Should I Have my Breast Lift and Augmentation Done at the Same Time?

I have had a couple doctors tell me that because my breasts are so droopy I would need to have my breast lift done first and then wait three months before having my breast augmentation. At the same time I have had a couple of doctors tell me they can do it with no problem. This is confusing and I'm not sure which way to go? How do I know which doctor's advice to take?

Doctor Answers 18

A breast lift with implants is commonly performed at the same time but not all plastic surgeons are comfortable doing it this wa

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for your question and the photos.

A breast lift with implants is commonly performed at the same time but not all plastic surgeons are comfortable doing it this way. For someone who does a lot of breast lifts and augmentations, it is usually not an issue.

To be sure, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery. I hope this helps.

Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

Lift and Augmentation at the same time?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Usually combining these two procedures can be done by an experienced Plastic Surgeon. However, if you have large, low hanging breasts, there may not be enough room on your upper chest to accept this breast volume under your skin, let alone the additional volume of an implant. There are only so many inches of skin around your chest and combining these procedures is like a double augmentation with all of your breast volume plus the volume of the implant. A size 9 foot cannot be made to go into a size 4 shoe. Surgical judgement is key.   

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 61 reviews

Lift aug simultaneous or staged

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi, both ways are certainly appropriate but nowadays more liftings and augmentations are done simultaneously except in some specific situations with possible risk factors. the major fear of the combined procedure is jeopardy to the blood flow to the nipple and areola areas causing serious complications.

in the absence of risk factors like smoking, suboptimal skin envelope condition etc.., a lot of surgeons will perform both procedures at the same time. I strongly recommend you consult with a board certified plastic surgeon who has enough experience with these procedures whether combined or staged.  

Breast Augmentation/Lifting: To Stage or Not To Stage?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It is not possible to give you precise advice/recommendations without direct examination or viewing pictures. A full communication of your goals would also be necessary.

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.

Breast augmentation and lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I quite often do the breast augmentation and lift at the same time. Some surgeons are more conservative and stage them.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast augmentation and lift together

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

While breast augmentation and breast lift (mastopexy) are each relatively easy operations, the combination is always a challenge.  Even in the best hands, there is a high chance that some sort of revision will be needed.  Though some surgeons insist on performing the mastopexy (lift) first and the augmentation a few months later, many surgeons will perform the combination together.  It is extremely important, though, for the plastic surgeon to explain the risks of the combination surgery to the patients.  In cases after massive weight loss, where the skin and tissues are extremely stretched out, dividing the surgery into stages is often the wisest choice.

Bruce E. Genter, MD, FACS
Abington Plastic Surgeon
4.3 out of 5 stars 17 reviews

Augmentation and lift done together is common, but separate is not incorrect. Every patient (and surgeon) is different!

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

If a breast lift is indeed necessary, most experienced breast surgeons would do both lift and augmentation as a single operation and achieve excellent results with low risks or re-operation for any reason. Even doing two separate operations does not guarantee that a third revisional surgery will not be necessary for your best result. So, you see, you could choose one combined operation with a (slightly) higher risk of possible re-operation (one, possibly two procedures), OR you could choose two separate operations with a (slightly) lower risk of re-operation (two procedures for sure, and possibly a third). The cost for two operations is higher, you must take off work or social activities twice, and the risk (very low) is still twice as great with two operations.

Unless your surgeon feels really uncomfortable with combined breast lift and augmentation (Why?), and you decide to go with two operations, then I would absolutely perform the lift first, which allows healing of the scars with less tension and better overall (least stretched or visible) scar appearance, as well as allowing the best circulation. Once healed for at least 3 months, your perky (small) breasts can be augmented with the appropriate implants for your new skin brassiere. Going with implants first may cause excessive tension on a subsequent breast lift, and increased risk of ischemic healing concerns. Not incorrect, but less-than-ideal order of operations, IMHO.

Properly performed, neither operation is very painful, but pain is so very subjective and variable. Submuscular implant placement is somewhat more uncomfortable, but a breast lift involves more incisions, so if you asked 100 patients who had each, you would likely get about even pain numbers both ways. After-surgery restrictions on patients with each operation are exactly the same in my practice. Get opinions from several ABPS-certified plastic surgeons experienced in breast surgery before you decide, but ultimately, you will need to trust the judgement and advice of your chosen surgeon. For examples of my patients undergoing single-stage breast lift plus augmentation, click on the link below. (Case 3 had 3 prior surgeries by 2 other surgeons before my operation for her).  Best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
As you can read, this is very much a function of surgical preference. I typically combine the procedures. Let me also add that my patient population is conservative in terms of implant size. If you are contemplating large implants, there is a rationale behind staging the procedures.

Breast Lift and Augmentation Done at the Same Time

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

There is no appropriate way of answering this question without performing a physical exam and reviewing your lifestyle, lifestage, and objectives. Generally, you can combine the procedures unless the augmentation involves larger implants. In that case, the surgeries are often done in stages.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

Breast lift and a mastopexy

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

This question comes up over and over again. The answers are always the same. This breaks down about 50-50 among plastic surgeons. The two opinions you've had already are accurate and classical. A more conservative approach is always to do them as separate operations. As there was no picture along with your question all of us are answering only in general terms.

Sherwood Baxt, MD
Paramus Plastic Surgeon

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.