Does Breast Lift Require Augmentation Afterwards?

I want to get a breast lift. In my first consultation with a cosmetic surgeon he said my breast may lose 15% of volume because of skin removed. Does this mean most women get breast implants at the same time as a lift, or is this a path to greater complications?

Doctor Answers 35

If you like your breast size- don't get implants

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If you like your breast size then don't change it. There are many different types of breast lifts today;

1-skin only circumareolar breast lifts - a bad technique that flattens out the breast. The scars are not acceptable and the position of the nipples is rarely symmetrical. Most importantly, the durability is about 1 year,if you are lucky!

2-An anchor scar skin only lift - not much better than the above. The breasts have a nice shape, but the scars are awful and the sag returns within a year. The better newer techniques change the shape of the breast tissue under the skin and as the tissues moves to it's new position, the skin reshapes around the tissue without much effort - even if you think you have lots of extra skin.

3- The Vertical scar mastopexy (lollipop scar) this comes in many flavors - the two most common are the Hall-findlay and the Lejour. The Lejour is harder to learn and perform by the physician but gives a more natural, perky shape (look at the photos on my website). The Hall-findlay is more common today because of the ease of use, but the scars do not heal as nicely and the breast is not as perky. These techniques require a small a mount of volume reduction, so if you decide to have this type of lift, you must accept the slight loss in volume or get an implant as well.

4- the Goes Circumareolar breast lift is a great technique with a minimal scar around the areola for patients who have less that 5 cm of sag. That is the amount of movement of the nipple from its old position to the desired new position. This technique moves and shapes the breast tissue under the skin. It is a great technique, although not as perky as the Lejour technique. This technique does not have to remove any tissue at all if desired.

5- My Tear Drop Augmentation Mastopexy technque is a fabulous way to lift and augment a breast that is sagging and needs a small to large amount of volume improvement. I have been performing this technique for 11 years with almost no complications and it is designed to eliminate the hollow appearance along the top of the chest wall that so many of the other techniques have. The key is to only use the implant that gives you the size that you need. If you hear a doctor telling you that you need to go bigger than you want to fill out a sagging breast - then run.

6- My newest lift The IBM technique (inframammary breast medialization) is designed for patients wanting to move there nipples, areal and breast tissue toward the center of their chest. This is especially designed for those with a wide space between their breasts. Fron a 3 cm incision under the breasts, I can place the implants under the muscle and move the breasts toward the middle. The procedure is new, so durability is to be determined, but the patients that have had it are ecstatic. Good Luck.

New York Plastic Surgeon
4.8 out of 5 stars 34 reviews

Everything depends on you as an individual

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This is a great question that gets to the point- there are no sweeping answers that apply to every patient. What you have been told is likely true, in that during a lift, some tissue (mostly skin) is taken away in order to re-suspend your breast in the new, improved position. That being said, some women with larger breasts and more drooping (called "ptosis" and pronounced without the "p") may need more involved lifting procedures that actually involve removing even more tissue, such as in the vertical mastopexy.

Other women have only had "deflation" of their breast tissue may have the skin envelope remain in the correct position. These women benefit from a small implant that serves to "re-inflate" the breast in the proper position, and this does not remove any tissue at all.

A third group of patients have a combination of deflation and ptosis and wish to have larger breasts that are positioned higher, as a more youthful appearance. These women benefit from both a small implant as well as a lift that removes a small amount of skin or breast tissue in order to achieve their specific goals.

Use of an implant does bring some additional issues to the table, with "risks" of implant rupture and contracture of the scar capsule around the implant. But remember that breast implants are used every day, and while these may represent additional things to think about, breast implants are excellent tools when used in the correct patient population to help achieve their breast lifting goals.

Once again, the thing to remember is that the best operation for you may not be the best operation for your friend or neighbor. In fact the most important thing for each individual patient is to find a properly trained plastic surgeon certified by the American Board of Plastic Surgery, who you trust and feel comfortable with. That surgeon should individualize your operation for your breast shape, body shape, and postoperative goals. There are many ways to go about rejuvenating, enlarging, lifting, and enhancing the breast. You want to find someone who has a plan specifically for you.

Augmentation Mastopexy

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The reshaping of the breast with the lift procedure tightens the width of the breast. This often means a bra fits differently, by as much as a half-cup size smaller, even though no significant amount of breast tissue is actually removed.

Implants can help to restore or add volume, as well as contribute to a fuller, rounder shape.

