Breast uplift and implant - one surgery or two? (Photos)

Question

I am 30 years old and really want to get a breast uplift and implant in one stage. My surgeon had said that I wil also need a slight reduction on one side. My surgeon recommended two stages but I would prefer to have it done in one stage. I understand two stages ie more likely to result in a revision. I am okay with this as I am unsure whether I will have children so i know a revision will be needed either way. Is it doable in one stage? I am happy enough with the size of them but really want upper pole fullness.

Daniel Barrett, MD · Answer

Dear laurenCal24,

it is hard to tell for sure without an examination. Generally speaking, it is possible to get breast lift and implants at the same time. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

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

Donovan Rosas, MD · Answer

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume, ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive. Many patients, whether they are aware or not, will benefit from both. There are two factors which can help to answer the question of which surgery will deliver the most satisfying result: mastopexy, augmentation or both. Patients must first consider the position of the NAC (nipple areolar complex i.e. the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease the patient may benefit from a lift or mastopexy. The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts. This is typically accomplished via a periareolar (around the nipple) incision with or without a vertical incision. Mastopexy is an effective way to address sagging breast, however, the changes which accompany weight loss or pregnancy can also decrease volume of the breasts. When a woman wants the volume restored, or increased, a breast augmentation will also be needed in conjunction with mastopexy. Augmentation can help restore the volume loss which is well known to women following children. There are a number of options available to women considering augmentation ranging from size and implant type to access incision. A breast augmentation alone may also be appropriate if ptosis is mild. If the patient is comfortable with the natural appearance of the breasts but desires them to be larger, a breast augmentation alone is the right procedure. Augmenting significantly ptotic or sagging breasts tends to magnify the problem. In these cases, a mastopexy performed in conjunction with an augmentation is preferred. Based on your photos, you would certainly benefit from both. The risk of revision is greater when combined. This does not necessarily mean combined procedures is the wrong approach but it does carry a greater risk. There is a procedure for every problem. To determine which technique is right for you, consult with a board certified plastic surgeon Patient should discuss their concerns with their physicians in order to make an educated decision.

Leila Kasrai, MD, FRCSC · Answer

If you are happy with your current size, a lift alone is most likely all you need. This would improve upper pole fullness. Implants are only necessary if you want to be larger or have significantly more upper pole fullness.
It is the experience and opinion of your surgeon that determines whether a lift and augmentation can be performed at the same time for you.

Gary M. Horndeski, MD · Answer

You state you are happy with the size of the breasts but want upper pole fullness. For this reason, I recommend The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Stanley Okoro, MD · Answer

Hi Lauren, 
I think you are a great candidate for a breast lift (mastopexy) and implants (augmentation). This is something that can definitely be done during one surgery. Doing it together will help enhance the volume of your breasts as well as correct the sagginess (ptosis)! Upper pole volume is typically achieved with implants, however a lift can help enhance it as well, just not as significant. We would be happy to help with a virtual consultation

Ted Eisenberg, DO, FACOS, FAACS · Answer

One surgery. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon' s experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Oliver Chang, MD · Answer

Based off your photo - you have right side larger, lower (which will always be like that even after lift and implants (which your breasts are sisters, not twins to begin with) something that you have to accept to advance through your post op journey. There will be a slight reduction needed for the right side compared to the left and can be done in 2 stages (which allows the tissues to settle to see how your breasts shaped from the lift prior to adding implants) versus 1 stage where everything is measured and cut along with adding the implants which means more factors to affect the post-op healing and settling of the breast to the final product. Usually, more experienced surgeons will do it in 1 stage (like your breast anatomy) because there will be one time for general anesthesia or any type of anesthesia, one cost, one healing journey and - like you said you will likely have children - which will likely lead to some type of redo in the future (as your breast stretch and deflate from breast feeding / pregnancy). There are risks to both, slightly less for the 2 stage when it comes to healing issues, skin necrosis, etc but in experienced hands - that percentage is pretty close for 1 stage vs 2 stage. Seek out a few different opinions and see who you feel best with. Good luck.

Robert L. Steely, MD, FACS · Answer

Hi there!

Despite your asymmetry a very nice result is not only possible but highly likely with a one stage augmentation with mastopexy.  Your understanding of the possibility of a small revision needed after one stage shows you have a good  grasp on the issues.  Be sure you are seeing a surgeon well versed in doing these procedures in one stage- many just do not have the experience in doing so.

I hope this helps

Ronald J. Edelson, MD · Answer

I think you have enough breast tissue to avoid an implant altogether.  There’s no right or wrong answer to this and you will get conflicting recommendations from different surgeons. But if you can avoid an implant it makes the surgery simpler and avoids the problems  associated with implants.