Breast Lift with Implants at Same Time?

Question

I am 5'6, 131 pounds about a deflated 36 c. I know I need a vertical lift (told so by more than one ps). the size of implant I want will most likely be 600-700 cc's. I know it's not possible to do at once with that large. but I am wondering why some ps's don't mind doing a lift with a smaller implant at once and some make you do it In two operations? I am confused and dont know what to do?

Kenneth Hughes, MD · Answer

If you are a C cup already, 700 cc implants will place you somewhere in the neighborhood of a DDD or more. This probably is not the best idea for your long term health or the health of your breasts. However, I place implants this large upon patient request. I have never even had a partial nipple areolar necrosis after hundreds of breast augmentation and lift combinations. Although no two patients are alike, I perform breast augmentation and lift together but like to limit implant size to 500 cc or smaller in most cases. Find the plastic surgeon with ELITE credentials who performs hundreds of breast augmentations and breast lifts each year. Look at the plastic surgeon's website before and after photo galleries to determine the plastic surgeon who can produce the results you would like. Kenneth Hughes, MD Los Angeles, CA

Larry S. Nichter, MD, MS, FACS · Answer

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.

Jerome Edelstein, MD · Answer

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.

Lewis Albert Andres, MD · Answer

Hello!  Thank you for your question!  These two procedures can safely 
and effectively be performed in one setting.  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 ill 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!

Andrew Rosenthal, MD · Answer

I don't know your specific anatomy, but I would never use 600-700cc implants at the same time as a lift. These combined procedures are very difficult to do together especially large lifts or large implants.

	Patients fall into 1 of 3 categories:

	1) small lift needed, definitely need more volume--> implant first (perhaps a shaped implant to get better lower pole fill and rotation of nipple upwards); then a lift later if they need it.

	2) large lift needed, may need implant --> do the lift first and stage the implant.

	3) need small or moderate lift and moderate amount of volume --> can do MODERATE size implant and lift at same time.

	Also, when you do a lift at the same time, you usually get significantly better projection, so you usually need only a moderate or moderate plus type implant.

	Also fat grafting can help in these circumstances and we are using that much more judiciously during these types of procedures to gain excellent results.

Tom J. Pousti, MD · Answer

Thank you for the question.  Whether the breast lift and augmentation should be done the same time  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 increased with breast augmentation / mastopexy surgery done at the same time. In 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 in 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 one stage  procedure and the patient does have a higher  likelihood of needing revisionary surgery.

	I hope this helps.

Deborah Ekstrom, MD · Answer

You are opting for very large implants for you body build.  You already have thinned stretched skin.  Over time these large (and heavy) implants will further stretch you skin and likely get droopy, (a ball in a sock look) until you are likely to need a complicated (and expensive) reconstruction to look better. Really thinned skin doesn't hold stitches very well and limits future lifts.

	 On top of that, you will likely look bulky in the chest which almost always makes a woman look overweight, no matter how thin the rest of her body might be. You will likely have problems finding clothes that fit both your upper and lower body and you may experience back and neck pain from the heaviness of your breasts.

	 Be careful to consider the long term effects of your decision today to see if it fits for you for the future.  If not, reconsider the size and compromise on a little smaller but still very sexy look.

Steven Wallach, MD · Answer

I think that a lift with an augmentation in most cases can be done at the same time.  Some surgeons like to stage them.

Antonio Gayoso, MD · Answer

Breast lift surgery (mastopexy) and breast augmentation surgery can often be done at the same time, depending on several factors. The reason to remain cautious in performing these procedures together is potential healing issues that can occur. Factors that might affect how well the breast skin and tissue heal after combined surgery include things such as: smoking, amount of lifting to be performed and size of implant. Your questions is specific to the size of the implant being contemplated. The larger the implant being placed, the more impact the surrounding tissue can experience. That means that a large implant (600+) can negatively effect how well you heal due to the tissue being rather tight after both procedures are done. I tend to be a bit more conservative in my practice and may not recommend such a large implant at the same time as a lift.

Jourdan Gottlieb, MD · Answer

The holding is that the lift is attempting to constrict the skin envelope of the breast, and the implant to enlarge it, two opposing goals that to some means that it better to separate the procedures.

	As the chosen implant gets larger, the number of proponents of separate operations increases, because the risks of wound complications and tissue loss increases. With implants of the size you seem to want, I would be inclined to recommend separate operations. 

	All the best.

Breast Lift with Implants at Same Time?

Answers (11)

More Breast Augmentation Questions

Can my Breast Still Grow at Age of 20?

Are Saline Implants Perkier then Silicone?

I Am 5'2 125 Lbs 32a Breast Aug with Silicone 390 Ml What Cup Size Will It Give Me?

How Long After Breast Augmentation Can I Do Heavy Lifting?

Opinions on 600-650 CC Implant Size for my Frame? (photo)

WE SEND PRETTY
EMAILS