It is common to place breast implants together with a breast lift.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.7 out of 5 stars 45 reviews

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Augmentation with breast lift

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During your consultation your board certified plastic surgeon will discuss your options breast lift alone or breast augmentation with lift. There are alot of things to consider. With a breast lift alone your are raising the nipple/areola into a higher position on the chest, taking out the skin to tighten, and possiblly taking out some breast tissue(you can discuss this with your doctor). However the upper pole of the chest will remain the same. If that area is flat it can be filled up with an implant. O f course there is added cost and potential complications associated with the implant. My recommendation is to discuss this with your doctor to determine what is best for you

Joanne Lopes, MD
Virginia Beach Plastic Surgeon
4.9 out of 5 stars 26 reviews

Breast lift surgery with implants

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A breast lift surgery may be customized to help the patient meet their specific aesthetic goals. If you require to position the breasts hiring your chest or to correct some extra tissue or sagging, a breast lift alone may suffice. However if you prefer additional volume or fullness a breast implant may be in order. A breast implant can fill your tissue envelope and can also help minimize the number of scars that you will ultimately require. Choose your plastic surgeon carefully as this is not a straightforward breast lift and you want to ensure having beautiful long-lasting results.

You don't always need an implant.

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When talking with women about breast lifts and the size of the breasts, the most important question is: are you happy with the size of your breasts now? Sometimes this is a little difficult to figure out if you have a lot of sagging, so the other way to look at this is: are you happy with the size of your breasts when you are in a bra? If this is the case, you do not need breast implants.

When performing the breast lift, very little volume needs to be removed with the skin removal. And the amount removed (probably 5% or less in terms of volume) will not have a big difference in the overall size of your breasts. And, the breast tissue itself can be moved in such way as to consolidate the breast tissue centrally and give better fullness in the upper part of the breast.

So, if you are having a breast lift and you are happy with the size of your breasts, you don't need an implant. If you breasts are smaller than you would like, then an implant at the time of the lift is a good option. If you are not sure, and are generally happy with the size of your breasts, then just have the lift. You can always have an implant placed later if you feel that you need it.

David B. Reath, MD
Knoxville Plastic Surgeon
4.9 out of 5 stars 111 reviews

Breast Lift: Plus or Minus Implants

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In our office we help many patients with that same decision, along with several others. You are right to have questions.

First, I would suggest that you may lose very little of your current volume if you choose breast lift (mastopexy) alone. It should improve breast contour and projection. It may also enhance breast firmness. Patients frequently report they change bra size a little (up or down) because the reshaped breast fits in a bra differently.

Second, I suggest you make the decision about implants based on whether you are happy with your current size or want to be fuller. If you do, and the surgeon thinks it can be done safely, implants can be a good choice.

Patients do generally get a different shape when implants are added during mastopexy. Implants give more fullness to the upper pole of the breast than lift alone. They can also give more projection for some patients. If you want those effects, you may choose to add implants.

Combining mastopexy and implants can increase the chance of complications, depending on the patient and type of mastopexy procedure (there are several, tailored to your needs). For most patients, they can be done together safely.

However, planning a two-step method may be excellent: an initial mastopexy to give you the best lift, followed months later be an implant augmentation to your desired size. This allows you to decide about the size, and get the tightest lift.

Sutton Graham II, MD
Greenville Plastic Surgeon

Depending on your goals a breast lift can be done with or with out an augmentation.

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If you are happy with your breast size but just want a lift after loss of shape following pregnancy or weight loss a breast lift may be just the right decision for you. This can be done with no real size loss but doesn't give quite the projection you could gain with a lift with a breast augmentation. Your decision to have either a lift alone or a lift with a breast implant is an important decision and requires a in depth consultation with your Board Certified Plastic Surgeon. While I perform both of these procedures on a daily basis, they require a great deal of experience. I would encourage you to see several Plastic Surgeons and check them out for your self. See photos of their surgeries including both lift with and with out breast augmentation. See many photos and find out how many they have done and what their results have been. Both are great operations to restore the size and shape of your breasts but must be done by some one with a great deal of experience.

Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 17 reviews

If you like the size of your breasts now, don't get implants.

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A good breast lift moves up your breasts and your nipples INTERNALLY and a little bit of skin is removed. At most, you should lose no more than 5% of your breast size with a lift. And the breasts look bigger anyway because they are higher on your chest. So this is not a good reason to get implants.

If you have "empty" or "deflated" breasts, on the other hand, then a combination lift-augmentation can be a good choice. Many women fall into this category after having children.

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

The procedure is tailored to your goals

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Breast implants certainly can be performed at the time of a lift if you are interested in a larger cup size. However, if your primary goal is to elevate the nipple or reshape the breast, and you're happy with your size, then all you need is a lift.

But your question about an augmentation at the time of a lift increasing the risk of the procedure is a good one. The short answer is that it can increase the risk of complications, the primary one being problems with the incision healing. In most healthy women, the incision heals fine, but I personally will not perform this procedure (called an "Augmentation/mastopexy") in a smoker, as the nicotine will increase the risk of poor wound healing.

Your anatomy and overall health will also play a part in terms of whether or not you have an increase risk of complications. This is why it is really important to trust your procedure to a Board Certified Plastic Surgeon who can review with you in detail your options and the risks and benefits of each option.

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
4.9 out of 5 stars 155 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.