I consulted w/ 2 doctors in my area,both of which I liked.However,they gave me conflicting advice on surgery.They both agree I need a breast lift & I'm opting for implants.The 1st dr is Board Cert in CS & told me he could do the lift & implants at same time.2nd dr is Board Cert in PS told me def not & that he would have to perform 2 surgerys,lift then the implants because my breasts are small & doing it at once could result in me losing my nipple.Thus, there is a $4000 difference, who is right?
Breast Lift W/ Implants in 1 or 2 Surgeries?
Doctor Answers (11)
Simultaneous or staged breast lift and augmentations
This is too complicated to cover in detail here but:
1. Only go to a Board Certified PLASTIC Surgeon, not a Cosmetic surgeon. There is zero comparison between the training to do what you need.
2. Lifts and implants can often be done together as long as you are healthy, don't smoke and are going with a conservative implant that will not overstretch the lift which is a tightening operation. Your surgeon has the final call on this.
3. If you need a full lift and want lots of fullness, you need to stage this and either do the implants first and then the lift or do the lift first and then the implants. 4-6 months between surgeries is usually needed.
4. Don't base your decision on cost as the price to fix bad work is much more than the first operation would ever cost in the hands of a top plastic surgeon.
Breast Lift with Implants in 1 or 2 Stages?
Thank you for the question.
I would strongly suggest that you consult with board-certified plastic surgeons only. I would not suggest that you consider having your breast surgery performed by a “board certified cosmetic surgeon”.
In regards to your question regarding breast surgery,this is not a question agreed-upon by all plastic surgeons. There are good plastic surgeons who will insist on doing the procedures separately and there are good plastic surgeons who can produce excellent outcomes wth a single stage operation.
The combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately. Furthermore, the potential need for revisionary surgery is increase with breast augmentation / mastopexy surgery done at the same time.
In my opinion, the decision to do the operation in a single or two staged fashion becomes a judgment call made by a surgeon after direct examination of the patient. For me, if I see a patient who needs a great degree of lifting, who has lost a lot of skin elasticity, or whose goal is a very large augmentation then I think it is best to do the procedures in 2 stages (in order to avoid serious complications). However, doing the procedure one stage does increase the risks of complications in general and the potential need for further surgery. This increased risk must be weighed against the practical benefits of a single stage procedure (which most patients would prefer).
Conversely, if I see a patient who requires minimal to moderate lifting along with a small to moderate size augmentation (and has good skin quality), then doing the procedure one stage is much safer. Nevertheless, the potential risks are greater with a 1 stage procedure and the patient does have a higher likelihood of needing revisionary surgery.
I hope this helps.
Breast Lift W/ Implants in 1 or 2 Surgeries?
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Breast lift with implants
As a board certified plastic surgeon I always give patients options and I will discuss a lift with implants as a one stage operation or as a two stage procedure. Depending on the patient's anatomy, medical history and their input we come to a decision; which 90% of the time is a one stage operation. I always tell patients that a touch up procedure may be needed when doing multiple procedures in one stage. It can be a safe and effective procedure and save money when all done at once. Please seek a board certified plastic surgeon for consultation and review his or her before and after photos to see if you like the results. Good luck.
Staging Breast Lift and Augmentation Procedures
I think you can tell the consensus is that you should choose to work with a Board Certified PLASTIC SURGEON. Staging procedures is a way to reduce complications. Being cautious is always a good thing. However, augmentation and lifts can be performed together very safely as long as you're healthy, non-smoker and select an implant that is fairly conservative. I absolutely will not operate on a smoker and even make all my lift patients take a nicotine test right before surgery.
If a patient wants a 325cc or smaller implant, I'll use a silicone gel implant. If a patient selects 350cc and larger, I use a Spectrum saline adjustable implant. I do not like a lot of tension on the nipple and incisions. The larger the implant the more tension created. I've been doing it this way for about 12 years and haven't had any complications with loss of nipple skin etc...since I switching to adjustable implants.
Breast augmentation and breast lift in one stage or two
To reiterate what others have said:
1. I would only chose a surgeon who is Board Certified by the American Board of Plastic Surgeons. There is really no such thing as "Board Certified in Cosmetic Surgery."
2. The only way to determine if you are a candidate for simultaneous breast augmentation and breast lift is through a consultation with a reputable plastic surgeon. I often combine the two procedures and have a very low complication rate. Some surgeons, however, prefer to do the two procedures at different times (staged procedures). As others have stated, there are times when it is prudent to do these procedures separately. For example, in a woman who needs a lot of lifting or in someone with risk factors such as diabetes.
Breast Lift with implants in one or two stages
In my practice I perform most breast lifts and augmentations in one stage. We published our series of 321 one-stage procedures that demonstrated safety and success. Two stages is also reasonable if the patient prefers it.
Augmentation and Mastopexy Decision
Breast augmentation and mastopexy can be done safely in some situations (See Dr. Rand's post) but should be a careful decision between you and a board-certified plastic surgeon (American Board of Plastic Surgery) that has examined you. You can always seek another opinion among ABPS-certified plastic surgeons. Of note, board certification in "cosmetic surgery" is not a recognized ABMS board and is quite easy to obtain.
Augmentation and lift at same time
I agree with the other respondents: This is a complicated operation, and one that you should see a board certified plastic surgeon for. I don't even really know what a "board certified cosmetic surgeon" is. Having said that, the decision to do this in one or two steps has many variables, including the degree of lift required, your tissues, the size of implants, and your surgeon's experience. I would encourage you to get another plastic surgical opinion if you are unsure how to proceed.
Staged vs Simultaneous augmentation/mastopexy
I agree with the other responders that you should only consult with a board certified plastic surgeon and that is especially true for this particular operation. By board certified we mean certified by The American Board of Plastic Surgery. There is a tremendous amount of marketing out there to convince prospective patients that one specialty is superior to another with regard to cosmetic surgical procedures. This can make the decision difficult for patients and may account for some of the differences in opinion.
With this operation the size and shape of the breast is going to change along with the size and position of the nipple and areolar. I believe this is one of the most challenging operations in plastic surgery because of these issues and because it has to be done twice.
There are personal preferences with regard to staged vs simultaneous. I tend to perform this operation simultaneously in almost all cases. The two operations do work against one another. The lift involves tightening the skin and breast tissue and the augmentation involves stretching the skin and breast tissue. I usually use a somewhat smaller implant when doing this combined approach because an implant that is too large will compromise the lift. That is a situation where the two stage approach may be better.
Cost alone should not be the final determinant. You do get what you pay for. The cost associated with re-operative plastic surgery to correct a problem will far outpace the difference in fees for the initial procedure.
Thank you for your question and best of luck.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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