Separate Breast Lift and Augmentation Procedures Due to Multiple Issues?

I have several issues - saggy breasts, asymmetry (nearly a full cup size difference), and loss of what little volume I had due to 135 lb. weight loss.

From what I've read, I believe I'll need a Breast lift and Breast augmentation, but I'm a little confused. Are they usually performed at the same time? I have consultations scheduled for next month, but I wanted an idea of what to expect.

Doctor Answers 21

Breast Lift and augmentation in one operation is safe

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Breast augmentation and a breast lift performed at the same time can be safe in the right experienced hands. The forces of the lift are counteracted by the augmentation and the scars can widen with the extra pressure of the implant, but if your surgeon is aware of these factors and carefully plans before, during, and after the operation, wonderful results can be obtained.

Jacksonville Plastic Surgeon

Breast augmentation with a lift

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These procedures are often performed together. Much is often said about a surgeon's experience and if he is 'comfortable' doing it at the same time. My feeling is more along the lines that many surgeons are experienced enough to know that a patient will leave if they are told two surgeries is in their best interest.

CAN it be done all at once? Of course, we do it all the time. SHOULD it be done all at once? Of course, we do it all the time. I think the most relevant question is directed towards do you have favorable anatomy for it to be done all at once (All bets are off if you smoke). There is a group of patients with difficult anatomy for this to work out. Some of my best results are from staged surgeries that simply could not have been done in one. The most often is to do both surgeries in one operation but be sure that your surgeon does stage them if it is necessary.

Best Wishes,


Ricardo A. Meade, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 125 reviews

Separate Breast Lift and Augmentation Procedures Due to Multiple Issues?

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Thanks for the question. Without viewing photos (of yourself as well as your goals) it will be difficult to give you accurate advice.
 Generally speaking, whether or not breast augmentation/lifting should be gone in a single  operation or staged fashion  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 one 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 implants

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Although I have always performed breast lifts with implants in a single stage with very low revision rates over the past 25 years and I have not experienced more excessive scarring. Even if this did occur it could easily be taken care of as an office procedure later. I have no problems however with other plastic surgeons who feel the need to do this in two stages. It is becoming a trend to do breast lifts with implants in one stage however the important point is that surgeons should do what they do best. Usually their training determines what technique they will perform in the future.You should never "force" a surgeon to do a technique that they do not feel comfortable performing.
Make sure you pick a board certified plastic surgeon.

Single Stage vs Staged Approach

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A breast lift and breast augmentation can be performed at the same time ("single stage") or at different times ("staged").  The most suitable option for you depends on the advice of your board certified plastic surgeon. 

Single Stage:
The advantages outweigh the minimal risks involved with the procedure for suitable patients. It reduces costs, only one anaesthetic is administered, and there is only one recovery period.  

The Staged Approach:
This is more common and benefits include a good control over the outcome of each procedure, since the subsequent procedure can be better designed to improve on the results that have been achieved, there is a lower rate of additional surgery to correct undesirable results, since it is harder to predict results from the single-stage approach and a better selection of surgical techniques to minimize incisions and resulting scars. There is also a lower complication rate as the single-stage approach is associated with higher risks and complications, including disruption to the blood supply to the tissues and capsular contracture.

Separate breast lift and augmentation procedures due to multiple issues?

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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 comorbidites 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. However, more importantly 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.  Given your history of massive weight loss, I would not be surprised if the recommendations would be for staging of the two procedures.

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 whow ill 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

Augmentation/mastopexy - separate or together

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I typically perform both of these procedures at the same time. I find this works well and most patients would rather have one operation rather than two.  There are several situations where I do think it is in the best interest of the patient to have the procedures performed separately but these probably account for only a small percentage of cases.

The breastlift or mastopexy portion of the procedure is a breast reshaping operation.  The nipple is raised and the breast is reshaped around this new nipple position and a more youthful shaped breast is created.  The areola is usually reduced in diameter.  

The breast augmentation portion of the procedure is used to provide primarily fullness in the upper portion of the breast, improved projection and to improve the overall shape of the breast. Typically when the two stage operation is completed there is a scar completely around the areola and there is a vertical scar from the lower part of the areolar to the breast fold.  In some cases there is a scar in the fold as well.

In cases where there is considerable sagging of the breast or if the breast is already larger a two stage procedure may be best. I agree with having several consultations. Ask to see before and after photos as well. Thank you for your question and best of luck.


Ralph R. Garramone, MD
Fort Myers Plastic Surgeon
4.8 out of 5 stars 69 reviews

Stage or combine breast lifts and breast augmentation: one or two surgeries

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Surgeons vary greatly on this difficulty of this decision. IT is my impression that most surgeons perform a combined procedure but may caution patients that a revision may be required for the best result as opposed to performing two procedures and guaranteeing that more than one is necessary

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Mastopexy and Breast Augmentation

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You pose a great question. Many surgeons prefer to perform the mastopexy seperately from the augmentation, however many surgeons feel comfortable doing both at the same time. If you have not had any other surgery to your breasts that would affect the blood supply to your skin, there is no reason that you could not have both done at the same time. I would be sure to ask the surgeons during your consultation what they prefer and why, and be sure to look at their before and after photos. A picture speaks a 1000 words! Good Luck!

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 109 reviews

Breast Augmentation and Lift are typically done together

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Unless there are medical issues, I do not see the benefit of staging breast augmentation and lift. Both procedures can be performed together, resulting in one anesthesia recovery and potentially saving you money as well.

Michael A. Jazayeri, MD
Santa Ana 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.