What Are the Pros and Cons Associated with Having a Breast Lift with Augmentation?

In other words should these two procedures be done in stages.... Say, if I wanted to increase the volumn of my breast, I should wait until the lift has "settled" (3 mnths + post sx) so as to increase better outcome.

Doctor Answers 10

What Are the Pros and Cons Associated with Having a Breast Lift with Augmentation?

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

This is best answered by the surgeon as each patient is unique and the pros and cons may vary for each patient. Based on the the picture, a breast lift may be enough.

Chicago Plastic Surgeon
4.9 out of 5 stars 76 reviews

Combination Breast Augmentation/Lift

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

It's not unusual to see women who have breast hypoplasia associated with breast sag. The majority of these women present because of changes in their bodies which occur because of pregnancy. During pregnancy, their breasts increase in size and after pregnancy, they shrink. This often leads to loss of breast volume and resultant skin sag.

To correct this problem, patients will require breast augmentation with a breast lift. There are basically two approaches to performing these two procedures. The first involves a single stage procedure in which breast lift and augmentation are performed simultaneously. The second involves a two-stage procedure in which the breast lift and breast augmentation are performed at two separate settings.

The issue of one or two stages for breast augmentation and breast lift continues to represent an area of significant controversy in plastic surgery. This appears to be driven by the large number of variables involved with breast augmentation and breast lift. Some surgeons feel that the additive impact of these variables results in a high revision rate. Some surgeons feel that this may be as high as 20%.

Many surgeons feel that the high rate of revision with this combination of procedures is too high. For these reasons, they prefer to stage these procedures. They typically prefer to perform the breast lift first and then follow with a secondary breast augmentation. They feel that by utilizing this approach, they can control multiple variables and provide an excellent satisfaction rate. The obvious disadvantage of this approach is that 100% of the patients will require two procedures, two recoveries and ultimately more expense.

Another group of surgeons feel strongly that a single, combined procedure is appropriate. They argue that the majority of patients following this approach have a good result. The 20% of patients who require a secondary procedure would have had a secondary procedure anyway if a two stage approach had been utilized. Not only do the majority of patients only have oneĀ  procedure, but they also only have one recovery and incur less expense.

Ultimately, the type of approach utilized depends upon the patient. Many patients are motivated to undergo a single combined procedure for social reasons. Time off work, child care and the day to day stress of normal life are powerful motivators. When patients choose this approach, it's important for them to realize that a secondary revision procedure may be necessary. Under these circumstances, they must understand that this doesn't mean an error has been made, but instead that we're dealing with a very complex set of variables.

Same Surgery for Breast Lift with Implants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I usually prefer to both lift and augmentation in one surgery. A number of plastic surgeons prefer two separate stages or surgeries; the mastopexy followed by implant surgery. These procedures are usually staged at 2-3 months minimum to allow for swelling and healing to be at a reasonable point.
My revision rate for one stage or a combined surgery, is less than 15%. Two stages is not necessary for at least 85% of the patients when performed by and experienced Plastic Surgeon.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Staged or simultaneous breast lift and augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Breast augmentation involves adding volume to your existing breast in hopes of expanding the existing skin envelope, filing it out, or just making it bigger and more stretched out. Breast lift surgery involves trying to remove the excess skin, reshape the existing breast tissue into a more compact and tighter geometry, and in general tighten the breast. These two procedures tend to "fight against each other" when done together. One is trying to stretch while the other is trying to tighten. For this reason, simultaneous breast augmentation and breast lifting can result in a higher risk for unsatisfactory scarring, especially when using large implants. 

Both procedures also take significant amounts of time before the final results of the surgery are visualized. Breast implants alone often take 3 months before they are softened and settled into the pockets in a natural way. Breast lift surgeries often look overly tightened for a period of time as well. Trying to make exact determinations about how much skin needs to be removed and how tight the lift should be made to match with a certain implant is often difficult. For that reason, breast lift and augmentation combination surgery is probably one of the highest revision rate procedures that is performed. 

Staging these surgeries does allow for a more precise end result in many cases. With that being said, most surgeons perform breast lift and augmentation together in a single procedure. And often the results are great. It is the way that I most often perform the procedures on my patients when we know for certain that both the lift and augmentation are going to be needed. But I make sure that my patients understand that the surgery, when combined, does have some challenges in precision and revision surgery is often needed for optimal results. 

Wm. Todd Stoeckel, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 88 reviews

Lift essential, augmentation option

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

Your photograph shows ptotic breasts and large volume.  Unfortunately, you have not stated your bra size but it is possible that a lift by itself will give you the projection you desire.  There is a new technique called The Ultimate Breast Lift, which reshapes your breast tissue creating upper pole fullness, elevates them higher on the chest wall and more medial to increase your cleavage.  This technique maintains nipple sensation, the ability to breast feed and avoids the ugly vertical scars of the lollipop or boat anchor shaped incisions.  Most women refuse breast lifts because of the ugly vertical scars but this technique eliminates them.  If you want an implant to increase your size that can also be done simultaneously but it may not be necessary. 


Best Wishes,


Gary Horndeski, M.D.

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

Breast lift and augmentation

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

Some surgeons stage a breast lift and augmentation and some surgeons do both at the same time.  It depends.

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

The pros of lift with augmentation

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

The choice of a single procedure makes lift with an implant an obvious positive for most, and staging a procedure is much talked about, though our guess few would op for two procedures. Unless your implant decision is very large and a challenge to the breast skin, a single operation ought to do.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Pros and cons of simultaneous breast lift and augmentation

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

There is no easy and general answer to this question. It all depends on the specifics of the two procedures and the experience and risk tolerance of the surgeon, as well as of the patient. When planned carefully and without extremes (such as extreme amount of lift or extreme size of implant), the two procedures may be performed simultaneously. The pro, of course, is you have one surgery with one recovery course and possibly a lower cost. The disadvantage is there may be an increased risk of complication due to compromised blood flow since a lift generally tightens the breast envelope and the augmentation with expand it. These to conflicting factors may compress the intervening blood flow and cause healing problems. The other disadvantage is that if there are too many moving parts (i.e. change in nipple location, change in skin envelope dimensions, change in volume and distribution of volume, etc.) the end result can be a bit less predictable. However, an experience surgeon can factor some of these variables and produce safe and reliable results. I typically will perform the two operations together if possible.

Robin T. W. Yuan, M.D.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

What Are the Pros and Cons Associated with Having a Breast Lift with Augmentation?

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

                      I typically perform the breast lift and augmentation at the same time, and my revision rate is next to nothing.   Certainly, the operations can be staged.    Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations and 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

What Are the Pros and Cons Associated with Having a Breast Lift with Augmentation

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

Those who prefer doing these procedures in stages do so in the belief that the risks of major complications are lower. In that regard, the outcome is better.

If the lift can be accomplished with a vertical mastopexy and the implant is not very large, many surgeons would do this in a single operation. 

All the best. 


Jourdan Gottlieb, MD
Seattle 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.