Breast Augmentation vs. Breast Lift

Two procedures that are commonly confused are breast augmentation and breast lift. It is very common for people to request a surgical procedure to their breasts. However, it is often difficult to understand which procedure they need. To figure out which procedure is best, we must first begin with describing what each procedure is specifically.

The most basic way of distinguishing between a breast lift and breast augmentation is that a breast augmentation “augments”, or enlarges. A breast lift “lifts.”   So, the first thing you have to figure out is what you want changed about your breasts. Do you want them lifted or do you want them larger?  Sometimes you want both.

How do you know if your breasts need to be lifted?

Let’s start with figuring out if your breast needs are drooping or sagging. Drooping breast is also called “ptosis.” This means that the breast tissue is hanging down below the breast fold. This results in nipples that point downward to the floor. Breast ptosis commonly occurs after weight loss, aging, and pregnancies. To figure out if your breasts are sagging, you need to look at the relationship between the breast fold and the nipple. You can place a pencil underneath your breast, within the fold, and look in the mirror. If your nipple is located below the breast fold, then you have ptosis. The surgical treatment is to lift your breasts up to a higher and more perky position with a breast lift, or “mastopexy.”

What exactly is a breast lift?

A breast lift, or mastopexy, is the surgical treatment for lifting the breast. This involves removing excess skin that is around the areola and the lower portion of the breast. This will elevate the breast tissue into a position, similar to if you were wearing a push-up bra. At the same time, the breast tissue on the inside is shaped, usually with internal stitches, making the breast tissue more round, giving a more youthful and perky appearance.  A breast lift basically only removes skin and elevates the nipple position, but does not remove any underlying breast tissue.

Where are the scars for a breast lift?

The surgical scars for a breast lift are specifically determined by the amount of skin that needs to be removed and the location of the skin that needs to be removed. There are several surgical techniques that are determined by the amount of ptosis you have. For very small lifts, it is common for the incision to be kept just around the areola. More extensive skin removal will involve an incision that goes down the front of the breast. This is commonly referred to as a “Lollipop scar”. In other cases, where the breast requires additional skin removal in the brass fold, a fold scar is added to the lollipop scar.  This gives an “anchor scar”. During your consultation your surgeon will be able to tell you which type of breast lift you will require for your desired needs, and therefore which scar you will have.

Does a breast lift make your breasts smaller?

This is a really good question. A breast lift by definition only removes skin and re-shapes the internal breast tissue. This means that there is zero change in your breast volume.  However, the breast is lifted into a tighter and more perky position. This commonly makes the breast appear slightly smaller even though it technically is the same size. Most people find that their breast will appear about half a cup to a full cup smaller after a breast lift. This is something to keep in mind because if you are going to be unhappy if your breasts appear smaller after your breast lift, then you may be someone who may want to discuss other options with your surgeon.

Can a breast lift be combined with a breast implant?

Absolutely! It Is not uncommon to combine a breast lift with a breast augmentation. This is specifically because sometimes people want their breasts larger AND lifted. Remember a breast implant does not lift, it only makes the breast larger. In many situations, a breast implant will give the appearance of a lift, but it’s not really lifting. It’s just replacing volume which fills the breast and can make it look round or fuller and more lifted. However, if you truly have ptosis, as described earlier, then only a breast lift will lift. If you would like your breast lifted and larger than you can have a breast lift and an implant placed at the same time.

The other reason to have a breast lift and a breast implant combined would be if you are concerned that your breasts will look smaller after your breast lift. As discussed, it is not uncommon for breast to appear about one half to one full cup smaller after a breast lift. Many patients will opt for placement of a very small implant at the same time as their breast lift in an attempt to replace volume decrease that often accompanies a breast lift.

Remember, breast implants come in a variety of sizes from extra small to extra-large and everything in between. Therefore, if you just want a very small amount of volume added to your breast lift, then you may do well with a very small implant at the same time. The other advantage of placing an implant at the same time of a breast lift is that the implant can give a rounder appearance to the breast, which is desirable, especially in situations of weight loss and deflation and drooping after pregnancy.

Does the scar change if I have a combined breast lift and breast implant?

When these two procedures are combined, the scar is the scar of the breast lift. This means that the implant will be placed through the incisions that are necessary for your breast lift – around the areolar, lollipop, or anchor.  Adding a breast implant to a breast lift procedure will not require any additional incisions and any changes in your scars.

Will combining a breast lift and breast implants make my recovery longer?

In general breast lift and breast implants are tolerated very well with a relatively rapid recovery. Doing these two procedures at the same time will not make your recovery significantly harder. If your implants will be placed under the muscle there will be some added chest pain associated with placement of the implants.

Can I have implants placed after my breast lift?

If you are unsure whether or not you want to have breast implants and a breast lift, it is not unreasonable to split these procedures up. This means that you would have the breast lift and then see what you think. It is very likely that you will be happy with your breast lift results. If after you are healed from your breast lift, you decide that you want your breast to be larger, then you can have a breast augmentation. This means that your surgeon will perform another procedure in which he or she places implants into your breasts. While this does mean that you will need a second surgical procedure, it is a very good option for people who are just not sure if they need implants to go along with their breast lift.

We understand that it can be a confusing topic, which is why it’s important to be examined by a board-certified plastic surgeon experienced in breast procedures to help you decide which is best for you. During your consultation, your surgeon will examine you and determine whether or not your primary issue is ptosis, or drooping, versus involution, or shrinking, of breast tissue. Figuring this out will help determine which procedure is best for you. In some situation it may even be possible to place your own fat in your breasts at the same time as your breast lift, to give you more volume without you having to have a breast implant placed.

To learn more about what is the best option for you, you can contact our office and set up your consultation with New York City board-certified plastic surgeon Dr. Matthew Schulman.

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