Do I Need a Breast Augmentation or Breast Lift – Or Both?

If you’re unhappy with the appearance of your breasts, you’re not alone. Many women have concerns about breast volume and sagging after pregnancy and nursing or as they age. But the good news is you have many solutions at your disposal. At my San Antonio plastic surgery practice, breast augmentation is typically an ideal option for women who want to restore volume to breasts. If your primary concern is fixing sagging breasts, a breast lift is often the best way to go. If you’re wondering whether a breast augmentation or breast lift is best for you or if you can benefit from combining both procedures, I’m breaking down everything you need to know below. Plus, learn why these two popular procedures often go hand-in-hand.

To learn whether or not breast augmentation, a breast lift, or a breast lift with implants is right for you, please request a consultation or call (210) 942-6672 to schedule an appointment. During your consultation, we will discuss your aesthetic goals and I will recommend the appropriate treatment for your needs.

Breast Augmentation

Breast augmentation, also known as augmentation mammoplasty, is a surgical procedure to increase the size, shape, or fullness of the breasts. This is typically achieved using breast implants or fat transfer. Here are the 4 main components of the procedure:

1. 1. Breast Implants: These are medical devices placed under the breast tissue or chest muscles. They come in various shapes, sizes, and materials, most commonly silicone gel or saline (sterile salt water). Dr. Ablavsky performs a breast augmentation with implants with an incision though the crease of the breast. The incision is well camouflaged, minimizes the risk of lateral implant malposition (implant falling of to the side), and capsular contracture which can occur at higher rates if placed though the nipple/areolar complex.
2. 2. Fat Transfer: This involves using liposuction to take fat from other parts of the body and inject it into the breasts.
3. 3. Surgical Procedure:
   • Incision: The surgeon makes an incision in one of several possible locations (in the crease under the breast, around the nipple, or in the armpit).
   • Placement: The implant is placed either under the pectoral muscle (submuscular placement) or directly behind the breast tissue (subglandular placement).
   • Closing: The incisions are closed with sutures, skin adhesive, or surgical tape.
4. 4. Recovery: Patients typically need some time to recover, with specific instructions on how to care for the breasts, medications to apply or take orally, and follow-up appointments with the surgeon.

Breast augmentation can be performed for various reasons, including enhancing the appearance of breasts that are naturally small, restoring breast volume lost after weight reduction or pregnancy, achieving better symmetry, or reconstructing the breast after mastectomy or injury.

Who Is a Good Candidate for Breast Augmentation?

A good candidate for breast augmentation typically meets several criteria. These include:

1. 1. Overall Health: Candidates should be in good general health, without any active infections, untreated cancer, or serious illnesses that could complicate surgery or recovery.
2. 2. Age: The FDA requires patients to be at least 18 years old for saline implants and 22 years old for silicone implants. However, individual circumstances can vary, and younger patients may be considered in specific cases, such as breast reconstruction.
3. 3. Realistic Expectations: Candidates should have realistic expectations about the outcomes of the surgery. They should understand what breast augmentation can and cannot achieve.
4. 4. Stable Weight: It’s generally advisable for candidates to be at a stable weight before undergoing breast augmentation, as significant weight fluctuations can affect the results.
5. 5. Non-smokers: Smoking can impair healing, so non-smokers or those willing to quit before and after surgery are preferred.
6. 6. Psychological Readiness: Candidates should be psychologically stable and have a positive outlook. They should be undergoing the procedure for themselves, not to fulfill someone else’s desires or to try to fit an ideal image.
7. 7. Breast Development: Candidates should have fully developed breasts. In some cases, developmental issues or asymmetry may be reasons for considering the procedure.
8. 8. Specific Concerns: Candidates often have specific concerns they wish to address, such as:

• Dissatisfaction with breast size
• Loss of breast volume after pregnancy, weight loss, or aging
• Asymmetrical breasts
• Breast reconstruction after mastectomy or injury

A thorough consultation with a qualified plastic surgeon is essential to determine if breast augmentation is a suitable option, as the surgeon will evaluate the candidate’s health, discuss goals and expectations, and explain the potential risks and benefits of the procedure.

