Keyhole Top Surgery in Istanbul
Keyhole top surgery leaves the smallest scar of all top surgery techniques, but it is suitable only for a narrow group of patients: those with a very small chest and firm, elastic skin. Because no skin is removed, careful assessment before surgery matters more than with any other technique. Dr. Hakki Izmirli performs keyhole top surgery in Istanbul for international patients.
What Is Keyhole Top Surgery?
Breast tissue is removed through a short incision along the lower half of the areola. No skin is cut away; the skin is expected to tighten on its own over the new, flatter contour. If needed, liposuction is used to refine the sides of the chest. The nipples stay attached to the tissue beneath, so no grafting is needed.
Who Is a Good Candidate?
Keyhole is usually only recommended if you have:
- a very small chest (typically an A cup or smaller)
- firm skin with good elasticity
- little or no sagging
- nipples that already sit in a suitable position
If there is any real skin excess, the chest can look loose or wrinkled after keyhole surgery, and a second operation may be needed to remove skin. In that case, periareolar or double incision usually gives a better result from the start. Dr. Izmirli will tell you honestly which technique suits your chest.
Advantages and Considerations
| Advantages | Considerations |
|---|---|
| The smallest scar of all techniques | Only works for small, firm chests |
| Nipples remain attached; no grafting | Cannot correct sagging or remove skin |
| Better chance of keeping nipple sensation | The areola can be reduced only slightly, if at all |
| Often a quicker recovery | Higher chance of needing a revision if the skin does not tighten |
How the Operation Is Performed
- Marking: the incision and the area to be treated are planned with you standing, before surgery.
- Surgery: under general anaesthesia, breast tissue is removed through the incision at the lower edge of the areola. The operation takes about 2 hours.
- Drains: if needed, small drains are placed to remove fluid during the first days of healing; they are removed at a check-up in Istanbul.
- Hospital stay: because the operation is performed under general anaesthesia, you stay one night in hospital.
Scars and Nipple Sensation
The only scar runs along the lower border of the areola, where the change in skin colour helps to disguise it. Because the nipples are not detached, keyhole gives a better chance of keeping nipple sensation than double incision with free nipple grafts, but sensation can still change and cannot be guaranteed.
Recovery Timeline
| Day 0 | Surgery (about 2 hours), one night in hospital |
| Days 1–7 | Stay in Istanbul for check-ups before flying home |
| About 1 week | Return to desk-based work |
| 1 month | Wear the compression binder |
| 2 months | Return to the gym and heavy lifting |
Recovery varies from person to person. Your aftercare continues remotely once you are home.
Risks
Like any surgery, keyhole top surgery carries risks. These include bleeding or haematoma, fluid collection (seroma), infection, contour irregularities, loose or puckered skin, changes in nipple sensation, and residual tissue. If the skin does not tighten as expected, a revision may be needed. Dr. Izmirli discusses your individual risks at your consultation.
Is Keyhole Right for Me?
Many people hope to be keyhole candidates because of the small scar, but choosing it for the wrong chest can lead to a less flat result and a second operation. Send your photos for a free online consultation, and Dr. Izmirli will tell you whether keyhole is realistic for your chest or whether another technique will give a better result. A letter from a psychiatrist or therapist is not required; a signed informed consent form is sufficient.
Request a Consultation
About the surgeon
Dr. Hakki Izmirli
Plastic surgeon with 20 years of experience, based in Nişantaşı, Istanbul. Dr. Izmirli trained at Istanbul University Faculty of Medicine and completed his residency in Aesthetic, Plastic and Reconstructive Surgery at Kocaeli University. His research on free nipple grafting has been published in Aesthetic Plastic Surgery, Plastic and Reconstructive Surgery and JPRAS.
Professional memberships: WPATH (Full Member) · ISAPS · ASPS (International Member) · TPRECD
Online
consultation
Ready to take the next step? Request your consultation today
Medical disclaimer: The information on this website is for general information only and does not replace a personal consultation with a doctor. Every patient is different; results vary from person to person and cannot be guaranteed.
© Dr. Hakki Izmirli – 2026 All rights reserved