Breast lift or auto-augmentation - which would be best? (Photos)

Question

Hi, I’m interested in a breast lift/augumentation. I don’t want to go down in size but I’m not sure which would be better.

Mert Demirel, MD · Answer

From the photos, you appear to have significant breast ptosis, meaning the nipple and breast tissue sit low. In this situation, a breast lift is usually the main procedure needed to raise the nipple position, remove extra skin, and reshape the breast.
Auto-augmentation means using your own breast tissue during the lift to create more upper fullness without an implant. This can be a good option if you do not want to be smaller and you already have enough breast volume. It can improve shape, but it usually does not create the same long-term upper-pole fullness as an implant.
If you want to keep your current size, a lift with auto-augmentation may be a very reasonable choice. If you want more roundness or upper fullness than your own tissue can provide, then a small implant with a lift may be discussed. However, implants add weight and can increase the chance of future sagging, especially if the skin is already stretched.
A lift alone may make you look slightly smaller because loose skin is removed and the breast is reshaped, but it does not have to be a true reduction unless you want less volume. Your surgeon can plan the lift to preserve as much tissue as safely possible.
My advice would be to ask your surgeon whether your goal is best met with a lift alone, lift with auto-augmentation, or lift with a small implant. Based on your wish not to go down in size, auto-augmentation is worth discussing, but the final choice depends on how much upper fullness you expect.

Serdar Bora Bayraktaroglu, MD · Answer

A breast lift (mastopexy) alone will reposition your existing tissue and correct sagging without reducing your overall size, you already have enough volume. Adding an augmentation is generally only necessary if you want to increase your size or restore lost volume. Because you already have sufficient breast tissue, a lift alone will achieve a perkier, elevated shape while maintaining your current size. Consult a board-certified plastic surgeon to evaluate your skin elasticity and confirm if a standalone lift meets your goals.

Joel Patrick Maier, MD · Answer

I think you are an excelle Candidate for a standard breast lift. I would not recommend auto-augmentation. In the hands of an experienced breast surgeon, a standard breast lift will be a great outcome. See attached reference for a case like yours. Thank you!

Semih Yildiz, MD, FEBOPRAS · Answer

In my opinion, based on the photos, you appear to have enough natural breast volume that a breast lift with auto-augmentation could be a very reasonable option. This means the breast tissue is reshaped and moved higher, often using some of the lower breast tissue to create better central and upper fullness. It can improve nipple position, breast shape, and sagging without adding an implant.
If your main goal is to keep roughly the same size and look lifted, I would usually discuss a lift/auto-augmentation before adding an implant. A lift removes extra skin, so the cup may feel a little different afterward even if very little breast tissue is removed, but it should not be planned as a reduction unless you want that. An implant becomes more useful if you specifically want more upper-pole fullness, a rounder implant look, or a larger size, but in a naturally heavier breast it can also add weight and may increase the chance of recurrent sagging over time. The best choice depends on measurements, skin quality, and the exact look you want.

Murat Diyarbakirlioglu, MD, FEBOPRAS · Answer

Hello! Thank you for sending your photos. After evaluating them, I can see that there is a significant degree of breast sagging (ptosis). In cases like yours, the priority is usually to first restore the breast position and shape safely with a breast lift procedure.

Although implants can provide upper fullness and volume, placing implants at the same time in cases of more advanced sagging can sometimes place excessive tension on the tissues and may increase the risk of complications or compromise the long-term result. For this reason, I would more commonly recommend a staged approach for patients with similar anatomy.

My recommendation would likely be:
• first stage: breast lift surgery to reshape and reposition the breasts
• optional fat transfer during the same procedure for additional softness and upper fullness
• then reassessing healing and volume after recovery

After the tissues heal and settle properly, if you still feel you would like more upper fullness or size, implants can then be considered safely as a second-stage procedure if necessary.

Many patients are actually very satisfied after the lift alone or with lift + fat transfer, because restoring the breast shape often creates a fuller and younger appearance even without implants.

Of course, the final recommendation would depend on a more detailed consultation and your goals regarding size, shape, and cleavage. You are very welcome to contact our team for a more comprehensive evaluation and personalized surgical plan.

Daniel Barrett, MD · Answer

Dear Fantastic945399,

my preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Leila Kasrai, MD, FRCSC · Answer

Only a small amount of tissue is removed during a lift, therefore you would be about the same size as you are now. Auto-augmentation would not be necessary.

Wayne I. Yamahata, MD · Answer

Your photos show the presence of substantial sagging to your breasts. The recommended treatment would be a breast lift. It appears you have generous volume so augmentation can be deferred. You may lose some volume with the lift, but most of it can be retained with autoaugmentation.

Mehmet Ozdemir, MD · Answer

Thank you for your question.
Based on your goals of improving shape without reducing size, you may be a good candidate for a breast lift, which can elevate the breasts and improve overall contour while maintaining your natural volume.
A detailed evaluation would help confirm the most suitable approach for your goals.

Don W. Griffin, MD · Answer

Thank you for your question. Based on your photos, you are ideally suited to have a breast lift using your own tissue. This procedure will reduce your areolar size and lift and tighten your breasts. You can also reduce breast volume with this procedure if that is a goal for you. Some of your breast tissue can be used as a pedicle to provide more projection, but I don't think you need to add more volume with an implant or fat injections. You seem to have plenty of natural breast volume to achieve a beautiful result with a lift alone.

Breast lift or auto-augmentation - which would be best? (Photos)

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