Breast Lift: Q&A

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Breast Augmentation a Year Post-Breast Lift?

I had a Breast Lift over a year ago while my husband was in Iraq, and was told I won't need a Breast Augmentation. I was a 36DD and am now a 36D, and I was told I had enough fullness.

Now, a year later, I am not happy because I am flat on the top part of my breasts and still have to adjust them in my bra often throughout the day. My doctor says now I will need an augmentation. Is this normal, and do I really need it? Why is it fair that I should have to pay for the full surgery now when I asked a year ago, and was told I won't need it? My husband and I are upset about me not being happy. We have spent a lot of money, I have tons of scars, and I'm feeling uncomfortable.

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23 Doctor Answers | Asked by jbunny in elkhorn, ne 68022

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Breast Lift vs. Breast Augmentation or Both: Decisions in Breast Surgery

The following question will help clarify whether you need a breast lift vs a breast augmentation and lift. Do you want to look better in the nude or in clothes? If you want to look better in clothes, a breast lift will generally not provide any benefit. A breast lift will reposition the nipple-areola to provide improvement in breast shape without a bra. This is usually a volume issue and can be addressed with an implant, otherwise a good pushup bra will do. If you want to look better in... more

Breast Augmentation After Breast Lift

Sorry to hear that you did not get the results you wanted. The breast lift is usually the best choice for lifting a droopy breast. Right sfter surgery, the breast will be very full and round on top. However, the surgery lifts the breast, but cannot change the tone of the tissue and the ability of the body to maintain the tightness and shape. Some settling occurs. At times, we use implants at the time of a breast lift to add volume; sometimes we use the implants to... more

A mastopexy will leave a full breast even without an implant.

A properly perfomed mastopexy should leave the breast looking full even without an implant. Breast implants make breasts larger. If the patient is satisfied with her size, an implant is contraindicated.

Talk to your surgeon

You should definitely relay your concerns with your surgeon, but don't be too angry with him. While it is difficult to know your exact situation without having seen you preop, I think it is certainly reasonable to assume that if you started as a DD, you would have had enough volume after a lift only and not required an implant. That being said, having the implant placed now is very straightforward and some would argue that it is safer as a two stage procedure. I think if you speak with... more

Communication is always important

Hello, When a patient naturally has a significant amount of breast volume (i.e. a "DD"), a breast lift can often be successfully performed WITHOUT an implant. This seems to be what your surgeon had in mind when he suggested the mastopexy without an implant. I agree with the other surgeons who have said that we cannot always predict the outcomes of the surgery--and in your case, it seems that you would have had better results by using an implant. I encourage you to express your... more

Breast lift and augmentation are commonly done as a staged procedure

Jbunny, Unfortunately, it sounds like there may have been a communication breakdown and/or misunderstanding between you and your doctor. While it is hard to give you specifics since none of us were there for your preoperative discussions, it is common to perform breast lift/augmentation as a staged procedure (2 surgeries). Additionally, if you would have had the augmentation and lift at the same time, then your initial surgery would have included an additional surgical procedure fee for... more

Augmentation?

I am sorry for your dissatisfaction. While I would let your surgeon know your concerns, DD is usually ample and he/she probably was using that in his/her mental process. Each surgeon has a different policy in ensuring a happy patient so he/she may charge you a reduced fee for the surgery if you approach properly.

Upper pole fullness

It is hard to achieve upper pole fullness with a breast lift or a reduction. That characteristic is unique to breast implants. You can achieve the look you desire with implants, but you will be bigger in size. It is unfortunate that was not conveyed to you before the initial procedure, but all is not lost. A second procedure may be exactly what you needed from the start. Maybe you can work out a compromise with your surgeon, you pay for implants, he does not... more

Breast implants after a breast lift

A breast lift can improve your nipple position and the overall shape of your breast, while making it slightly smaller. Depending on the amount and quality (firmness) of your breast tissue, it is sometimes difficult to achieve satisfactory fullness of the upper portion of your breast with a breast lift alone. It is not completely unusual for some patients to want or need an implant placed after (one year later) they have recovered from a breast lift. Sometimes these... more

Breast augmentation after breast lift

I'm sorry to hear that you were not satisfied with your outcome. Ideal breast size is a very personal matter. What may be too large for one is too small for another. In my opinion, deciding if a patient needs implants or just a lift is pretty simple. If she is happy with her breast size prior to a lift, wearing an unpadded bra, then implants are not necessary. If she would like to be larger then I would recommended implants.

Breast augmentation after breast lift

It is possible to undergo breast augmentation 1 year following breast lift. The addition of the implant should provide you with the upper pole fullness you wish for. Discussing your expectations and cost concerns with your plastic surgeon should hopefully resolve these issues prior to your undergoing another surgery.

