If you have seen an ABPS-certified plastic surgeon who is also a member of ASAPS and experienced in breast surgery, it seems foolish to think your training and experience in plastic surgery of the breast is somehow better than any plastic surgeon you may consult with. (I know, it's your body and your money. But that doesn't mean you should decide what is best procedure-wise.) An informed patient who has done her research is great, but not if she thinks she knows better than 4 years of medical school, 6-8 or more years of post-MD surgical training and plastic surgical training, and whatever years of surgical practice and hundreds or thousands of patients have taught the surgeon. So asking questions is great, and I applaud you for doing that here. But not if you're simply seeking validation of your own ideas. You gotta listen to the answers!A lift cannot be done with implants above the muscle (since that is the tissue layer where the lift is performed), so your surgeon is suggesting that above the muscle implants might be preferable to a lift, not in addition to a lift. But without photos or physical examination and careful measurements, it is impossible for any online consultant to give meaningful advice.To really figure out what might be best for your goals and anatomy, I'd suggest one or two more in-person consultations with ABPS-certified plastic surgeons (ASAPS members) with lots of breast surgery experience. State your goals, not your proposed solution, and listen to the suggested ways to best achieve your goals. If your goals are unreasonable, your consultants should tell you what part is unreasonable, and what parts are not. Now you can make an informed decision about whom to trust with your body and $$$.BTW, "fake" is a look that a few women really prefer (nothing wrong with that), BUT, what they don't understand is that the high, tight, "Baywatch coconut" look they find so attractive is also accompanied by feeling like a couple of croquet balls in your vest pockets! Capsular contracture is what causes this look in many women with poorly-performed breast implants, and above the muscle has a higher risk of this occurring. Below the muscle is not only required for a lift plus implants, but submuscular implants have a much lower risk of developing capsular contracture. Rarely do I recommend above the muscle these days. Just saying.Best wishes! Dr. Tholen