Get Implants First then Lift Due to Dropping?

At one of my breast aug/lift consults, the doctor said he prefers I get the implants first then once they drop, do the lift. He said this was because if both were done at once, once they drop, I may not be happy with how low/high the nipples sit; thus, if the lift is done after the implants, he could ensure we would have better results as they won't be dropping (not sure if I worded very well). What do you doctors think about this? Thanks :)

Doctor Answers 7

Lift before/after or at the same time as an augmentation

Everyone makes chicken soup a bit differently but they often all taste similar. Same thiing with the concept of lift before/after/ or at the same time as implants.  Certainly safest to split it up.  But it will cost more, and you still  may need a revision.  I often do them at the same time.

New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Augment breast first then lift?

This is a great question, and you will not find a unified answer to this. Photos would have helped to formulate an answer. In general, I prefer to do a lift first with a short scar technique. First I want to place the breasts back where they belong. If an enhancement is desired, an augmentation can be done later. If a minor lift is needed, I do both procedures at the same time. As you see, there's no right or wrong approach to this. It depends on you (the quality of your tissues, sagging, loss of tissue volume, etc.) and the surgeon's expertise and experience. If you do not feel comfortable with the first recommendation, seek another opinion from another board certified p[lastic surgeon. Good luck.

George Marosan, MD
Bellevue Plastic Surgeon
4.8 out of 5 stars 38 reviews

Lift before the augment - what is the best approach?

You have raised a good question that can not have a specific answer. It would be simpler for patients and Plastic Surgeons if the same recipe could be followed in every patient and the same outcome would be achieved. Plastic surgery does not work like this. Each surgeon will need to make their best recommendations for each patient based on their experience and training.

Patients  that need more volume and also have laxity/sagging are very challenging. Following every breast rejuvenation surgery, with or without implants, the shape and tone of the breast will change once the procedure is completed. How the breast shape and tone changes is highly variable but a good pre-operative assessment and careful planning can allow the experienced surgeon to achieve more predictable outcomes.

Breast augmentation adds weight to your breasts and will cause your tissues to stretch. Most of this stretch occurs in the first 3-6 months after an augmentation resulting in a less firm, less rounded, lower and more mobile breast than what is present in the first few weeks after surgery. When too much stretch occurs a lift is required to improve the shape. However, when too much stretch occurs it is also an indication that your tissues can not support the weight of the implant in place. Lifting an augmented breast that has already sagged frequently produces temporary benefits as your tissues will stretch again.

If you need a breast lift, I prefer to do the lift first or combine the augmentation with a breast lift using the smallest (lightest) implant possible that will achieve your goals.


Dr. Mosher


Mathew C. Mosher, MD
Vancouver Plastic Surgeon
4.5 out of 5 stars 34 reviews

Implants and lift; together or separat?

This is one of those questions that has no one, easy answer. A lot will depend on your individual anatomy and goals. With that said, I frequently recommend to my patients that we do the procedures separately as I think it is possible to get a better final result in many instances. Also I have found that if we do the implants first often the patient is so pleased with the results that the lift is not necessary for a number of years. You may want to talk with several plastic surgeons and see what they recommend for your individual case before you make your decision. Good luck to you.

Margaret Skiles, MD (retired)
Sacramento Plastic Surgeon
3.6 out of 5 stars 13 reviews

Get Implants First then Lift Due to Dropping?

I think that if your surgeon is getting good results that you like when looking at his photos, you should follow his advice. I personally prefer doing the lift first because some of my patients like the new look so much they never do the augment. But either way is a valid choice.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Combined or staged breast lift and implants

There is no absolutely right answer to this question and much depends on the surgeons experience, and on your starting point and how much lifting you need and how big you want to go.  Doing the implants first and the lift later or vice versa are both reasonable plans.  If the implants are conservative, both done together can also be done.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Breast Augmentation/Lifting: One or Two Operations?

It is in the nature of plastic surgery that you will receive many different opinions  as to the best way to proceed. In other words, if you visit 5 plastic surgeons you might come away with 5 different  recommendations. Therefore, seeking additional consultations may be helpful to you;  more so than online consultation ( where the consultants do not have the benefit of examining you and or communicating your goals).

Hopefully after you have met with a few well experienced board-certified plastic surgeons in person you will come away with a “consensus” as to the best way to achieve your goals.

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 1 stage  procedure and the patient does have a higher  likelihood of needing revisionary surgery.

Ultimately, I think you will be best off selecting the plastic surgeon who you feel will most likely be able to achieve the results you are looking for and follow his/her recommendations.
I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 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.