My Doctor Wants To Split My Lift And Implants Into Two Surgeries, Is This Normal?

In general, combining a breast lift with an augmentation is tricky because there's a higher chance of having asymmetry or complications. For patients with severe breast ptosis (meaning "droopiness"), who are smokers, don't have much breast tissue, and want large implants, it is safest to perform 2 surgeries instead of 1. Usually the first is the breast lift. This is followed at least 2 months later with the augmentation. Any slight differences between the breast shape and symmetry after the first surgery can be corrected at the time of the augmentation. Nonetheless, I often perform one-stage augmentation-breast lift operations. In experienced hands augmentation-lifts are safe and effective, and have excellent results in the right patient who has realistic expectations. This means that patients should not be smokers, they should choose modest sized implants (400 cc maximum), need a small-to-moderate lift (i.e. don't have much droopiness of the breasts), and have their implants placed under the chest muscle. Patients should also be aware that there is about a 16% chance of needing a revision. These are important factors to consider. However, consultation with a board certified plastic surgeon who routinely does breast surgery is the most important factor of all.

Hello! Thank you for your question! These two procedures can and effectively and safely performed in one setting.  Staging the procedures to have
them performed 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. However, 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.  For this reason, it would be wise to stage these procedures.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.   I would
discuss your concerns with your surgeon and see what your options are.
Hope that this helps! Best wishes for a wonderful result!

The augmentation/mastopexy in one procedure is desirable for most women because of reduced cost and going under anesthesia once.  The outcome is harder to predict for challenging cases - where there is a heavy degree of breast sag (ptosis) or when the degree of desired augmentation is high.  Staging the lift and breast augmentation surgery is a very safe approach to getting the best aesthetic result.  I would make sure that you feel comfortable with your surgeons assessment, and also seek another opinion if you are unsure.  Good luck.

If you have enough breast tissue - implants may not be an issue. Using the Ultimate Breast Lift technique will use your existing breast tissue and reshape it to look like an implant. It makes your breasts firm and perky. It also works for all breast types (very large or very saggy) An added benefit of this technique is that there is NO VERTICAL SCAR. So, if you don't necessarily desire larger breasts this technique may be ideal for you.

Best wishes,

Dr. H

It is not unusual to stage a breast lift and an augmentation.  It is nice when you can do them both at the same time, but this is only possible with a small lift.  Any sort of bigger lift, where you really need to change the architecture of the breast, makes it difficult to place an implant at the same time.  The reason is that thw two surgeries are diametrically opposed to each other.  The lift is designed to raise and tighetn things, whereas an implant wants to stretch everythingout and make it larger.  Most surgeons, when necessary, will do the lift first and get everything in the desired anatomical place.  After 3-6 months, the implants is then placed for the desired volume and better shape.  I hope this helps.

Occasionally, performing the breast lift and the breast implants separately is required to reduce post operative risks or to obtain symmetry. 

In my practice I stage the procedure when the breasts are very dense, the lower portion of the breast is tight or short (tuberous breast) combined with a fairly large implant.  This combination may lead to a very tight closure and lead to healing difficulties and unwanted post operative complications. 

Sometimes when there is a considerable asymmetry where one breast is much larger or saggier than the other, it is best to perform a lift on one side and a reduction/lift on the other first and then do the augmentation in 6 - 12 weeks later.  If you try to correct too many variables at once, then getting evenly sized, symmetrical results is very difficult even in skilled hands. With the staged result, you have a much better chance (and two attempts) of obtaining symmetry.

Ask your surgeon why he prefers to do a staged procedure in your case and see if he mentions some of my reasons above.  If however, he ONLY performs staged breast lifts with implants, then you may want get a second or even a third opinion.

If you have a long breast fold, thin or damaged skin, or have lost a large amount of weight, it may be best to first do a lift then add implants later.  

I place implants during breast lift quoite frequently, but it's all about selecting the proper patient.

Putting an implant in a breast that may not hold it's shape well invites a second more difficult operation and your surgeon likely wants to avoid this.

Thank you for the question.  Yes, often times the breast lift and the implants can be done at the same time. It makes the operation slightly more tricky but in skilled hands can get excellent results.

Without seeing a photo, it is difficult to answer you specifically. It depends on how large of an implant you choose, whether it's saline or silicone, and the amount of extra skin and sag that you have.

If you want it done at the same time, it is okay to seek a second opinion. You may also ask how many lifts with implants together your surgeon does each year and how long your surgeon has been in practice. It can sometimes take some years of experience to become facile at performing breast lift with implants at the same time.

Hello,

This was a hot topic about 7-10 years ago as plastic surgeons debated about the safety of combining the two procedures.  The evidence over the last few years has decidedly put the debate to rest as multiple publications have shown that combining breast augmentation and breast lift is safe and effective.  With that said, every plastic surgeon has his/her own preferences and every patient has different requirements.  If your plastic surgeon does all of the surgeries separate than that is their preference.  If they say that they do some together and some separate they will be able to tell you why you would benefit from doing the two procedures separate.

All the best,

Dr Repta

staged lift and augmentation has it's pros and cons. .... the obvious pro is one operation with less down time...the con is  less reliable and consistent results... After the lift and your  breast tissue settles, an augmentation can be done with a more accurate size assessment, and any touch ups from the lift that need to be addressed, can be surgically fine tuned.