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What Are the Risks of Getting Implants at the Same Time As the Lift?

I am planning a lift and tummy tuck on the same date and want to have implants done at the same time. My surgeon advised me that he would not be able to put the implants in until after the lift has healed. What are the risks if I change surgeons and get the implants done during the lift?

Doctor Answers (18)

Lift plus implants--is this really a higher risk as combined operation?

+2

As you can see from the other answers here, some surgeons prefer to do the lift first and then do a separate operation later for augmentation. This approach has the best likelihood of a good overall result, since any "adjustments" or surgical touch-ups can be done as part of the second operation. Since risks and complications exist with every operation (though truthfully, they are quite low overall), whatever that risk is (let's say 1 in 1000) is DOUBLED with 2 operations (now 2 in 1000). Sure, that's still an overall low risk, but if  doing the lift plus implants results in, say, 30% chance of requiring re-operation to correct a problem or perform a revision, you still have a 70% overall lowering of your total risk. This, of course assumes that your chosen surgeon is EQUALLY capable of obtaining the same quality result with either a 1-stage or a 2-stage procedure.

And that, dear lady, is the rub!

Some surgeons, by training or experience, really need to do things in two stages to feel safe and to obtain their best results for their patients. Others (and I am in this group) feel that a single-stage lift plus augmentation, if skillfully performed (and with years of experience doing things this way), yields great results with a low re-do rate. If I performed single-stage lifts plus implants and had a 40-70% re-do rate, then I too would recommend two procedures.

I must add that the WAY a lift plus implants is traditionally taught is to do the lift incisions, raise skin flaps, and then (while the breast is "open") create the submuscular pocket, put in the implants, after which the lift flaps are stitched closed. This can cause unanticipated "tightness" and circulation problems with  the flaps (too tight, perhaps because too-large implants were chosen for the remaining skin brassiere), and position of the implant pocket and final implant position is more difficult to assess with the breast "open." This approach can obviously lead to suboptimal results, healing problems, malposition, and the thought that "I'm not doing things this way again! I will start recommending two stages."

Two stages avoids the circulation concerns (since the lift flaps have previously healed) and the too-large concerns (since the situation is now like a primary breast augmentation patient--you only use what "fits"). Positioning the implant pocket is again like a primary breast augmentation--not always perfect, but usually quite predictable and mostly right-on.

The way I personally perform my single-stage lift plus augmentation is to essentially perform it as two stages done at the same time: I first do the complete lift on each breast, and suture closed the incisions (except for the 4cm in the crease where I would normally make my breast augmentation incision). This essentially gives me the "lifted" non-droopy breast for which augmentation alone is appropriate. This also ensures the circulation is good prior to my proceeding with the implants, since I can always defer this to a second stage if it truly is best for my patient, and prevents me from choosing implants that are too large for the lifted breast flaps.

With the "standard" approach to a single stage lift plus implants, you are already committed to the implant pocket creation and implant placement prior to closing the lift incisions, which makes it a difficult choice to "go back" even if the thought crosses the surgeon's mind. Again, this is why many of my colleagues like the two stage approach, which is certainly not "wrong," but IMHO (and with the technique I use) unnecessary.

For examples of my patients with lift plus implants (all one-stage), except for case 3, which was a patient who had implants plus lift (3 operations by 2 surgeons elsewhere prior to coming for corrective surgery by me), click on the link below. Best wishes!

Web reference: http://mpsmn.einsteinapps.com/photogallery/breast-lift-plus-augmentation-5861

Minneapolis Plastic Surgeon
5.0 out of 5 stars 90 reviews

What Are the Risks of Getting Implants at the Same Time As the Lift?

+2

It is obvious you want a large implant. So it is very hard to do a full lift and have a large implant placed. Discuss in detail with your surgeon to fully understand the effect of healing on the breast scar. 

Miami Plastic Surgeon
4.5 out of 5 stars 55 reviews

Breast Lift with Implants

+2

Plastic Surgeons arel clearly divided on whether doing breast lift and augmentation in one or two stages. All would agree that the risks are somewhat higher with a single stage procedure, but disagree as to how much higher. If executed properly, the risk profile of combining the two is, in my opinion, acceptable. There is also the issue of having two "moving parts" (implant and breast tissue) and getting everything to end up exactly where you want it because both the breast and the breast implant will settle after surgery. In some patients, a second stage will be required to adjust the position of the implant, but if this is a small percentage, many of us would argue that it is preferable to having every patient undergo two procedures. Listen to opinions on both sides of this discussion and choose what makes the most sense to you.

