Breast lift with teardrop implants in Turkey

There are three distinct complaints and they have three different answers. If the breast has lost volume but sits where you want it, an implant alone may be enough. If the volume is fine but the breast and nipple sit lower than you want, a lift alone is the operation. If both are true, the combined procedure is what is being discussed here.

Ask the surgeon to say which of the three you are, and to say it before any implant catalogue comes out. The order of that conversation tells you a great deal: an assessment that begins with sizes has started at the wrong end.

• Volume lost, position fine

  An implant alone may be enough, and adding a lift adds scars for nothing. This is the case people most often over-treat.

• Position dropped, volume fine

  A lift alone is the operation, and it leaves the breast the size it is. Adding an implant here is a decision about size and not about lift.

• Both, after pregnancy or weight loss

  The combined operation. It is the more demanding plan and the one with the higher revision rate, and it is worth knowing that before you book.

• Still changing

  If you are still losing weight or plan another pregnancy, both the skin and the volume will change again. Operating now is buying a revision later.

For the lift on its own see breast lift, for implants on their own see breast implants, for the shape decision in detail see teardrop breast implants, and for the same combined operation with round devices see breast lift with round implants.

An anatomical implant is fuller at the lower pole, which is meant to produce a more sloped upper chest. The trade is that it has to stay in the right orientation: if an anatomical implant rotates, the breast looks wrong and correcting it means another operation. A round implant cannot rotate in a way anyone can see, because it is the same shape all the way round.

The other thing worth knowing is that most anatomical implants are textured, because texture is what holds them in position. Textured surfaces are the ones associated with breast implant-associated anaplastic large cell lymphoma, and certain macro-textured devices were withdrawn from the market worldwide after regulators in Europe, North America and Australia acted. That is a question to ask about the specific device you are being offered, by name.

• Higher revision rate than either operation alone. This is the defining fact of the combined procedure and it follows from the two forces working against each other.
• Blood supply to the nipple. A lift moves the nipple on its own blood supply and an implant increases the tension around it. Combining them is precisely why this risk is discussed more here than for a lift alone.
• Sensation change. Reduced or altered nipple sensation is a recognised outcome and is not always temporary.
• Capsular contracture. Scar tissue tightening around the implant, which can change the shape and cause discomfort and is a common reason for further surgery.
• Rotation, with anatomical implants. The specific failure mode of the teardrop shape, and correcting it means returning to theatre.
• Wound healing where the scars meet. The junction of the vertical and horizontal scars is the spot most likely to be slow to heal, and smoking makes it considerably worse.
• Implants are not lifetime devices. Further surgery at some point over a lifetime is expected rather than exceptional, and that belongs in the cost of the decision.

• Ask for the implant details by name. Manufacturer, model, surface, size and the implant card to take home. Without it no one can help you years later.
• Ask about the surface specifically. Whether the device is textured or smooth, and what the surgeon's position is on textured devices given the lymphoma association.
• Ask whether one stage or two is being proposed, and why. In terms of your tissue, not the length of your trip.
• Ask to see healed results at a year. Photographs at a few weeks show a shape that has not settled and scars that have not matured.
• Ask what a revision costs and who pays. This operation is revised more often than most, and a package that ends at the airport covers none of it.
• Agree the follow-up in writing. Names, dates and a route back to the surgeon from home for at least the first year.

• United States Food and Drug Administration, safety communications on breast implants and breast implant-associated anaplastic large cell lymphoma.
• American Society of Plastic Surgeons, patient information on mastopexy and augmentation mastopexy.
• British Association of Aesthetic Plastic Surgeons, patient guidance on breast implant surgery.
• Medicines and Healthcare products Regulatory Agency, information on textured breast implants.
• Turkish Ministry of Health, register of facilities licensed for health tourism.