissue, remove excess skin and reposition the nipple to a higher, symmetrical position. Surgical experience plays a key role in scar quality and natural contour preservation.
Tissue Support and Safety Principles
In mastopexy–implant surgery, balance between natural tissue and implant support is critical. Skin alone cannot bear the load; therefore support strategies are essential.
Key principles include:
● Deep tissue fixation
● Maintaining lower pole support
● Use of internal bra techniques when necessary
● Careful hemostasis and tissue protection
● Respecting natural breast anatomy
These ensure long-term stability and controlled shape.
Recovery and Stabilization of Results
Recovery is multi-stage. Swelling and tension are expected initially. The body gradually adapts as tissues settle.
Factors positively affecting healing:
● Controlled arm movement and activity regulation
● Complete smoking cessation
● Proper edema management
● Use of supportive surgical bra
● Maintaining circulation and body temperature
Final breast shape typically settles within 3–6 months.
Managing Patient Expectations
Strong communication between surgeon and patient is essential. Expectations must be realistic and aligned with anatomical limitations. Even if a patient desires very large volume, implant size must match tissue capacity to avoid long-term deformity or complications.
The goal is not only visual enhancement, but preservation of tissue health and balanced, natural architecture.
Surgical Strategy and Tissue Management
Mastopexy with implants is one of the most refined procedures in aesthetic surgery. It is not simply placing an implant or removing skin — it is a comprehensive reconstruction that considers breast tissue, skin envelope and anatomical foundation together.
Long-term patient satisfaction depends on:
● Precise tissue handling
● Anatomical harmony
● Surgeon expertise
● Personalized surgical planning
The outcome aims for lifted, fuller and naturally contoured breasts while protecting breast function and tissue health — achieving harmony between aesthetics and biology.
Physician Information
Assoc. Prof. Dr. Sedat Tatar is a Plastic, Reconstructive, and Aesthetic Surgery specialist who is Double Board Certified by two international boards. He holds the titles of Fellow of the American College of Surgeons (FACS) and Fellow of the European Board of Plastic, Reconstructive and Aesthetic Surgery (FEBOPRAS).
His international professional memberships include ISAPS (International Society of Aesthetic Plastic Surgery) and ASPS (American Society of Plastic Surgeons).
His clinic is located in Istanbul and is officially authorized by the Turkish Ministry of Health as a Health Tourism Center. His company is registered in the United Kingdom & Wales.
CONTACT INFORMATION
Telephone No : +90 (555) 100 10 83
Contact Link : [email protected]
Address : Levent District, Karanfil Araligi Street No: 18 Besiktas/ISTANBUL