Web reference: http://www.breastsurgeryindianapolis.com/breast-lift-augmentation-implants.html

Indianapolis Plastic Surgeon
5.0 out of 5 stars 49 reviews

Risk Of Combining Augmentation & Breast Lift

+2

There is always some increase in risk simply by the additional time required in performing multiple simultaneous surgeries.  Some plastic surgeons feel that there are added risks in performing a breast lift at the time of an augmentation and insist of staging these two procedures.  Other plastic surgeons are willing to perform the procedures at the same setting.  If you feel strongly about having everything done at the same time, obtain a second opinion, but remember that there is a slight increase in having complications (assuming that you are in good general health).

Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Breast implants combine well with breast lift

+2

For some surgeons the idea of combining breast implants with a breast lift can be unsettling, however we find that few enjoy the lift as well without the fill in the upper breast that the implant will provide. We have little difficulty in adding a breast implant at the time of breast  lift, and have not suffered any complications from doing so. You may need another opinion if your surgeon is unwilling and you wish to avoid an additional procedure.

Best of luck,

peterejohnsonmd

Web reference: http://www.peterejohnsonmd.com/breast-lift

Chicago Plastic Surgeon
4.0 out of 5 stars 25 reviews

breat augmentation and lift at the same time

+2

The moment I saw this question I knew there would be a lot of answers and they would be 50-50. If you get several opinions in your neighborhood I'm sure it will be the same thing. As you can see, the more conservative approach is to do the operations separately. I  see a significant number of patients who are marginal for augmentation alone and have been told by several people they need a lift at the same time. Most patients of course would like to avoid the extra scars and expense. I will  explain the alternatives and often suggest  we do the augmentation alone and there is a good likelihood that they will not ask for the lift. The great majority of these patients are happy with the single procedure. If they do need a lift at a second operation is usually a minimal procedure with less expense and less scarring

Paramus Plastic Surgeon
4.0 out of 5 stars 11 reviews

Your surgeon is correct

+2
The combination of the lift and implant is a high risk procedure. The revision rate for the breast augmentation with implant is more than 40%. The complications include nipple loss, nipple asymmetry, implant bottoming out, breast sagging off implant, breast asymmetry and infection. I would recommend staged procedure and you should not change your surgeon.
New Orleans Plastic Surgeon
5.0 out of 5 stars 46 reviews

Breast lift is best done together with implants.

+2

Hi.

I think it is safe to say that the vast majority of plastic surgeons who do a lot of cosmetic surgery of the breast do breast lifts and breast implants at the same time.  This saves you an additional operation and in fact produces better results than doing it in two stages.  There are only a very few exceptions to this rule.

It is true that combing breast lift and breast augmentation can increase the risk, but this is just a matter of experience and good technique and good judgment.

Hope this is helpful.

Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

Breast Augmentation with a Lift in one Procedure

+2

There are pros and cons involved in performing a breast augmentation with a lift as one or two procedures, and plastic surgeons are in general divided on this.  I think the bottom line is that certain patients can do fine with both the augmentation and the lift performed as one procedure, while others really need two procedures to get the best result.  Similarly, some surgeons have better results with two procedures versus one, and there is no one absolutely right way to perform the procedure.  So ultimately it comes down to finding a surgeon that you feel comfortable with and can get you the results you want with the least risk possible, even if it may mean more than one procedure.

Web reference: http://www.drsalemy.com

Seattle Plastic Surgeon
5.0 out of 5 stars 85 reviews

Doing breast implants and a breast lift at separate times

+2

The main reason to perform a breast augmentation and a breast lift separately is that the complication rate is much lower if both procedures are done separately. The blood supply to the skin and nipple is much more robust if done separately. The shape and contour is typically better if you can stage the procedures (do separately). The surgeries should be spaced out by about 4-6 months. Although almost all patients want to have the procedures done simultaneously, this is not always the best approach. The safest way is to stage the procedures. This is a general guideline, not an absolute rule.

Each person has their own unique anatomy, so a consultation with a board certified plastic surgeon is the best way to find out what's best for you.

Best wishes,

Dr.Bruno

Web reference: http://www.williambrunomd.com

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 122 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.

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