Advantages of a Breast Augmentation

Breast augmentation offers several advantages, which can be both physical and psychological. Here are some of the main benefits:

• Enhanced Appearance: One of the most significant advantages is the improvement in the size, shape, and symmetry of the breasts, which can enhance overall body proportion and aesthetics.
• Boosted Confidence and Self-Esteem: Many women experience increased self-confidence and self-esteem following breast augmentation. Feeling more satisfied with their appearance can positively impact various aspects of their lives.
• Improved Fit of Clothing: Breast augmentation can make it easier to find clothing and swimwear that fits well and looks flattering, which can be a significant boost to one’s confidence and comfort.
• Restoration After Pregnancy or Weight Loss: The procedure can restore breast volume and shape lost due to pregnancy, breastfeeding, or significant weight loss, helping women regain their pre-pregnancy or pre-weight loss body contours.
• Correction of Asymmetry: Many women have naturally asymmetrical breasts. Breast augmentation can correct this imbalance, creating a more symmetrical and harmonious appearance.
• Reconstruction After Mastectomy: For women who have undergone mastectomy (breast removal due to cancer or other conditions), breast augmentation can be a crucial part of breast reconstruction, helping restore a sense of normalcy and wholeness.
• Personal Satisfaction: Achieving a desired breast size and shape can provide personal satisfaction and happiness, fulfilling a long-held desire or addressing insecurities.
• Customization: The procedure is highly customizable. Women can choose from various implant types, sizes, shapes, and placement options to achieve their desired look.
• Long-Term Results: Breast implants are designed to be long-lasting, providing durable results. While implants may not last a lifetime, many women enjoy their enhanced appearance for many years.
• Minimal Scarring: Advances in surgical techniques have led to less invasive procedures with minimal scarring. Surgeons can often place incisions in discreet locations to reduce visible scarring.

Breast Lift

A breast lift, also known as mastopexy, is a surgical procedure designed to raise and reshape sagging breasts. Unlike breast augmentation, which focuses on increasing breast size, a breast lift aims to improve the contour and position of the breasts. Here are the key aspects of a breast lift:

What Is the Purpose of a Breast Lift?

• Lift and Reposition: The primary goal is to lift the breasts to a higher position on the chest and improve their shape.
• Reshape: It can also reshape the breast tissue to create a firmer and more youthful appearance.
• Nipple Repositioning: The procedure often involves repositioning the nipple and areola to a more youthful height.

How Do I Know If I Need a Breast Lift?

A good candidate for a breast lift typically meets several specific criteria. These include physical, emotional, and situational factors that can influence the success and satisfaction with the procedure. Here are the characteristics of an ideal candidate:

• Sagging or Drooping Breasts: Candidates usually have breasts that sag or droop due to factors such as aging, pregnancy, breastfeeding, weight fluctuations, or genetics. The nipples may point downward or fall below the breast crease.
• Breast Asymmetry: Candidates with asymmetrical breasts or nipples can benefit from a breast lift to achieve a more balanced and symmetrical appearance.
• Stable Weight: Candidates should be at or near their ideal body weight. Significant weight fluctuations can affect the results of the surgery.
• Good Overall Health: Candidates should be in good physical health, without any medical conditions that could impair healing or increase the risk of surgery.
• Nonsmokers or Willing to Quit: Smoking can impede the healing process and increase the risk of complications. Candidates who smoke should be willing to quit before and after surgery.
• Realistic Expectations: Candidates should have realistic expectations about what the surgery can achieve. While a breast lift can improve the shape and position of the breasts, it may not significantly change their size or fullness. Understanding the potential for scars and the recovery process is also important.
• Emotional Readiness: Candidates should be emotionally stable and undergoing the procedure for personal reasons, rather than to meet someone else’s expectations or to achieve an unrealistic ideal.
• Fully Developed Breasts: Candidates should have fully developed breasts. Typically, this means the procedure is more suitable for adults rather than adolescents.
• No Plans for Immediate Pregnancy: Future pregnancies can alter the results of a breast lift, as the breasts may sag again due to hormonal changes and weight fluctuations. Candidates should ideally have completed their families or not plan to become pregnant soon after the procedure.

