Practical Do-It –Yourself Device for Accurate Volume Measurement of Breast

1. Introduction: Where Aesthetics and Functionality Meet in Breast Aesthetics

Breast lift (mastopexy) and breast reduction surgeries are among the most frequently sought surgical procedures not only to achieve an aesthetic form, but also to relieve the physical discomfort caused by the weight of the breasts and to improve quality of life. However, the greatest concern of patients considering these operations is the durability of the lifted appearance obtained after surgery. Many women are wary of the risk of that ideal form obtained after the operation "sagging again" under the effect of gravity and time.

The **"Lateral Pillar Suspension"## technique, developed by

Prof. Dr. Erdem Tezel** and contributed to the world plastic surgery literature, offers a radical and scientific solution to this chronic problem. This method sets a new standard in aesthetic surgery by suspending the breast not merely with the help of the skin, but with a solid support mechanism constructed from the inside.

2. The Limits of Traditional Methods: The "Bottoming Out" (Sagging of the Lower Pole) Problem

One of the most common and patient-dissatisfying long-term complications encountered in traditional vertical-scar breast surgeries is the downward displacement of the breast tissue over time and the loss of fullness in the upper part of the breast. This phenomenon, referred to in the medical literature as "bottoming out," causes the lower part of the breast to succumb to gravity and sag, distorting the form.

In classic methods, the preservation of the breast shape relies largely on skin sutures. However, because the skin has an elastic structure, it cannot resist gravity forever; over time it loosens, stretches, and becomes unable to carry the heavy breast tissue inside it. This leads to the inevitable distortion, over the years, of the ideal form obtained after surgery.

3. What Is Lateral Pillar Suspension? An Internal Support Mechanism

This innovative technique, developed by Prof. Dr. Erdem Tezel and Dr. Burak Ersoy, aims to base the breast tissue on the body's most stable anatomical structures rather than on the skin. At the foundation of the technique lies the fixation of the lower end of the prepared "lateral pillar" triangle by suturing it to the rib periosteum (the membrane of the rib) adjacent to the lower-inner border of the sternum (breastbone) in the chest.

To explain this process with a visual analogy, it serves a function similar to the "Lockwood ligament" that supports the tissues of the eyelid from within, and like a "fishnet" it grasps and carries the weight of the breast tissue from the inside. In this way, the entire load of the breast is taken off the skin sutures and transferred directly to the bone membrane of the chest wall.

4. The Advantages of the Technique: Why Should This Method Be Preferred?

The advantages offered by the Lateral Pillar Suspension method guarantee both the aesthetic success of the surgery and a durability that will last a lifetime:

• Lasting Firmness: Because the support system against gravity rests directly on the rib periosteum rather than on the skin, the downward sagging of the breast (bottoming out) is prevented.

• Upper-Pole Fullness: Because the breast tissue is suspended upward from the inside, the volume in the upper part of the breast is preserved, providing a firmer, fuller appearance in the décolletage area.

• Natural Conical Form: The breast tissue is centered by folding over itself. In this way, an aesthetic and upright conical form is achieved, with the nipple at the highest point of projection.

• More Imperceptible Scars: Because the weight of the breast is carried by the internal suspension system, the tension on the skin sutures is minimized. This low tension allows the suture scars to heal in a much finer and higher-quality manner.

• Elimination of Lateral Fullness: In particular, breast tissue overflowing toward the armpit (lateral fullness) is gathered toward the center with this technique, creating a tidy breast appearance in harmony with the body's contours.

5. Areas of Application: Who Is It Suitable For?

This technique gives excellent results not only in reduction surgeries where breast tissue is removed, but also for patients who need only a lift (mastopexy) without volume loss.

In cases where removal of breast tissue is not required, the existing tissue is folded over itself and suspended upward, gathering the volume at the top as if an "internal bra" had been created. In breast reduction cases, tissue removal is performed predominantly from the inner part of the breast (the medial pillar), and the continuity of the ideal form is ensured with lateral pillar suspension.

6. The Surgical Process and Recovery

In the Lateral Pillar Suspension technique, no load is placed on the skin sutures to maintain the form of the breast and carry the tissue; the weight is carried by the internal structures. This allows the skin sutures to be closed in a "tension-free" manner. The tissue taking its position through its own internal structure makes the postoperative recovery process much more comfortable and painless for the patient.

The vertical scar (upright suture scar) that forms as a result of the surgery is hidden, in harmony with the new, lifted position of the breast, above or exactly in line with the inframammary fold. The radical reduction of stress on the skin makes the greatest contribution to the scars becoming imperceptible over time after healing.

7. Prof. Dr. Erdem Tezel's Contribution to the Literature and Expertise

The Lateral Pillar Suspension technique is regarded as a scientific revolution in the world of plastic surgery. This method entered the medical literature when it was published in 2008 in the Journal of Plastic, Reconstructive & Aesthetic Surgery (JPRAS), one of the world's most respected scientific platforms.

This technique was developed as a solution to the "sagging over time" problem, the greatest shortcoming of the classic vertical-scar methods developed by legendary names such as Lassus and Lejour. This innovation, presented under the leadership of Prof. Dr. Erdem Tezel, is a prestigious approach that proved to the world, in Istanbul aesthetic surgery practice, that the breast should be shaped not with the skin alone but with an anatomical suspension system.

8. Conclusion: Looking to the Future with Confidence

In breast aesthetics, true success is measured not merely by the appearance immediately after surgery, but by the upright form that is preserved even as the years pass. Lateral Pillar Suspension is the strongest answer modern medicine offers on the matter of "durability," where traditional methods fall short. You too can choose this scientifically proven technique for upright, firm, and natural-looking breasts that will last a lifetime.

For detailed information and surgical planning tailored to you, you can get in touch with Prof. Dr. Erdem Tezel and experience the privilege of lasting aesthetics and comfort.