Breast Lift with Implants Vs Lift Now, Implants Later?

I'm in the consultation phase of my mommy makeover. I'm definitely getting a tummy tuck, but also considering breast surgery. I would require both a lift and implants to achieve the look I desire. Some doctors prefer to do both the lift and implants at once (along with the tummy tuck). Others prefer to do just the lift with the tummy tuck, followed by implants six months later. I realize the situation differs based on the individual patient, but what are the pros and cons to each method?

Doctor Answers 10

Breast lift with implants?

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Thank you for the controversial question.

This is not a question agreed-upon by all plastic surgeons. There are good plastic surgeons who will insist on doing the procedures separately and there are good plastic surgeons who can produce excellent outcomes in a single stage.
The combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately. Furthermore, the potential need for revisionary surgery is increase with breast augmentation / mastopexy surgery done at the same time.
I'sn my opinion, the decision  to do the operation in a single or two  staged fashion becomes a judgment call made by a surgeon after direct examination of the patient.  For me, if I see a patient who needs a great degree of lifting, who has lost a lot of skin elasticity, or  whose goal is a very large augmentation then I think it is best to do the procedures in 2 stages (in order to avoid serious complications). However, doing the procedure one stage does increase the risks of complications in general and the potential need for further surgery. This increased risk must be weighed against the practical benefits of a single stage procedure (which most patients would prefer).
Conversely, if I see a patient who requires minimal to moderate lifting along with a small to moderate size augmentation (and has good skin quality), then doing the procedure one stage is much safer. Nevertheless, the potential risks  are greater with a 1 stage  procedure and the patient does have a higher  likelihood of needing revisionary surgery.
I hope this helps.

Breast Lift vs Augmentation

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Patients who come to see that are dissatisfied with the appearance of their breasts and there is a bit of confusion as to which operation will improve their breast contour.  The question can really be answered by first identifying if the volume of the breast is satisfactory to the patient.  One simple way to determine this is to ask yourself this:  If you are in a well-supported bra, do you like the size of your breasts?  If you answer yes to this question, then it is unlikely that breast augmentation will be indicated for your particular situation. 


If the breasts have more a droopy appearance, the next step is to identify to what degree.  Then, we can determine which operation is best suited to correct the drooping.  We, as Plastic Surgeons, have methods of identifying the degree of drooping by how low the breast tissue and nipple have descended below the level of the inframammary fold.  The inframammary fold is the landmark of the chest at the very base of the breasts that affixes the lower part of the breast to the chest wall.  The specific lift operation to address this issue depends on the amount of drooping or how low the breast tissue and nipple have descended below that inframammary fold.  

Paul Fortes, MD
Houston Plastic Surgeon
4.1 out of 5 stars 17 reviews

Breast Lift With or Without Implants?

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It's not unusual for women to request treatment of breast hypoplasia associated with breast sag. A variety of surgical approaches are currently available to treat these problems. These approaches include both staged procedures and combined procedures. Unfortunately, opinions vary amongst plastic surgeons as to which option is best.

Many surgeons feel that the large number of variables that are present when these procedures are performed together significantly increase the potential for complications and the need for secondary revisional surgery. For this reason, they feel it's appropriate to perform breast lift surgery as an initial procedure. Once healing is complete, they then proceed with secondary breast augmentation surgery. When this approach is utilized, patients have excellent clinical results and high levels of patient satisfaction.

Unfortunately when this approach is utilized, every patient with this problem requires two surgical procedures. For this reason, many surgeons prefer a combined approach to these procedures. They acknowledge that patients may occasionally require secondary surgery, but this scenario is far better than committing every patient to two surgical procedures. When this approach is utilized, clinical results are excellent and patients are happy to avoid multiple procedures.

In the majority of cases, it's reasonable to combine breast lift and breast augmentation surgery, but occasionally when the situation is unusually complex, it may be appropriate to stage these procedures. If you're considering breast augmentation and breast lift surgery, it's important to thoroughly discuss your options with your plastic surgeon. Your surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.

Breast lift and implants

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Although I have always performed breast lifts with implants in a single stage with very low revision rates over the past 25 years and I have not experienced more excessive scarring. Even if this did occur it could easily be taken care of as an office procedure later. I have no problems however with other plastic surgeons who feel the need to do this in two stages. It is becoming a trend to do breast lifts with implants in one stage however the important point is that surgeons should do what they do best. Usually their training determines what technique they will perform in the future.You should never "force" a surgeon to do a technique that they do not feel comfortable performing.
Make sure you pick a board certified plastic surgeon.

Combining a breast lift and implants is straightforward when carefully planned

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Combining a breast lift and implants is straightforward when carefully planned.  Some surgeons prefer to stage it, first do a lift and then a few months later perform an augmentation when they are unsure about the effect of the lift.  In some cases where a significant breast asymmetry exists, or the breasts are very sagging, it might be beneficial to stage it, however, in our experience that is rarely necessary.  Ultimately, each surgeon does things a little differently and you want to find one that you believe will give you the best possible results and care, not just simplest and cheapest offer.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 521 reviews

Single vs staged approach

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About half of my patients get “staged” augmentation mastopexy (where the procedures are performed separately). The benefits of this are the following:

  • Since you can see the results of the first procedure (the lift), you can adjust the second procedure to complement results.
  • A lower rate of revision.
  • Surgical techniques can be selected to better achieve desired improvement.
  • A lower complication rate.
You can always get a second opinion from another surgeon as well, pending a physical examination.

Breast lift with implants vs lift now and implants later?

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Hello! Thank you for your question! These two procedures can safely and effectively be performed in one setting, given you are healthy and without medical comorbidities to prevent such. Staging the procedures to have them done 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, more importantly than the financial aspect, 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. If 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. Consult with a plastic surgeon well-versed in breast surgery who will discuss and examine you, while assisting you to decide which procedure will be the best option for you. I would discuss your concerns with your surgeon and see what your options are - sometimes multiple consultations with board-certified plastic surgeons is helpful for you to decide. Hope that this helps! Best wishes for a wonderful result!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

Breast lift w/ implants vs. Lift now and implants to follow

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Thank you for your question. Some plastic surgeons do the mastopexy first and then add volume later. Each patient is different, and so sometimes the treatments may be different. One stage breast augmentation and mastopexy is also done. Remember it depends on the individual's goals, tissue, etc;, Best to talk with a board certified plastic surgeon, (or two...). Together you will come up with a plan.

Jeffrey J. Roth, MD, FACS
Las Vegas Plastic Surgeon
4.6 out of 5 stars 17 reviews

Implants and lifts together or separately?

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Augmentations and lifts are procedures that can work against each other and each increase the risks of the other. They can be done together but getting them just right can be a challenge, and not always under the complete control of the surgeon. Mild periareolar lifts can be easily done at the time of implants, but the more complex the lift (vertical, anchor), the more possible the problems with contour issues and blood supply problems with the nipple. That does not mean that many experienced surgeons can not get good results with the combined procedures, but the risk of revisions is higher than in most other surgeries, and longterm revisions are not uncommon. It simply must be understood...aug/lifts are many times more complex than augs or lifts alone, and the results less predictable, so many surgeons feel that they can control the results better by lifting the breast into the proper position first and, after sufficient healing, more precisely control implant position.

Breast lift and augmentation

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The difference between having the lift and augmentation as one operation vs two is that you may need a revision of the first more commonly than the second choice.  However, in most cases it saves a second operation.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 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.