Breast Lift followed by a separate Breast Augmentation - pros & cons?

My breasts are different sizes (one a B the other a C ), and undersized in relation to my body shape e.g. looking to go to a D or DD. A recent consultant recommended the best result is to lift both and reduce the C in size, and then 8 weeks later have a separate surgery for augmentation (for a better result as the augmentation would cause the lollipop stitching to stretch with the implant whilst healing). I would appreciate your thoughts on if this approach is better?

Doctor Answers 4

Usual Combination of the Implants and Lift

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A #mastopexy or breast lift operation is designed to improve the shape and position of the breasts without reducing their size. It is used for #breasts which sag or droop (ptosis). Sagging of the breasts may occur with normal development for some women, or as part of the aging process. Pregnancy, breast-feeding and weight loss are other conditions which increase breast ptosis. Some patients will have a better shape to their breast such as increased superior fullness if an #implant is used at the time of mastopexy. This is called an #Augmentation/Mastopexy. The procedure can also be combined with a minor breast reduction to reduce the breast width if desired. The surgery will create an elevated, more youthful breast contour. Also, the procedure will create nipple and areolae of the desired size and at the correct height. 

#FatGrafting is another option to using #breastimplants and requires a small amount of liposuction to obtain the fat which is the prepared and transferred to the breast. 

A hybrid operation may use both an implant and fat to provide the best contours of the lifted breast.

I prefer to use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.


Implants and No Lift: This is usually a mistake. Most breasts will look larger and droopier.  They will sag more and sooner because of the excess weight.  The shape will usually not be satisfactory. There will sometimes be a “Snoopy” breast or double bubble.

If the nipples are in a fairly high position on the breast or “glandular” ptosis or drooping, an implant may be useful.

Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Breast Lift followed by a separate Breast Augmentation - pros & cons?

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Thanks for the question. Without examination (or seeing photos of yourself as well as your goals) it is 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 breast augmentation two separate operations

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Hello and thank you for your question.

What you are describing is a "staged" approach in correcting breast asymmetry, breast sagging, and hypomastia or deflation (smaller breasts). There are a number of ways to treat these issues and if you ask three different surgeons, you will likely hear three different answers (lift and implant together, implant first then lift, lift then implant)

Performing a breast lift/reduction excises excess skin to lift the breast tissue and tighten the skin envelope for its given volume. These forces are opposed by placing an implant, which adds weight to the breast and increases its volume.

Performing a breast lift with augmentation in the same operation has the benefit of potentially treating all issues with one operation and in many surgeon's hands is a safe option to consider. However, performing this does have an increased risk of developing wound healing complications and persistent asymmetry that could require a revision surgery. For many surgeons, this risk is acceptable despite being slightly higher than performing two operations in a "staged" fashion.

Doing staged operations by way of performing a breast lift (treating the asymmetry and sagging) first, would slightly decrease your chances of having a wound healing problem and also offer an opportunity to correct any potential minor asymmetries from the breast lift at the time of your augmentation (second surgery).

Deciding on how to proceed has a lot to do with your current amount of asymmetry and what will give you the best results in your surgeon's hands. The key here is to find a plastic surgeon with whom you feel comfortable and trust. Express your questions and concerns then see if their answer makes sense to you.

Hope this helps. Good luck.

Joseph Brown, MD
Tampa Plastic Surgeon
5.0 out of 5 stars 11 reviews

Breast lift with implant

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Hello and thank you for your question. What you are describing is a staged attempt to correct the breast. Some surgeons would consider doing both at the same time with the possibility of minor revisions. Others would consider doing each procedure separately. Without an exam or pictures it is hard to determine which would be best but your surgeon has the advantage of examining you. His approach is not unreasonable. 

Best Wishes

Theodore Nyame, MD
Charlotte Physician

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.