Should I Have Mini Breast Lift Along with Implants for Droopy Breasts?

After two completely different consultations, I am unsure about what to do. My breasts (B cup) are small and drooping. The nipples are not pointing south, but are more towards the bottom. Doctor A suggests mini breast lift with breast implants under the muscle, both done at the same time. Doctor B says mini breast lift with implants over the muscle, will NOT do both at same time, due to risks of infection and healing.

Both said this could be done without a lift, and I could choose to do the lift later. I really prefer not to have the lift. Also, should I go over the muscle or under? I would be willing to send photos if necessary.

Doctor Answers 10

Photos would be helpful

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You are in the same situation as many women who present for this surgery - the imporatnt distinction is how much upper pole fullness you desire. If you want upper pole fullness, you may need submuscular implants and a lift. However, is you want a natural looking breast, you may well be happy with implants alone, whether you decide to go above or below the muscle.

Breast Lifts for Sagging Breasts

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Breast lifts will correct the saggy shape. Implants replace volume, but do not do a great job of lifting a breast or making it look pretty. In an effort to create some lift, some doctors put the implants above the muscle, but in the end, the entire breasts sags even more.

As for two surgeries, your risks are higher for anesthesia as welll as infection.
My suggestion is to have a lift and add an implant if you want more volume -- and do it at the same time!

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 34 reviews

Breast lift and breast augmentation

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There is no question that you might need a breast lift and a breast augmentation.  Your breasts appear to be empty sacks of skin.  A lift is needed to reposition the nipple to the proper height and an augmentation is needed to restore your breast volume.  As far as size this is a conversation that you will need to have with your plastic surgeon. 

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

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Drooping, small breasts

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I think you have answered your own question. You describe your breasts as small and drooping. It sounds like you need a breast lift and an augmentation. As far as placement I prefer under the muscle but I really think this becomes more of an issue of surgeon preference and what they are used to. I was trained to do under the muscle as less breast tissue is blocked when having a mammogram. I prefer to do both together in one stage.

Sharon Theresa McLaughlin MD
Long Island City Plastic Surgeon

Breast implants with breast lift.

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I am afraid I disagree with both of your doctors, on different points.

1) It sounds like you really need a breast lift with a circular scar around your nipples. The scars fade, you will have much better shape, and you will ultimately be happier. The lift should be done AT THE SAME TIME as the breast augmentation. With experience, the risk of complications is very, very low.

2) I recommend round, smooth walled, moderate plus profile, cohesive silicone gel breast implants, placed OVER the muscle. This allows the implant to fill the loose skin envelope.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Mini Breast Lift and / or Breast Augmentation

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The question of whether to perform a breast lift is a common. Without pictures, it is impossible to give you specific advice. However, in most cases, if you have any ptosis (drooping of the breasts) you will need a breast lift in addition to your breast augmentation. Otherwise, if you just have the implants, you have still have drooping breasts on top of the implants. Some surgeons choose to do the procedure in two separate surgeries. However, I find that I get the best results by doing it all at the same time. I hope this is helpful.

Is it best to have a Breast Lift and Breast Implants together in one procedure?

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Some patients who experience #sagging breast, achieve a better breast shape if an implant is used at the time of #mastopexy. The shape and position of the breast are improved as well as restoring #volume lost in the breast.
The procedure can also be combined with a minor breast reduction to reduce the breast width if desired. The surgery will create an elevated, more youthful breast contour. Also, the procedure will create nipple and areolae of the desired size and at the correct height; if desired.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Should I have mini breast lift along with implants for droopy breasts?

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Hello! Thank you for your question! These two procedures can safely and effectively be performed in one setting, given you are healthy and without medical comorbidities to prevent such. Staging the procedures to have them done at various times will likely not have any cost benefit for you. When you combine procedures, there is often a discount that is provided by the surgeon for multiple procedures. Also, when having multiple procedures performed at the same time, you save on anesthesia and facility fees, which otherwise are paid for with each individual procedure. In addition, you may benefit by the single recovery time. Cost of these procedures will vary amongst plastic surgeons in addition to geographic location.

However, more important than the financial aspect, your plastic surgeon will have to determine for you if the viability of the breast as well as nipple-areolar complex may be placed at jeopardy if done at the same time. If for this reason, it would be wise to stage these procedures. Without an examination, it is difficult to tell you what to recommend.

Certainly it is you decision as to whether you have your procedures performed in one or multiple stages, but your surgeon will give his/her recommendations.  You definitely can do the augmentation, and have a lift performed at a later date, if unhappy with the results.  However, given the fat that both consultations suggested a lift, you should consider that along with the above, to optimize your results.  Consult with a plastic surgeon well-versed in breast surgery who will discuss and examine you, while assisting you to decide which procedure will be the best option for you. I would discuss your concerns with your surgeon and see what your options are - sometimes multiple consultations with board-certified plastic surgeons is helpful for you to decide. Hope that this helps! Best wishes for a wonderful result!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

Breast lifting and augmentation simultaneously?

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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 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 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.


Drooping breasts and implants

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If your breasts are drooping, then you need a lift. I often combine a lift and implant during the same procedure.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 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.