Will I Be Able to Do a Breast Lift and Augmentation at the Same Time? (photo)

I had my breast augmentation done back in Feb 2011 and at first was very satisfied with the results, but now they are starting to sag and I need a breast lift. Will I have to have the implants removed, have a breast lift performed, and come back at a later date for implants? Or will someone be able to do it all at once? I posted some pictures from right after surgery and then from today.

Doctor Answers 17

Can a breast lift and augmentation be performed at the same time?

It appears from your early post-operative photos that you had a sub-glandular augmentation with relatively large prosthesis.  As you have experienced, these tend to descend and settle inferiorly because the only support that you have is essentially the skin envelop of the lower pole of the breast. You may initially have had a small amount of ptosis (drooping) that your surgeon was trying to correct with a sub-glandular augmentation. But this tends to eventually lead to a larger - but still drooping - breast. 

If the augmentation had been performed sub-pectorally, then after the settling period, you would still have superior fullness (which is not present in your post operative photos). 

The way I approach situations such as yours is relatively straight-forward: in a single procedure, I switch to a sub-pectoral pocket and perform a vertical mastopexy.

The sub-pectoral placement produces a nice breast mound with superior fullness while the mastopexy repositions the breast tissue over the mound.  In experienced hands, situations like yours can be corrected in a single procedure with a relatively low re-operation rate. 

When you stage the procedure, you commit the patient to two operations when in the majority of cases, excellent results can be achieved in one surgery.  I hope that this helps and good luck. 

Albany Plastic Surgeon
4.9 out of 5 stars 181 reviews

Can a breast lift and breast augmenation be done at the same time?

If you are happy with the size of your breasts, there is no need to replace them and only a breast lift can be performed.  If you are not happy with the size of your breasts, it is better to remove the implants and wait at least 3 months for the swelling to resolve. You can then be re sized with different breast implants thus allowing you to find the best size for you.  During the second surgery, both augmentation and breast lift can be performed at the same time. I recommend this two stage approach as it will give you the best, most accurate means of finding the right breast implant size.

Michael A. Jazayeri, MD
Santa Ana Plastic Surgeon
4.7 out of 5 stars 13 reviews

Breast implant dropped without breast lift

Thank you for your question and your photos. I agree in general with the other comments.  Breast lift and implants can be successfully done together, and some surgeons prefer to do it separately.

You have already had the augmentation portion. The implants have dropped into the skin envelop.  Now, you need a lift.  

It is possible to have a breast lift now and keep the implants you have.  If you do not like the size of the implants, the implants can be changed at the time of the breast lift.

I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 182 reviews

Combining breast lift and breast augmentation surgery in Los Angeles

In Los Angeles most board certified plastic surgeons favor performing breast augmentation and breast lift at the same time. In my personal experience women do well with this procedure since I can adjust the breast implant and breast size along with the shape of the breasts at the same time.

Sean Younai, MD, FACS
Beverly Hills Plastic Surgeon
4.4 out of 5 stars 49 reviews

You may need separate surgeries

Your breast tissue appears dense and if you elect an average or large implant you may run into post-operative complications if the lift and augmentation are done at the same time.  You run the risk of blood supply shortage to your nipple as well as opening of the incisions due to too much tension.  I would probably advise two separate surgeries although I do over 90% at the same time.  Experience has alerted me to your situation.  Obviously, a final decision would have to made after proper consultation.

Lawrence W. Shaw, MD
Arizona Plastic Surgeon
4.9 out of 5 stars 73 reviews

Breast Augmentation and Lift at the Same Time

There is no correct answer for this question.  However, the options are do both the augmentation and lift in one procedure or separate it into two procedures - lift then implants or implants then lift.  However, with the second options you are guarenteed the need for two procedures.  So, why not do both procedures at the same time, with the understanding that you may need a touchup.  In the vast majority of these patients, a second surgery / touchup is not required and you saved yourself a second surgery... 


Good Luck

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 75 reviews

Mastopexies and BA-together or separately

This is an often debated question among plastic surgeons.  There are many articles in our journals outlining the increased risks of doing the procedures together in addition to the higher rate of revisions, but most patients want it all done at once.  The two procedures work in opposite directions; the aug filling outward and the mastopexy tightening things inward.  When the lift and the implant are small I am comfortable doing them together.  When they are big I prefer doing them separately.  If your implants are over the muscle you would be wiser to have the procedures separately, but this would entail not only two more procedures, but another set of implants  All mastopexies are not the same.  I would favor a superior or medially based pedicle often referred to as a vertical mastopexy over the older Wise pattern inferior pedicle.  This is technical stuff for you, but an important distinction that you should ask your surgeon about.  Get several opinions from board certified surgeons who will have the advantage of examining you and getting a more detailed history.  Good Luck

Lori H. Saltz, MD
San Diego Plastic Surgeon
4.3 out of 5 stars 28 reviews

Breast lift and augmentation at the same time

Yes, you could do both at the same time. The implants that you have now, will probably have to be traded to a smaller size in order to have a successful lift. However, if you wish to have the same size cup you have now, then a second operation with implant exchange will do the trick. Remember, the larger the implant the sooner you will need another lift. I hope this helps, Dr. H

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 223 reviews

Breast lift and breast augmentation

Certainly a breast lift can be performed with implants intact or with replacment of implants. I do this all the time.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Breast lift with breast implants

As your breast augmentation is already complete the lift you would like to consider is not really at the same time as breast implants. Some surgeons are concerned with breast augmentation with a lift especially if the implant is quite large. Most however will combine a lift with implants if possible.

Best of luck, peterejohnsonmd.com

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 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.