Q: What are the pros and cons of a breast lift with implants?

Pros A single, safe surgical procedure can address multiple cosmetic issues. Breast implants re-volumize the breast envelope, improving shape and projection, while the lift (mastopexy) eliminates excess tissue and raises the breasts higher on the chest wall. The procedure also gives the nipples and areolas a more youthful size, shape, and position. Having both procedures simultaneously saves time, in both surgery and recovery. You’ll also save money by paying just once for the anesthesia and facility. Many providers also discount their total surgeon’s fee when you combine procedures. Having both procedures may also make you more satisfied with your results. According to a 2018 study on quality of life after breast augmentation , patients who got breast implants with a breast lift were significantly more satisfied than patients who had a standard breast lift alone. Cons You’ll pay more than you would for just one procedure, though your combined cost will be less than having both procedures separately. You’ll also be under anesthesia longer than if you had just one procedure, which adds some risk. Every surgical procedure creates scars, though they will soften and fade over time. It’s possible that your results won’t match your expectations. You may even decide to have revision surgery to improve your outcome, which could add significantly to your cost. Results of a breast lift with implants aren’t always permanent. Sagging can recur as you age or your weight changes. Related: 5 Myths About Saggy Breasts and Restoring Perkiness with a Breast Lift

Question 1

What is a breast lift with implants?

Accepted Answer

The combination of a breast lift with implants, also known as “mastopexy with augmentation,” can enhance breast shape, size, and position.

This outpatient cosmetic surgery addresses both sagging tissues (ptosis) and lost breast volume, restoring a full, youthful appearance to breasts that have deflated and sagged due to aging, pregnancy, breastfeeding, and/or dramatic weight loss.

It’s not unusual for women seeking breast lift surgery to have reservations about getting saline or silicone breast implants along with a lift—especially if they want their breasts to be higher, perkier, and rounder, but not necessarily bigger. Dr. Otto Placik, a board-certified plastic surgeon in Chicago, explains that there are two ways to accomplish this: the surgeon can reduce excess lower breast tissue and skin, while restoring the upper pole fullness that creates cleavage with an implant (commonly called minus/plus procedure). Or they can perform selective fat transfer to the upper or inner areas of the breast, “to enhance localized fullness or cleavage.”

Question 2

What are the pros and cons of a breast lift with implants?

Accepted Answer

Pros

A single, safe surgical procedure can address multiple cosmetic issues. Breast implants re-volumize the breast envelope, improving shape and projection, while the lift (mastopexy) eliminates excess tissue and raises the breasts higher on the chest wall.
The procedure also gives the nipples and areolas a more youthful size, shape, and position.
Having both procedures simultaneously saves time, in both surgery and recovery.
You’ll also save money by paying just once for the anesthesia and facility. Many providers also discount their total surgeon’s fee when you combine procedures.
Having both procedures may also make you more satisfied with your results. According to a 2018 study on quality of life after breast augmentation, patients who got breast implants with a breast lift were significantly more satisfied than patients who had a standard breast lift alone.

Cons

You’ll pay more than you would for just one procedure, though your combined cost will be less than having both procedures separately.
You’ll also be under anesthesia longer than if you had just one procedure, which adds some risk.
Every surgical procedure creates scars, though they will soften and fade over time.
It’s possible that your results won’t match your expectations. You may even decide to have revision surgery to improve your outcome, which could add significantly to your cost.
Results of a breast lift with implants aren’t always permanent. Sagging can recur as you age or your weight changes.

Related: 5 Myths About Saggy Breasts and Restoring Perkiness with a Breast Lift

Question 3

How much does a breast lift with implants cost?

Accepted Answer

The price you pay will depend on the details of your surgery (including the type of implants you get), your surgeon’s level of experience, their practice location, the type of anesthesia you have, and a few other key factors.

See our complete guide to the cost of a breast lift with implants

Question 4

Breast lift with implants before and after pictures

Accepted Answer

The breast lift with implants photos in our gallery have been shared by the surgeon who performed the procedure, with the patient's consent.

Question 5

Who makes a good candidate for a breast lift with implants?

Accepted Answer

Good candidates for a breast augmentation with lift are healthy nonsmokers who have maintained a consistent weight (excluding pregnancy) over time, and have at least one of these concerns:

Nipples pointing down or falling below the breast crease (inframammary fold)
Breasts that have become flatter or longer over time, due to volume loss or sagging (ptosis)
Skin that has stretched due to aging or weight loss

Not everyone needs both a lift and implants, but if you have sagging breasts and breast volume loss, a combined procedure can remedy both issues.

Implants alone are not a substitute for a breast lift. If you have only mild dropping and your breast tissue still has good elasticity, an implant may slightly elevate the nipple. But for patients with moderate to severe drooping, deflated breasts (a condition known as “pseudo ptosis”), implants can make the heaviness worse.

If you just want more lifted, smaller breasts, you might consider a breast lift with a breast reduction instead. Dr. Placik also notes that “a small amount of fat transfer may achieve limited areas of fullness,” without the need for an implant.

Question 6

What happens at the initial consultation?

