Lateral Pillar Suspension in Vertical-Scar Mammaplasty

Prof. Dr. Erdem Tezel’s innovative "Lateral Pillar Suspension" technique, published in the Journal of Plastic, Reconstructive & Aesthetic Surgery, addresses this fundamental challenge by creating an internal support system that defies gravity.

The Evolution of the Vertical Scar Technique

The "vertical scar" technique is celebrated for achieving a beautiful, conical breast shape with significantly less scarring than the traditional "Anchor" (T-inverted) incision. While pioneers like Lassus and Lejour popularized this approach, the risk of the breast tissue sliding downward during the late postoperative period remained a drawback. The Tezel Technique modifies this elegant technique to ensure that the "lifted" look stays lifted for years to come.

How Lateral Pillar Suspension Works: The "Internal Bra" Concept

Unlike traditional techniques that shape the breast by tightening the skin, the Tezel Technique focuses on the internal architecture. In this procedure:

• Deep Anchoring: The inferior end of the "lateral pillar" (the outer segment of the breast tissue) is tightly sutured to the periosteum of the rib—the tough membrane covering the chest wall.
• Biomechanical Support: This suspension acts similarly to a "fishnet" or the "Lockwood ligament" of the eyelid, supporting the entire weight of the mammary tissue from the inside.
• Conical Design: By anchoring the tissue to the chest wall near the sternum, the breast is naturally molded into a firm, conical shape with the nipple positioned at the highest point of projection.

Key Benefits of the Tezel Technique

1. Permanent Upper Pole Fullness: By preventing the tissue from sliding down, the upper part of the breast (the cleavage area) remains full and youthful.
2. No More "Bottoming Out": The weight is carried by the internal rib anchorage rather than the skin, eliminating the risk of the breast looking saggy or heavy at the bottom over time.
3. Inconspicuous Scars: Because the internal structure supports the weight, there is minimal tension on the skin sutures. This leads to much finer, thinner, and less noticeable vertical scars.
4. Reduced Lateral Fullness: The technique effectively "tucks in" excess tissue from the sides, creating a narrower and more athletic silhouette.

Who is an Ideal Candidate?

This association of techniques is versatile. It is equally effective for breast reduction (where excess tissue is removed) and mastopexy (breast lift), where the goal is to reposition existing tissue without removing volume. It is particularly beneficial for patients with significant sagging or those who want to avoid the "boxy" look often seen with older surgical methods.

Conclusion: Art Supported by Science

A successful breast surgery should provide not just a temporary change, but a lasting transformation. By shifting the burden of support from the skin to the internal skeletal structure, Prof. Dr. Erdem Tezel ensures that the aesthetic results are durable and stable. With the Lateral Pillar Suspension, you can achieve a natural, upright, and beautiful breast form that stands the test of time.