Combining Breast Lift with Augmentation: What You Need to Know

Many women experience both loss of volume and breast sagging—common after pregnancy, breastfeeding, weight loss, or aging. When this happens, combining a breast lift with augmentation often provides the best results. Understanding this combined procedure helps you determine if it's right for your goals.

When Is Combined Surgery Recommended?

A combined breast lift with augmentation, called augmentation mastopexy, addresses two issues simultaneously:

Signs You May Benefit from Combined Surgery

• Loss of breast volume AND sagging
• Nipples that point downward or sit below the breast crease
• Stretched, larger areolas
• Breasts that have lost shape and fullness
• Significant size difference between breasts with sagging

The "Pencil Test"

A simple way to assess sagging: If a pencil placed under your breast stays in place when you release it, you may have ptosis (sagging) that a lift can address.

Understanding Each Procedure

Breast Lift (Mastopexy)

A lift reshapes and raises the breast by:

• Removing excess skin
• Tightening surrounding tissue
• Repositioning the nipple and areola higher
• Reducing enlarged areolas if needed

Breast Augmentation

Augmentation adds volume through:

• Silicone or saline breast implants
• Fat transfer (in some cases)
• Placement above or below the muscle

Benefits of Combining Procedures

Single Surgery, Single Recovery

• One anesthesia experience
• One recovery period
• One set of post-operative visits
• Less overall downtime than two separate surgeries

Optimized Results

• Surgeon can balance lift and volume in one procedure
• Better control of final shape and position
• More harmonious, natural-looking outcome

Cost Efficiency

• Single facility and anesthesia fee
• Reduced total surgical costs compared to staged procedures
• One period of time off work

Considerations and Trade-offs

Increased Complexity

Combining procedures is technically more demanding, making surgeon experience particularly important.

Slightly Higher Risk Profile

• Longer surgery time
• Potential for more bruising and swelling
• Healing of lifted tissue around implants requires careful technique

Staged Procedures Sometimes Preferred

In certain cases, your surgeon may recommend separating the procedures:

• Very significant sagging requiring extensive lift
• History of poor wound healing
• Certain health conditions
• Patient preference for staged approach

What to Expect: The Procedure

Consultation

Your surgeon will:

• Assess your breast anatomy and skin quality
• Discuss your size and shape goals
• Recommend implant type, size, and placement
• Explain the specific lift technique needed
• Review incision patterns and resulting scars

During Surgery

1. General anesthesia is administered 2. Lift is performed first (excess skin removed, tissues tightened) 3. Implant pocket is created 4. Implant is inserted and positioned 5. Incisions are closed with layered sutures 6. Surgical bra or bandages are applied

Surgery typically takes 3-4 hours.

Recovery Timeline

First Week

• Most critical healing period
• Moderate to significant swelling and bruising
• Surgical bra worn 24/7
• Limited arm movement and no lifting
• Prescription pain management
• Rest at home essential

Weeks 2-4

• Swelling begins to decrease
• Many return to desk work by week 2-3
• Continue surgical bra wear
• Gradual increase in daily activities
• No strenuous exercise

Weeks 4-6

• Significant improvement in swelling
• Transition to supportive sports bra
• Light exercise may be approved
• Implants begin to "drop and fluff"

Months 3-6

• Final results become apparent
• Scars continue to fade and mature
• Full activity typically resumed
• Enjoy your rejuvenated, enhanced shape

Incision Patterns and Scarring

Combined surgery typically requires more incisions than augmentation alone:

Common Incision Patterns

• Anchor/Inverted-T: Around areola, vertical line down, and along breast crease (for moderate to severe sagging)
• Lollipop/Vertical: Around areola and vertical line down (for mild to moderate sagging)
• Periareolar: Only around areola (for minimal sagging)

Your surgeon will recommend the incision pattern that best addresses your sagging while minimizing visible scarring.

Choosing the Right Surgeon

Augmentation mastopexy requires advanced surgical skill. Ensure your surgeon:

• Is board-certified in plastic surgery
• Has significant experience with combined breast procedures
• Can show before-and-after photos of similar cases
• Takes time to understand your goals
• Explains realistic expectations clearly

Questions to Ask at Your Consultation

1. Am I a candidate for combined lift and augmentation? 2. Would you recommend staged procedures instead? 3. What implant size and type do you recommend? 4. What incision pattern will you use? 5. How do you manage the risks of combined surgery? 6. What is your revision rate for this procedure?

Realistic Expectations

Understanding what combined surgery can and cannot achieve helps ensure satisfaction:

Can Achieve

• Lifted, more youthful breast position
• Increased fullness and volume
• Improved shape and projection
• Better symmetry
• Enhanced self-confidence

Cannot Achieve

• Perfect symmetry (some natural asymmetry is normal)
• Prevention of future aging or sagging
• No visible scarring (scars will fade but are permanent)

With the right surgeon and realistic expectations, combining breast lift with augmentation can beautifully address both volume loss and sagging, creating results that neither procedure alone could achieve.