Can I Get a Mastopexy/augmentation in 1 surgery with Stage3 Ptosis? Is It Better to Have Lift Done Before Augmentation Surgery?

I'm a 5'3, 120lb healthy female. After gaining (quickly) &loosing over 100lbs my breasts have gone from a D cup, to tiny saggy stretched skin with little breast tissue. I was shocked when the surgeon said he would only do the mastopexy&augmentation separatly (the only way to ensure good results)-1st mastopexy-resulting in a lifted Acup breast. After I have healed he would do an augmentation-$10000 for 2steps is not affordable. Do they have to be done separately to achieve good results? The 2 staged surgery cost is $10000 (mastopexy) and after healing the quote for an augmentation is $12000. I figure the 2 stage will cost me an additional $10000, this is why I hope to get it done together. I am consulting with 2 other plastic surgeons tomorrow, and am wondering if one stage is a feasable option with similar results?

Doctor Answers 16

Can I Get a Mastopexy/augmentation in 1 surgery with Stage 3 Ptosis?

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Thanks for the question and congratulations on your significant weight loss; you should be very proud of this accomplishment.

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.

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, and the attached link, helps.

Breast lift and implant in stages

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Dear Roxanne,

while this is very surgeon dependent, looking at your picture, you're a very good candidate for mastopexy augmentation and after an examination I would likely recommend you undergo this procedure in one stage. In experienced hands, revisions are rare and if necessary are much smaller than undergoing the planned second procedure.

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
4.7 out of 5 stars 113 reviews

Breast lift and augmentation commonly done concurrently.

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There is no particular reason to stagger these two operations in lesser cases exceptional. This operation is commonly done although I always place the implants below the muscle for purposes of blood supply.

Breast lift with Implants can be done in one or two stages and the choice is surgeon dependent

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Hi there-

As others have explained, both options are acceptable, and I think the recommendations you are likely to be given are going to depend on who is giving them, and their experience with the procedures and techniques.

Generally, I believe that the less experience a surgeon has performing complicated breast procedures, the better off they are performing them in two stages. This is a simpler approach, although more expensive.

If you are able to find a surgeon with a lot of experience and training in complex breast operations and who has the work record (photos) to prove it, I believe beautiful outcomes are certainly likely in one stage.

As you can hopefully see- everything depends on who you choose to perform your surgery.

Good luck

Mastopexy/augmentation - staged?

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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. Cost of these procedures will vary amongst plastic surgeons in addition to geographic location.

However, more important 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. Without an examination, it is difficult to tell you what to recommend, but it appears, on your photo, that it may be done as a single stage.

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

Can I Get a Mastopexy/augmentation in 1 surgery with Stage3 Ptosis? Is It Better to Have Lift Done Before Augmentation Surgery?

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I perform the two procedures together, and I have never had an issue with even partial nipple areola necrosis. The cost of the procedure can be at the lower end of what you have mentioned. Find a plastic surgeon with ELITE credentials who performs hundreds of breast lifts each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD Los Angeles, CA

Simultaneous augmentation and lift

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Your photograph shows significant ptosis and very little breast volume.  It is possible to reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage.  Aligning the areola and breast tissue over the bony prominence of the chest wall maximizes anterior projection.  If mastopexy is insufficient then you would need augmentation.  A separate augmentation will cost an additional fee.  It would be more cost effective to do them at the same time, although there would be slightly increased risk.  The cost for augmentation with simultaneous lift would be approximately $11,000 using silicone gel implants. 


Best Wishes,


Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Multi stage breast procedures

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Thanks for your question and photo.  I agree that you would be an excellent candidate for both a mastopexy and an augmentation.  I cannot comment on price other than the fact that this varies by region of the country.  I would perform your surgery in one stage with the caveat that you might need a touch up/revision.  Best of luck.

Can I Get a Mastopexy/augmentation in 1 surgery

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I would only do your procedure in two stages just as your surgeon suggested. The risk of skin loss in such a thin breast is dramatically reduced by doing the surgery in stages. Other doctors feel differently. I'm not sure where you live, but those quotes are extremely high for this area of the country. I would think 10k-12k total for both surgeries. Maybe you misunderstood the quote?

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Mastopexy & Augmentation: separate or combined?

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There are surgeons who approach it the way yours does (in stages), and others that will do both at the same time. Typically there is only a small price advantage over combining them in a single stage, but again that will depend on the surgeon as well. If you are going with either approach, it is VERY IMPORTANT that you see a number of before and after pictures of your surgeon's other patients, with a similar issue, treated with the same procedure proposed to you. If you like what you see, then you will probably be happy with your results. Good luck!

Matthew Concannon MD

Matthew Concannon, MD
Columbia Plastic Surgeon

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