Accepted Answer

Your first step is a consultation with at least one qualified, board-certified plastic surgeon, to make sure that a lift with implants is the best way to get the results you want.

Bring “wish pic” photos of how you’d like to look. “The use of ‘goal’ pictures is very helpful. I have found that terms such as ‘natural’ or ‘full DD cup’ mean different things to different people,” says Dr. Tom Pousti, a board-certified plastic surgeon in San Diego.

You’ll need to disclose your medical history, including any medications or supplements you’re taking, your past surgeries or medical conditions, and your overall health. Also let your provider know if you or someone in your family has a history of breast cancer.

Your surgeon will examine, measure, and photograph your breasts. Then they’ll discuss your surgical options. Your treatment plan will be tailored to your body shape, aesthetic goals, and personal preferences about scars.

Your plastic surgeon will also help you determine which type of implants you want—you can choose between saline or silicone gel—and what size and shape you’d like to be.

Related: 5 Things to Know About Choosing the Right Breast Implant Size

Then you’ll discuss whether the implants will be placed above or below the pectoral muscle. Both options have pros and cons.

Once the details of your treatment plan have been worked out, your prospective surgeon should provide you with a detailed cost estimate, including the anesthesia, facility fee, supplies, and any other costs (not just their surgeon’s fee). If you’re not comfortable paying out of pocket, ask if they offer payment plans or accept financing options.

RealSelf Tip: According to the American Society of Plastic Surgeons (ASPS), you may be advised during your breast lift surgery consultation to “get a baseline mammogram before surgery and another one after surgery to help detect any future changes in your breast tissue,” which could be a sign of breast cancer. Mammograms are essential for every woman over age 40. After a breast lift and augmentation procedure, you’ll need to wait several months (up to six) for your incisions to heal and scars to strengthen before having another mammogram.

Question 7

How does a breast lift with implants procedure work?

Accepted Answer

This outpatient procedure usually takes 2 to 4 hours. You’ll most likely be under general anesthesia (fully numb and unconscious), but some surgeons do perform breast surgeries with local anesthesia and IV sedation.

Once the anesthesia takes effect, your provider will use one of these incision techniques:

Lollipop or vertical lift: One incision is made around the areola, and another runs vertically from the bottom of the areola to where the breast and chest meet (aka the inframammary fold), creating the shape of a lollipop.
Anchor or inverted-T lift: Incisions are made around the areola and vertically down the middle of the breast (forming that lollipop design), and then a separate cut is made horizontally along the breast crease, creating an upside-down T. This method is ideal for patients with heavy sagging, often after significant weight loss.
Periareolar, “donut,” or “Benelli” lift: A full-circle incision is made around the outer edge of the areola (a procedure often used for sagging or areola resizing). This technique lifts the breast just about two centimeters; to achieve a greater degree of lift, your surgeon will need to use one of the techniques described above.
Crescent: One incision is placed around part of the areola, in a crescent moon shape. This technique is best for correcting minor sagging or for nipple positioning.

Next, your surgeon will reshape your breasts, removing excess skin and tissue while repositioning and possibly reducing the size of your nipples and areolas.

Then they’ll insert the breast implants either above or below the muscle, depending on the decision you made together during your consultation.

Finally, your surgeon will insert interior stitches to support your breast tissue. “For cases of severe laxity of weak ‘atrophic’ tissues,” the surgeon may use an internal absorbable mesh, aka an “internal bra,” to “reinforce and maintain the position of the breast tissue and/or implant,” notes Dr. Placik.

Related: An Internal Bra Could Be the Key to Achieving Perfectly Perky Breasts

Finally, the incisions will be closed with sutures, medical glue, or surgical tape.

They may also place surgical drains, to collect excess blood or fluid. You'll get instructions on how to empty the drains and monitor the fluid levels until the drains are removed.

Once you’ve recovered from the anesthesia, you’ll go home with your breasts wrapped in dressings, possibly wearing a surgical bra.

You’ll be groggy from the anesthesia, so make sure you have a friend or family member there to take you home and stay with you for at least the first night.

Question 8

How long does recovery take?

Accepted Answer

Full recovery from a breast augmentation with lift takes about six weeks, starting with a week of downtime (possibly longer, if your job involves heavy lifting). Here’s what to expect during that time:

You’ll be given prescription pain medication, to alleviate any discomfort during the first week.
Your chest will feel tight, and you’ll have swelling, bruising, and soreness. Sleeping upright can help reduce swelling.
You may also experience numbness in your nipples or throughout the entire breast, which can last from four to six weeks.
If you have surgical drains, your surgeon will remove them at your first post-op appointment, within the first week of your recovery. They’ll probably change or remove your bandages as well.
You won’t be able to reach for things or lift anything over five pounds during the first week, and you may need to keep your arms at your sides.
Pain can often be managed with over-the-counter painkillers after the first week.
“Surgeons vary in their recommendations for post-operative supportive garments during the first 6 weeks after surgery,” Dr. Placik explains, but yours may recommend a support bra.
Your doctor may give you the green light to return to work (especially a desk job) at the one-week point.
“Most patients are not ready to go back to strenuous activity, like going to the gym, for at least four to six weeks,” advises Dr. Paul Fortes, a Houston plastic surgeon. “But returning to light activities, such as going back to work under conditions that do not require a whole lot of physical exertion, is feasible after one week of recovery time.” Dr. Placik agrees that “only low-impact activities are advised during this period.”
After your incision sites heal, you will have scars. They should be relatively thin but can be raised, red, or lighter/darker than your skin tone. The scars will fade and the texture will smooth out naturally over time. However, you can apply a silicone scar treatment to reduce discoloration and flatten raised scars.

