Is a breast reduction combined with a lift and implants a known procedure?

Question

I was going to make an appointment for a consult with the doctor for a breast lift and augmentation. They asked me what size I currently was. I am at 34D in Victoria’s Secret bras. I look smaller. They told me I might need a breast reduction as well which would be another thousand dollars. I’ve never heard of needing a breast reduction when getting a breast lift and implants. I have tried to do some research but cannot find anything. Is this a thing or are they just trying to get more money?

Kristopher Day, MD, FACS · Answer

You ask a good question and one that I hear frequently from a different perceptive. While I can't speak to the intentions of those you received a consultation from, what each procedure means is a common question that can be clarified like this: 
Reduction smallerAugmentation biggerLift elevated
You can lift and reduce size: that's a breast reduction, which virtually always includes a lift. You can lift and increase the size: that's an augmentation-mastopexy. You cannot, however, reduce the size and increase the size. That's like saying up is down and right is left. They're mutually exclusive. Where we most often encounter this question is patients sometimes ask if they can have a breast reduction covered by their insurance and then put in implants. That answer is always "no." You can get an augmentation-mastopexy, or "enlargement and lift," but this is not a reduction. A reduction removes tissue, lifts the nipple and areola, and leaves the breast smaller without the replacement of it with an implant.

Alan Gonzalez, MD, FACS · Answer

Hello @Fearless507109, thank you for your question. Every doctor has a different way of performing surgery and a surgical technique. To get the best possible results for each particular case, it's critical that you consult with several board certified specialists. This will enable you to understand various medical criteria of how to obtain the results you want. Best wishes! Alan Gonzalez MD, FACS.

Daniel Barrett, MD · Answer

Dear Fearless507109,
I understand your concern. It is best however that you consult with a board certified plastic surgeon to determine whether you can have several aesthetic surgeries in one session, as this would depend on various factors including but not limited to your general health condition, the type of anesthesia that will be used, and the type of surgeries that will be performed among others.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Tommaso Addona, MD · Answer

Thank you for your question.
This procedure is well known; however, without proper photos and evaluation it is difficult to say if this is the correct procedure for you. Oftentimes an augmentation in combination with these two procedures are to move the nipple into a more favorable position and to remove any excess skin. I recommend speaking with a board certified plastic surgeon to discuss your options.

Carmina Cardenas, MD · Answer

The combination of Breast reduction (which will have implicit the lift) with implants is kind of common in cases where patients want a perky and full upper pole of the breast, otherwise the breast lift will never achieve that fullness and roundness. 
Implants in this case will be used only with the purpose of Roundness and and not augmentation. 
Be encouraged. 
Dr. Cárdenas

Gary M. Horndeski, MD · Answer

The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scar are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Scott W. Vann, MD, FACS · Answer

If you a Victoria's secret D then you are probably a large B to small C in normal bras. You should be able to have a breast augmentation and lift without "extra cost" of a reduction. Hard to be sure without examining you or at least a photo. I recommend you seek more in person opinions. Good luck.

Ronald J. Edelson, MD · Answer

There are cases where the surgeon will reduce the breast but add implants.,although I don’t care for this approach there is a reason to do it. Breast lifts and reductions do not give upper pole fullness which the implant will provide. However it is a riskier procedure. I suggest the lift first then decide later if you need implants.

James Knoetgen, III, MD · Answer

Yes, a breast reduction combined with a lift and implants is a real and valid surgical approach — though it's relatively uncommon, it is medically sound and not a money grab when properly indicated. Here's how and why that might be recommended:
Why All Three Procedures Might Be Combined:
1.	Breast Lift (Mastopexy): Lifts sagging breasts and repositions the nipple.
2.	Implants (Augmentation): Adds volume, especially in the upper pole (top half) of the breast.
3.	Reduction: Removes excess breast tissue/skin to reshape and reduce size or weight.
Why You Might Need a Reduction with Implants:
•	If your natural breast tissue is heavy, saggy, or wide, simply adding implants and doing a lift might not give a balanced or long-lasting result.
•	The goal is often to reduce natural tissue while adding a lighter, more shapely implant, giving a perkier, rounder, longer-lasting outcome — especially helpful if your tissue is very soft or droopy.
•	Surgeons sometimes call this a "reduction with augmentation" or "implant exchange with mastopexy and tissue reduction."
The recommendation may be completely legitimate, but you should absolutely get a second opinion from a board-certified plastic surgeon who specializes in breast procedures. A skilled surgeon will explain your anatomy, goals, and the reasoning behind the proposed plan — not just quote a price.

Shana Kalaria, MD · Answer

In my opinion, I would not recommend to remove your native breast tissue in a breast reduction and replace the tissue with an implant. If you need a reduction, you will get a breast lift included in the procedure. I do a special technique for breast reductions which gives good upper pole volume and even looks like an implant. Please visit with a board-certified plastic surgeon. Good luck.

Is a breast reduction combined with a lift and implants a known procedure?

Answers (13)

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