Is It Better to Have a Breast Lift and Augmentation in Two Seperate Operations? (photo)

I'm going to have a breast lift, and an augmentation due to having lost 5 stones. My surgeon said it would be better if I had 2 seperate operations if I could afford it, otherwise I could have both proceedures done in 1 operation. Why is it better to do it in 2 operations? Is there less risk of something going wrong, such as infections etc? Or will the final result look better? If so how will it look better? I don't want big implants as I have heard they will sag again. What do you recommend?

Doctor Answers (11)

Breast lift

+2

It is acceptable to have a lift with implants in either one or two stages, depending on a number of factors.  I prefer  two stages if the breast needs to be lifted a lot.  I feel it is safer as well as easier to obtain a better result.   If your surgeon recommends two stages, then that means he or she is more comfortable doing it that way based on their own experience.  Based on your photos, I would likewise recommend two stages but other surgeons answering this question may recommend doing it in one stage.I would do the lift first  and place the implants about two months later.


San Diego Plastic Surgeon
5.0 out of 5 stars 8 reviews

Breast Augmentation/Lifting in One or Two Stages?

+2

Thank you for the question.
Whether the breast lift and augmentation should be done the same time  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 in a single stage.
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 increased 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 in 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.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 707 reviews

Is It Better 2 Hve Breast Lift & Aug in 2 Seperate Operations?Answr:

+2

Mastopexy-Augmentation is one of the more challenging things we do in Cosmetic Breast surgery....There is a lot going on at the same time and experience from the surgeon is very important...And there is no one way to do this surgery. I prefer to do both at the same time although I understand why some surgeons prefer not to...

John J. Corey, MD
Phoenix Plastic Surgeon
4.5 out of 5 stars 16 reviews

Breast lift and augmentation together is best option

+2

Combining breast lift with implants can be a challenging surgery, but I also prefer to perform these with a one-stage surgery if possible. This decreases cost and recovery time.

Donna Rich, MD
Houston Plastic Surgeon
4.0 out of 5 stars 12 reviews

Augmentation and Mastopexy - one stage vs two stages

+2

One stage vs two stages:  the answer depends on your breast shape, degree of sagging, skin quality and volume goals.  Although I perform one stage augmentation and mastopexies multiple times per week, there are times to perform these procedures in 2 separate stages.  There are some limitations of what can be achieved in one setting, especially if you have severe sagging and very loose/thin skin.   Based on your photos, it appears you do have significant ptosis and I'm guessing you have loose/thin skin.  Although I would need to examine you formally, I would likely also suggest a two-staged approach for you.  If you opt for a one-stage procedure, it is almost certain you will require a secondary procedure to further correct/fine tune your results.

C. Bob Basu, MD, FACS
Houston Plastic Surgeon
4.5 out of 5 stars 115 reviews

Breast lift and augmentation

+2

An augmentation and a lift can certainly be done at the same time, but some surgeons like to stage it because they feel that they have a bit more control.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Augmentation and mastopexy

+2

This is one of the most difficult operations plastic surgeons perform.  some prefer two operations to obtain the best result.  An experienced surgeon would be comfortable with one procedure.

David A. Lickstein, MD
Miami Plastic Surgeon
5.0 out of 5 stars 3 reviews

Lift and implants as one procedure

+2

The combined lift and implants has a high revision rate but my philosophy has always been to do both at the same time. Although many times an additional procedure will need to be done to get the results as good as possible, in the majority of cases the second procedure will not be required or desired. If you do it in two stages you will always have two operations.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 17 reviews

Why a breast lift and implants in two stages

+2

Some do indeed do better with breast implants and a lift later, though all depends on the skin envelope and how it will behave with the pressure of the implant beneath. With breast droop (nipple) and a snug fit for the implant the lift might be better delayed to avoid tension on the repair. With skin as lax as yours, a lift at the same time should work out well to lift and shape the breast over the implant.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 27 reviews

Breast lift with Implants in 2 stages

+2

Great question! It depends on the experience of the surgeon and the quality of your tissues. It is not uncommon to do the procedure in two stages in patients after significant weight lose due to poor elasticity of the skin. It is more difficult to lift and position the nipple areolar complex and place an implant at the same time. I personally do due the procedure in one stage when the skin quality is good and the lift needed is mild to moderate. It takes careful planing since breast lift is making the breast tighter while the augmentation procedure actually expands the breast envelope. I would make sure the surgeon has good experience with these lifts prior to scheduling surgery.

 

Good luck! 

Tal T. Roudner, MD, FACS
Coral Gables Plastic Surgeon
5.0 out of 5 stars 80 reviews

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.