Before an implant

Sinus lift

A graft placed between the upper jaw and the floor of the sinus above it, to build the height an implant needs. It is the procedure that turns "there is not enough bone" into a plan.

Surgery: 60–90 minutes
Anaesthetic: Local or sedation
Graft matures: 4–9 months
Then: The implant

What it is

Above the back teeth of the upper jaw sits the maxillary sinus, an air space with a thin floor. When an upper molar is lost, the bone below that floor stops being loaded and recedes, and the sinus tends to expand downwards into the space. Between them they can leave too little height to hold an implant — sometimes only two or three millimetres where ten are wanted.

A sinus lift makes that height. The membrane lining the sinus floor is carefully raised and graft material is placed underneath it, where it turns into the patient's own bone over the following months. Nothing is put into the sinus itself; the membrane stays intact and the new bone forms below it.

How it is done depends on how much is missing. A small deficit can be lifted through the implant socket itself, at the same appointment as the implant. A large one needs a window in the side of the jaw, and then months of healing before the implant goes in — which is the part worth knowing early, because it turns one trip into two.

Nobody wants a sinus lift. What they want is an implant in the back of an upper jaw, and this is what makes that possible.
Dr. Aykut

Which one you need

Crestal lift
Done through the implant site itself with the sinus floor tapped gently upward. The implant usually goes in at the same appointment, so it adds almost nothing to the timetable.
6–8 mm of bone, needing a few more
Lateral window lift
A small window in the side of the jaw, the membrane lifted under direct view, and the space filled with graft. More surgery, more healing, and the only way to get height where there is very little.
Under 5 mm of bone
Simultaneous placement
Graft and implant in one operation. Possible when there is enough bone for the implant to be stable while the graft matures around it.
Where the remaining bone can hold an implant
Staged placement
Graft first, implant four to nine months later. Slower and safer: an implant placed into graft that cannot hold it is a lost implant.
Where it cannot
Avoiding it
Angled implants or a shorter implant placed in front of the sinus sometimes reach the same result without a graft. Worth asking about — the best sinus lift is the one you turn out not to need.
Where the anatomy allows

What happens to you

Two visits, and a wait at home in between

Before anything
The CBCT
A three-dimensional scan, not a flat X-ray. It measures the bone height, the shape of the sinus floor and the thickness of the membrane, and it is what decides which of the routes above applies.
The surgery
60–90 minutes
Under local anaesthetic or sedation. The membrane is lifted, the graft placed, the site closed. You feel pressure rather than pain.
The first week
Not blowing your nose
No nose-blowing, no straws, sneeze with your mouth open, and no flying for a few days — the common thread is pressure across the sinus while the membrane heals. Swelling and some bruising are normal, and a little blood-tinged discharge from the nose can be too.
4–9 months
The graft becomes bone
This part happens at home. The graft is gradually replaced by your own bone; nothing to do but keep the mouth clean and let it work.
The second visit
The implant
A new scan confirms the height, and the implant goes into bone that now exists. From there it is the ordinary implant timetable.

Before anything
The CBCT
A three-dimensional scan, not a flat X-ray. It measures the bone height, the shape of the sinus floor and the thickness of the membrane, and it is what decides which of the routes above applies.
The surgery
60–90 minutes
Under local anaesthetic or sedation. The membrane is lifted, the graft placed, the site closed. You feel pressure rather than pain.
The first week
Not blowing your nose
No nose-blowing, no straws, sneeze with your mouth open, and no flying for a few days — the common thread is pressure across the sinus while the membrane heals. Swelling and some bruising are normal, and a little blood-tinged discharge from the nose can be too.
4–9 months
The graft becomes bone
This part happens at home. The graft is gradually replaced by your own bone; nothing to do but keep the mouth clean and let it work.
The second visit
The implant
A new scan confirms the height, and the implant goes into bone that now exists. From there it is the ordinary implant timetable.

Before anything
The CBCT
A three-dimensional scan, not a flat X-ray. It measures the bone height, the shape of the sinus floor and the thickness of the membrane, and it is what decides which of the routes above applies.
The surgery
60–90 minutes
Under local anaesthetic or sedation. The membrane is lifted, the graft placed, the site closed. You feel pressure rather than pain.
The first week
Not blowing your nose
No nose-blowing, no straws, sneeze with your mouth open, and no flying for a few days — the common thread is pressure across the sinus while the membrane heals. Swelling and some bruising are normal, and a little blood-tinged discharge from the nose can be too.
4–9 months
The graft becomes bone
This part happens at home. The graft is gradually replaced by your own bone; nothing to do but keep the mouth clean and let it work.
The second visit
The implant
A new scan confirms the height, and the implant goes into bone that now exists. From there it is the ordinary implant timetable.

Before anything
The CBCT
A three-dimensional scan, not a flat X-ray. It measures the bone height, the shape of the sinus floor and the thickness of the membrane, and it is what decides which of the routes above applies.
The surgery
60–90 minutes
Under local anaesthetic or sedation. The membrane is lifted, the graft placed, the site closed. You feel pressure rather than pain.
The first week
Not blowing your nose
No nose-blowing, no straws, sneeze with your mouth open, and no flying for a few days — the common thread is pressure across the sinus while the membrane heals. Swelling and some bruising are normal, and a little blood-tinged discharge from the nose can be too.
4–9 months
The graft becomes bone
This part happens at home. The graft is gradually replaced by your own bone; nothing to do but keep the mouth clean and let it work.
The second visit
The implant
A new scan confirms the height, and the implant goes into bone that now exists. From there it is the ordinary implant timetable.

Questions

Is it as bad as it sounds?

It sounds much worse than it is. It is done under local anaesthetic or sedation, takes about an hour, and the recovery is closer to a surgical extraction than to anything people imagine when they hear the word sinus.

Will I feel it in my sinus?

Pressure and congestion on that side for a few days, sometimes a little blood-tinged discharge from the nose. What you must not do is blow your nose during the first week, because the pressure works directly against the membrane that was lifted.

Where does the graft material come from?

Usually a processed bone substitute rather than from you — which avoids a second surgical site. Whichever is used, it acts as a scaffold: your own bone replaces it over the following months.

How long before I get the implant?

Nothing extra if it is a small crestal lift done at the same appointment. Four to nine months if a lateral window was needed — and that wait happens at home, not in Istanbul.

What if it fails?

The commonest complication is a small tear in the membrane, which is usually repaired during the same operation. Graft that does not mature can be redone. Infection is uncommon and treatable — and all of this is decided on the scan before anyone starts.

Patients

The people who already came

Six of our patients, filmed at the clinic and talking about their own treatment. They are the clinic’s patients rather than any one procedure’s — what each of them had is in the film.