RealSelf Tip: One week before breast lift surgery, prepare for your recovery by picking up prescriptions and any recommended supplies—such as antiseptic soap and arnica cream, a homeopathic remedy sometimes used to reduce bruising. Also buy a backrest or travel neck pillow for sleeping upright at night, to help reduce swelling, protect your breasts while they heal, and make it easier to get out of bed.

Related: Expectation vs. Reality: 5 Women Share What Their Breast Augmentation Recovery Was Really Like

Question 9

When will you see results from a breast lift with implants?

Accepted Answer

You’ll see more fullness and less sagging immediately after this type of breast lift surgery.

Sometimes the breasts are higher than they will be when they eventually settle. This process, commonly called the “drop and fluff,” can take up to six months. Your surgeon can recommend self-massage techniques to help with the process.

Results are long-lasting, but don’t assume they'll be permanent. The aging process will continue, and weight fluctuations can affect your breast size and shape. Some women choose to have implants removed or replaced years down the road.

RealSelf Tip: Doctors on RealSelf recommended waiting to have breast surgery if you’re currently pregnant or nursing or plan to be soon. It’s not risky, but breasts can change dramatically during pregnancy and breastfeeding, so Dr. Placik recommends that surgical planning “take future childbearing and nursing into consideration.” It’s best to wait until at least six months after you’ve finished breastfeeding before having breast surgery.

Question 10

What are the risks of a breast lift with implants procedure?

Accepted Answer

A breast lift and augmentation is considered a safe outpatient procedure, but all types of surgery can have potential complications.

Risks associated with a breast lift with implants include:

capsular contracture, a hard capsule of scar tissue that can form around the implant
numbness, which usually resolves within a few months as the nerves repair
uneven breasts or nipples
damage to the nipples or areolas and future difficulty with breastfeeding

Asymmetry is a cosmetic risk of this procedure. “While all breasts have some minor degree of asymmetry, combining a lift with an implant increases the potential for asymmetry of the scars, nipples, areola, breast volume and/or implant position,” cautions Dr. Placik. In some cases, it can be so noticeable that patients choose to have a revision procedure.

For more information on implant risks, see our complete breast implant safety guide.

A 2013 study published in the journal Plastic and Reconstructive Surgery concluded that the rates of complication and revision for a combined breast lift and augmentation surgery were not any higher than for each of the procedures when performed separately.

Following your mastopexy with implants, you’ll need to alert the technician performing your routine mammograms to your implants. “Several special mammography views must be taken to allow visualization of both the breast tissue and the implant,” says Encino, California plastic surgeon Dr. Sean Younai.

Implants can obscure up to 25% of breast tissue during imaging, so “women with implants [must] undergo four additional views, as well as the four standard images taken during diagnostic mammography,” explains Dr. Younai. “In these additional X-ray pictures, called Eklund views or implant displacement (ID) views, the implant is pushed back against the chest wall and the breast is pulled forward over it. This allows better imaging of the forward-most part of each breast.”

These mammogram ID views are easiest to capture when the implants are placed underneath the chest muscle.

Question 11

What are the alternatives to a breast lift with implants?

Accepted Answer

There aren’t many procedures that will give you the same results as a breast lift with implants.

A breast lift by itself may be all you need if you’re concerned with sagging, while a breast augmentation will just restore fullness. If you’re concerned with sagging due to heavy breasts, you can get a breast reduction instead.

As we mentioned above, a “minus/plus” procedure can reduce excess tissue at the bottom of the breasts, while restoring upper pole fullness with an implant. This procedure also involves repositioning the nipple and areola, for a more youthful look.

If you don’t want implants, it is possible to have a breast augmentation procedure with fat grafting. This procedure takes fat from your hips, thighs, or stomach via liposuction and moves it to your breasts.

Question 12

Sources & studies

Accepted Answer

“Combined Breast Lift and Augmentation Is Safe, Suggests Study in Plastic and Reconstructive Surgery.” American Society of Plastic Surgeons, 2 Jan. 2013.

Kalaaji, Amin, et al. “Quality of Life After Breast Enlargement With Implants Versus Augmentation Mastopexy: A Comparative Study.” Aesthetic Surgery Journal, vol. 38, no. 12, Dec. 2018.

Rinker, Brian, et al. “Breast Ptosis.” Annals of Plastic Surgery, vol. 64, no. 5, May 2010.

BREAST LIFT WITH IMPLANTS

Dr. Otto Joseph Placik

Jolene Edgar

Dr. Otto Joseph Placik

Jolene Edgar

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Dr. Otto Joseph Placik

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