Breast Lift W/ Implants in 1 or 2 Surgeries?

I consulted w/ 2 doctors in my area,both of which I liked.However,they gave me conflicting advice on surgery.They both agree I need a breast lift & I'm opting for implants.The 1st dr is Board Cert in CS & told me he could do the lift & implants at same time.2nd dr is Board Cert in PS told me def not & that he would have to perform 2 surgerys,lift then the implants because my breasts are small & doing it at once could result in me losing my nipple.Thus, there is a $4000 difference, who is right?

Doctor Answers 13

Simultaneous or staged breast lift and augmentations

This is too complicated to cover in detail here but:

1. Only go to a Board Certified PLASTIC Surgeon, not a Cosmetic surgeon.  There is zero comparison between the training to do what you need.

2. Lifts and implants can often be done together as long as you are healthy, don't smoke and are going with a conservative implant that will not overstretch the lift which is a tightening operation. Your surgeon has the final call on this.

3. If you need a full lift and want lots of fullness, you need to stage this and either do the implants first and then the lift or do the lift first and then the implants.  4-6 months between surgeries is usually needed.

4. Don't base your decision on cost as the price to fix bad work is much more than the first operation would ever cost in the hands of a top plastic surgeon.

Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Breast Lift with Implants in 1 or 2 Stages?

Thank you for the question.

I would strongly suggest that you consult with board-certified plastic surgeons only. I would not suggest that you consider having your breast surgery performed by a “board certified cosmetic surgeon”.

In regards to your question regarding breast surgery,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 wth a single stage operation.

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.
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 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.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 reviews

Age old questions

This can be a very hotly debated topic! In most cases I will do it in one but if there are risk factors (smoker, diabetic, lots of scarring, big implants) etc I would stage it

Ryan Neinstein, MD, FRCSC
New York Plastic Surgeon
4.9 out of 5 stars 76 reviews

Breast lift w implants in 1 or 2 surgeries?

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. I take more merit in a plastic surgeon over a "cosmetic" surgeon.  Hope that this helps!  Best wishes for a wonderful result!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 26 reviews

Breast Lift W/ Implants in 1 or 2 Surgeries?

My answer is clear that you should only work with Board Certified PLASTIC surgeons.  Beyond that, the decision to do the work in 1 or 2 surgeries is to be determined by your goals, expectations and your overall health/physical status as well as the surgeon's ability to deliver or match your goals safely.  Many of us perform combined procedures such as what you describe and do it in a safe manner.  Another opinion from a Board Certified Plastic Surgeon should help you decide.  Wishing you all the best

For more information, please go to my website at:

Garrett A. Wirth, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 12 reviews

Breast lift with implants

As a board certified plastic surgeon I always give patients options and  I will discuss a lift with implants as a one stage operation or as a two stage procedure. Depending on the patient's anatomy, medical history and their input we come to a decision; which 90% of the time is a one stage operation.  I always tell patients that a touch up procedure may be needed when doing multiple procedures in one stage. It can be a safe and effective procedure and save money when all done at once. Please seek a board certified plastic surgeon for consultation and review his or her before and after photos to see if you like the results. Good luck.

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 59 reviews

Staging Breast Lift and Augmentation Procedures

I think you can tell the consensus is that you should choose to work with a Board Certified PLASTIC SURGEON. Staging procedures is a way to reduce complications. Being cautious is always a good thing. However, augmentation and lifts can be performed together very safely as long as you're healthy, non-smoker and select an implant that is fairly conservative. I absolutely will not operate on a smoker and even make all my lift patients take a nicotine test right before surgery. 

If a patient wants a 325cc or smaller implant, I'll use a silicone gel implant. If a patient selects 350cc and larger, I use a Spectrum saline adjustable implant. I do not like a lot of tension on the nipple and incisions. The larger the implant the more tension created. I've been doing it this way for about 12 years and haven't had any complications with loss of nipple skin etc...since I switching to adjustable implants.


Jeffrey Hartog, MD
Orlando Plastic Surgeon
4.5 out of 5 stars 60 reviews

Breast augmentation and breast lift in one stage or two

To reiterate what others have said:

1. I would only chose a surgeon who is Board Certified by the American Board of Plastic Surgeons.  There is really no such thing as "Board Certified in Cosmetic Surgery."

2. The only way to determine if you are a candidate for simultaneous breast augmentation and breast lift is through a consultation with a reputable plastic surgeon.  I often combine the two procedures and have a very low complication rate.  Some surgeons, however, prefer to do the two procedures at different times (staged procedures).  As others have stated, there are times when it is prudent to do these procedures separately.  For example, in a woman who needs a lot of lifting or in someone with risk factors such as diabetes.  


Good luck. 

Laurence Weider, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 99 reviews

Breast Lift with implants in one or two stages

In my practice I perform most breast lifts and augmentations in one stage.  We published our series of 321 one-stage procedures that demonstrated safety and success.  Two stages is also reasonable if the patient prefers it.

David Stoker, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 54 reviews

Augmentation and Mastopexy Decision

Breast augmentation and mastopexy can be done safely in some situations (See Dr. Rand's post) but should be a careful decision between you and a board-certified plastic surgeon (American Board of Plastic Surgery)  that has examined you.  You can always seek another opinion among ABPS-certified plastic surgeons. Of note, board certification in "cosmetic surgery" is not a recognized ABMS board and is quite easy to obtain.

Jeff Scott, MD
Everett Plastic Surgeon
5.0 out of 5 stars 10 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.