A breast lift with fat transfer can be done at the same time, and in fact, it is a common combination procedure. The breast lift (also called mastopexy) involves removing excess skin and reshaping the breast tissue to raise and reposition the breasts higher on the chest wall. Fat transfer, also known as fat grafting, involves harvesting fat from other areas of the body, such as the abdomen or thighs, and transferring it to the breasts to add volume and shape. During a breast lift with fat transfer procedure, the surgeon will first perform the breast lift portion of the surgery, which will involve making incisions on the breast and lifting the breast tissue. Then, the surgeon will use liposuction to remove fat from the donor areas, purify it, and inject it into the breast tissue to create the desired shape and volume. In terms of scarring, the scar from the breast lift portion of the procedure will depend on the extent of the lift and the technique used by the surgeon. The scar from the fat transfer portion of the procedure is usually very small and may not be noticeable. The newly grafted fat may cause some stretching of the skin, but a skilled surgeon will take this into account and adjust the amount of fat transferred to avoid over-stretching the skin and creating wider scars. It is important to discuss your goals and expectations with a board-certified plastic surgeon who has experience in breast lift with fat transfer to determine if this is the right procedure for you and to learn more about the potential risks and benefits. Best of luck !