Breast augmentation after breast lift

You cite that lack of superior pole breast fullness as your current concern- there is little that a breast lift can do to solve this problem long-term. There are some auto-augmentation breast lifts, but I'm not sure the results will last a long time. A breast implant is the only thing that is going to give you reliable upper pole fullness. It sounds like you and your surgeon did not meet eye-to-eye on your aesthetic concerns prior to the first operation. The good news is that a... more

Breast augmentation after a breast lift

it is possible to receive a breast augmentation after a breast lift. However, please keep in mind that this is not a simple or straightforward breast augmentation has yet changed the character and shape of your breast with the previous surgery. The previous surgery has also changed the blood supply to your breast. For these reasons, it is incredibly important to be evaluated by a board-certified plastic surgeon who is very experienced in breast lift breast augmentation surgery... more

Discuss breast augmentation after a lift with your doctor

Hello, It is not always known how a patient will do with a cosmetic operation. Talk with your doctor and try to come up with a compromise. Maybe he can charge you less and still not do it free and you can both be OK with it. There are docs who do the operation in a staged fashion like this all the time. It is a matter of opinion. Best Regards BTW - At that breast size there may be a reason not to place implants...like later breast sagging. Maybe that is what yor doc was thinking? more

Upper pole fullness hard to achieve without breast implants

Technically upper pole fullness is hard to acheive without an implant. From a practical stand point you might be charged for the cost of the surgery with minimal or no surgical fees.

Breast lift (mastopexy) without implants

SEE VIDEO FOR EXAMPLE OF BREAST LIFT WITHOUT IMPLANTS: Unfortunately there are no reliable techniques to achieve long term maintenance of upper breast fullness without an implant. Some surgeons prefer a two stage approach as yours and strongly disagree with a single stage procedure due to risk of complications. Many paitents are very happy with the lift alone. In your case the size of your breasts makes you paritcularly prone to recurrent ptosis. This means that should you decide to get... more

Otto Joseph Placik, MD

32 reviews

Chicago Plastic Surgeon

"High & Tight" Breast in perpetuity

Most of us have distinct opinions on how a breast should look. My generation has been thoroughly brainwashed by the media but, Gravity and Age conspire to thwart the best made plans. The augmentation-lift is probably one of the most difficult procedures in cosmetic breast surgery because there are so many expectations, which need to be met: a) size, shape, and position of the breast; b) length and quality of the scar; c) mobility and feel of the breast; d) longevity of the result. ... more

Lavinia Chong, MD

22 reviews

Orange County Plastic Surgeon

www.chongmd.com

Two stages may give you a better result.

You may come out ahead in terms of best breast shape. By having a breast lift first and healing completely you achieve the best tightness. If your surgeon had added an implant at the first operation, he or she would have had to leave some slack to allow space for the implant. You probably have a tighter lift since you didn't have implants. If you go back for a second stage now you can achieve more fullness and tightness than if you had both done at the same time. I often suggest a two... more

Lack of upper pole fullness following a breast lift is not totally uncommon

The key to a successful breast lift is the quality of the skin. The final result will only be as good as the remaining elasticity of your existing skin. The plastic surgeon cannot alter the quality of the material that you bring to the operating room table. That being said, it is important to have a thorough examination and discussion of the operation and expected results prior to surgery. If your breasts were as large as a DD and you were happy with the size of your breast in a bra or... more

Discuss with your doctor

Doctors do not want unhappy patients. If there was a communication problem, than this has to be addressed. Speak to the doctor so you can be reassured about the next step.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Need Better Communication

I'm really sorry you're not happy- unhappy patients reflect poorly on our entire profession... It sounds like communication before your surgery wasn't as good as it might have been- It has been my experience that no matter how large a breast a patient has, in order to achieve a full, round appearance at the top of the breast, you need an implant. Having said that, if placing an implant will make the breasts larger than the patient would be comfortable with, the advantages and disadvantages... more

Your doctor wants a happy patient. Talk to him or her.

To jbunny, What I would do in this situation is charge you for the expenses (operating room, implants, anesthesia) but not charge you a surgical fee.

Yes you do need an implant but don't be angry at your doctor

When a patient has "DD" volume preop and needs a lift, they can often be happy with the result without an implant. On some occasions, the upper pole needs more volume and this comes from an implant. Sometimes you know this preop and sometimes you can't tell. The second operation is just a straightforward augmentation because the lift improved your shape to where now all it needs is some more volume. Ideally if one knows more volume will be needed preop, the 2 procedures are done... more