What Is a Breast Lift Procedure Like?

During a breast lift procedure, there are usually 4 primary steps required to achieve a lifted, restored shape:

• Anesthesia: The procedure is typically performed under general anesthesia, although intravenous sedation may also be used. This ensures the patient is comfortable and pain-free during surgery.
• Incisions: Various incision patterns can be used, including around the areola, vertically down to the breast crease, and horizontally along the breast crease.
• Reshaping and Lifting: After making the incisions, the surgeon lifts and reshapes the underlying breast tissue to improve breast contour and firmness. If necessary, the surgeon removes excess skin, tightens the surrounding tissue, and lifts the breast tissue to a higher position. The nipple and areola are often repositioned to a more natural, youthful height. If necessary, enlarged areolas are reduced by excising skin at the perimeter. In some cases, the areola may need to be completely detached and grafted to a higher position, though this is less common. Incision lines are typically well-concealed within the natural breast contours but will result in some permanent scarring.
• Post-Surgery Dressings and Support: Dressings or bandages are applied to the incisions. You may be required to wear a supportive surgical bra or compression garment to minimize swelling and support the breasts as they heal.

What Kind of Incisions Are Used During a Breast Lift?

The specific technique and incision pattern depend on the degree of sagging, the patient’s anatomy, and the desired outcome. Common incision patterns include:

1. 1. Periareolar Incision: An incision made around the areola.
2. 2. Vertical Incision: The incisions are made around the areola and vertically down to the breast crease (also known as the “lollipop” incision).
3. 3. Anchor Incision: The incisions are made round the areola, vertically down to the breast crease, and horizontally along the breast crease.

What Is Recovery from Breast Lift Surgery Like?

Recovery time varies, but most patients can return to normal activities within a few weeks. Patients may need to wear a surgical bra or compression garment to support the breasts as they heal. Follow-up appointments with the surgeon are necessary to monitor the healing process.

For the first several days, you will likely experience some swelling, bruising, and discomfort, which can be managed with prescribed medications. I advise my patients to avoid strenuous activities and heavy lifting for several weeks. Follow-up appointments with your surgeon are crucial to monitor the healing process and ensure proper recovery.

Learn more about step-by-step recovery from breast lift on my blog.

Benefits of a Breast Lift

A breast lift, or mastopexy, offers several benefits for individuals looking to improve the appearance and position of their breasts. Here are some of the main advantages:

• Improved Breast Shape and Contour: A breast lift can create a more youthful and aesthetically pleasing breast shape by removing excess skin and tightening the surrounding tissue.
• Enhanced Breast Position: The procedure lifts sagging breasts to a higher position on the chest, which can enhance overall body proportions and create a more attractive silhouette.
• Rejuvenated Appearance: By repositioning the nipples and areolas to a more natural, youthful height, a breast lift can significantly rejuvenate the appearance of the breasts.
• Increased Confidence and Self-Esteem: Many women experience a boost in confidence and self-esteem after a breast lift, feeling more comfortable and satisfied with their appearance.
• Better Fit of Clothing and Bras: Post-surgery, many women find that their clothes and bras fit better, which can enhance comfort and improve their overall look.
• Correction of Asymmetry: A breast lift can address asymmetrical breasts, making them more even in shape and position, which can improve overall body balance and symmetry.
• Long-Lasting Results: While the aging process continues, the results of a breast lift are long-lasting, especially when combined with a healthy lifestyle and stable weight.
• Minimal Risk of Complications: When performed by a qualified and experienced surgeon, the risks of complications from a breast lift are relatively low, and the procedure is generally considered safe.
• Customizable Procedure: The surgery can be tailored to meet the specific needs and aesthetic goals of the individual, allowing for a high degree of customization in terms of the extent of lifting and reshaping.
• Enhanced Body Proportions: By lifting and reshaping the breasts, the procedure can improve overall body proportions, creating a more balanced and harmonious figure.
• Combination with Other Procedures: A breast lift can be combined with other procedures, such as breast augmentation or reduction, to achieve the desired breast size and shape, offering comprehensive breast enhancement.
• Natural-Looking Results: Advances in surgical techniques have made it possible to achieve natural-looking results, with minimal visible scarring and a more natural breast shape and feel.
• Long-Term Results: The results of a breast lift are immediately visible, with improved breast shape and position. However, final results will become more apparent as swelling subsides and incision lines fade over time. The longevity of the results can be influenced by factors such as aging, gravity, weight fluctuations, and lifestyle.

