I am debating between a breast lift vs. a breast lift and augmentation.

After 3 kids and aging (4o years old) my breasts are droopy, I am a C cup. Does one (lift vs augmentation) have longer lasting results (when it comes to sagging again)? I am concerned that even with the smallest of implants that they will become too big for my liking. But, I am also unsure if a lift on its own will be enough. Will they remain deflated and flatten when putting on a bikini top for example with just a lift?

Doctor Answers 13

The Bellesoma Method for natural perkier breasts

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Thank you for your question, 

You do not need implants! All you need is a breast lift that will use your own tissue to fill the top of your breasts. The Bellesoma Method was not only designed to achieve upper pole fullness without implants, but it has also eliminated the dreaded vertical scar component. Breasts are beautifully reshaped and elevated with minimum scarring. Long term results are this technique's hallmark. An internal support is fashioned using a woman's own tissue to keep the newly shaped breast high for years to come. Nipple sensitivity along with the ability to breast feed is also preserved. Remember, implants are not stable devices and as such require maintenance in the form of costly revisions. 

I hope this helps. 

Best wishes and kind regards, 

Dr. Gary Horndeski

Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Breast reduction, breast lift, lipolift, mastopexy

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I appreciate your question.

Its hard to answer your question without photos.

I perform a liposuction breast lift that removes tissue from the areas you don't want such as near the armpit and the lower portion hanging near your stomach. Once I use this to shape the breast I then remove the skin to tighten the breast and create a better shape with nice cleavage. Since I perform this less invasively the recovery time is faster and drains are not necessary. The size would depend on the proportion with your body versus going for a cup size. It works very well if there are asymmetries. I can also use the removed fat as a natural breast augmentation by grafting the fat back into the breast to create more projection or into the top to create more cleavage. If you have shoulder grooves from your bras, I can also use the fat to fill these areas in and give you more cushioning as well as contour. This procedure can also be combined with an implant if needed or wanted.  It should not affect nipple sensation, mammograms, cancer risk or breast-feeding. If you gain or lose weight, the transferred fat can do the same.

The best way to assess and give true advice would be an in-person exam.  Please see a board-certified plastic surgeon that specializes in aesthetic plastic surgery.  

Best of luck!    

Dr. Schwartz 

Board Certified Plastic Surgeon



Breast Lift versus a Breast Lift and Augmentation

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An experienced plastic surgeon can often sculpt breast tissue during a breast lift to give good support to the breast. If you do not want to change your size with implants a very reasonable consideration is to have the breast lift without an implant and live with it for a while and decide how you like it.

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Breast lift vs. a breast lift and augmentation

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If you are happy with your breast size, do not want any increase, and, as you state, you are afraid that even a small implant may make you larger than you wish, then you should just have a breast lift. This will not decrease your volume, just lift and reshape your breast. It will not, however, give you any increased upper pole breast fullness. If you are looking for upper pole fullness, then you will need an implant. Also, you state that your breasts are droopy. If by droopy you mean overhanging, then be aware that you will need a breast lift whether or not you get implants, as implants fill out but do not lift breasts, and an excessively overhanging breast will hang off the implant unless a lift is performed as well. If by droopy you mean deflated but not overhanging, then a lift is not indicated (there is no place to lift them!), and implants to fill out the deflated breast is the best option. 

Fill them up vs. Lift them up

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If you want your breast fuller and are happy with the shape of them, then an implant will be fine. Keep in mind an implant will only "fill our breast up" it will not "lift them up". They will look just like they do now, they are just bigger and fuller with an implant only. If you feel this will meet your goals, then an augmentation should be fine. If you are unhappy with the position of your breast and feel they are too low, then an implant will likely not satisfy you and you will want to consider the lift. A lift will "lift them up" and put them in a higher position, change the size of the areola and "lift" them off of your chest. Often times both of these procedures are combined to achieve an optimal result. By lifting them and adding volume, the breast will not only sit higher on your chest but will also have the nice fullness from the implant. In your case a breast lift with augmentation is likely going to give you the best result.  Dr Scott Ennis

Lawrence Scott Ennis, MD, FACS
Pensacola Plastic Surgeon
5.0 out of 5 stars 162 reviews

Whether or not to have implants

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is a pretty easy decision because its based on whether you want to be larger or not.  If you want size, then you will need implants.  If you just want perky, a lift will be good enough.  And fat grafting (assuming you have some extra fat around) can be used to bolster the upper pole and even add a little size to the mound as lifts tend to slightly diminish your cup size.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Breast Lift Options

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If you're looking for perkiness, you may need  a lift—but  if you also want more volume, an implant may be sufficient to increase your breast size and give your breasts a perkier appearance. A breast lift raises droopy breasts from one to several inches and excess skin is removed. If you just want to go bigger, the only way to do that is with implants or even fat grafting which is the newest technique for you to enlarge your breasts without resorting to implants! Specially prepared fat taken from another part of the body, such as the stomach or hips, is placed under the breast tissue to provide increased breast size without the need for artificial implants. The technique is called autologous fat transfers and autologous simply means "your own." These are some of the factors I weigh with my patients when evaluating what type of procedure to do.

Michelle Copeland, MD, DMD
New York Plastic Surgeon
4.6 out of 5 stars 10 reviews

I am debating between a breast lift vs. a breast lift and augmentation.

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It's a very good question. A breast lift raises the nipple and reshapes the breast. This gives a very natural appearance. Some women desire more fullness at the top of their breasts. This is where adding an implant to the lift can help. The breast implant provides this additional fullness at the upper pole and in the upper portion of the cleavage area. Implants can be sized conservatively for women who don't want to be too big. Consultation with a board-certified plastic surgeon will be most helpful. They will talk with you about a lift, and give you the opportunity to try on implants. It's also possible to perform a breast lift first and then wait to judge your results, before deciding whether to add an implant at a later date.

Lift vs Lift Plus Augmentation?

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It is difficult to offer guidance without photos but here are a few thoughts to consider. The simultaneous combination of lift and augmentation is associated with  a high complication and revision rate particularly if a significant lift is required or a larger implant is used. So you could proceed with just a lift for now and see how well that works for you. If you find that it doesn't provide sufficient upper pole fullness you could return after six months and add in an implant. While this approach requires two separate operations the risks are lower and you will have a better idea of what size implant will work well for you.

I am debating between a breast lift vs. a breast lift and augmentation.

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The difference between your two options being considered is volume. If you are relatively happy with your volume or something a we bit smaller, then just the lift would be appropriate. I always tell patients if they can be happy with just a lift and no implants they are better off because once you have implants you can be sure there is always another surgery in your future. And there is nothing wrong with doing the lift alone and if you are not totally satisfied, then add the implants at a later date. Without photos to know your specific situation, that is about as far as we can go with advice at this time. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

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.