Important Considerations When Deciding to Have a Breast Lift

A breast lift does work to reshape and reposition the breasts, but it does not significantly change the size of the breasts. If increased volume is desired, a breast lift can be combined with breast augmentation.

You will have scars on your breasts. Scarring is a consideration, but many women find the benefits outweigh the visibility of scars, which often fade over time.

Benefits of Combining Procedures – Why This Approach Is a Win-Win for Most Women

Combining a breast lift (mastopexy) with breast augmentation can offer several significant benefits, providing a comprehensive approach to breast enhancement. Here are the key advantages of undergoing both procedures simultaneously:

1. 1. Enhanced Shape and Size: The combination of a breast lift and augmentation not only lifts sagging breasts but also adds volume and fullness. This dual approach can create a more youthful and attractive breast contour.
2. 2. Improved Breast Symmetry: For women with asymmetrical breasts, combining both procedures allows the surgeon to address differences in size, shape, and position, achieving a more balanced and symmetrical appearance.
3. 3. Single Surgery and Recovery Period: Performing both procedures in one surgical session reduces the overall recovery time compared to having them done separately. This means less time off work and daily activities and a quicker return to normal life.
4. 4. Cost-Effective: Combining the procedures can be more cost-effective than having them done separately, as it often reduces the overall cost of anesthesia, operating room fees, and other related expenses.
5. 5. Customized Results: This approach allows for a high degree of customization. The surgeon can tailor the procedures to meet the specific aesthetic goals and anatomical needs of the patient, whether they desire a subtle lift with slight augmentation or a significant change in both size and position.
6. 6. Comprehensive Enhancement: Women experiencing both sagging and loss of volume (commonly after pregnancy, breastfeeding, or weight loss) can achieve comprehensive enhancement, addressing both concerns in one surgery.
7. 7. Natural-Looking Outcomes: When performed together, the procedures can complement each other, resulting in more natural-looking outcomes. The lift can enhance the position and shape, while the augmentation adds volume and fullness.
8. 8. Increased Confidence and Satisfaction: Many women experience a significant boost in confidence and satisfaction with their body image after combining a breast lift and augmentation, feeling more youthful, balanced, and proportionate.
9. 9. Correction of Multiple Issues: This combination is particularly effective for women dealing with multiple breast issues, such as sagging, deflation, and asymmetry, providing a comprehensive solution to achieve their desired breast appearance.
10. 10. Long-Lasting Results: The combined procedures can offer long-lasting results, especially when performed by a skilled and experienced plastic surgeon. Maintaining a stable weight and a healthy lifestyle can further extend the longevity of the results.
11. 11. Harmonious Proportions: By addressing both the lift and augmentation, the procedures can create harmonious proportions not only in the breasts but also in the overall body silhouette, enhancing the patient’s figure as a whole.

Take the Next Step

Combining a breast lift with breast augmentation can be an excellent option for women seeking comprehensive breast enhancement. Schedule your breast enhancement consultation online or call Ablavsky Plastic Surgery in San Antonio at (210) 942-6672 to discuss individual goals, the potential risks, and the benefits of the combined approach to ensure it aligns with your expectations and needs