A breast lift and breast augmentation are very different surgeries. However, it is fairly common for a woman to have both. The greatest determining factor is whether your breast position, size/volume or appearance bothers you. If something bothers you about your breasts, but you are not able to pinpoint exactly what, an expert breast surgeon can help you clarify your goals for a breast lift vs. breast augmentation.
Your surgeon will help to determine whether a breast lift and breast augmentation is needed to reach your desired look—or whether you need just a lift or just an augmentation. Many women need a combination of both procedures, so that’s why we always stress that your procedure must be individualized and planned around you.
When to Combine a Breast Lift and Breast Augmentation
An experienced and dedicated breast surgeon will advise you about your options and help you clearly understand the effect of various choices you might make about breast lifting and augmentation. At your consultation, your breast surgeon will often create a solution that combines a breast lift and breast augmentation. In many cases, however, one or the other is sufficient.
Since bodies are typically not symmetrical, it is also common to perform a slightly different procedure on each breast. You may need a larger implant on one side or a lift that brings both breasts into a more even alignment. The combinations and possibilities are nearly endless, especially when you get into implant types, sizes and insertion procedures.
To make your choices simpler, choose an experienced surgeon with whom you communicate well. With proper forethought about your options and careful planning to meet your needs, the satisfaction rate for both breast lifts and breast augmentation is very high.
Keep in mind that your specific breast surgery may be very different from what another woman with a similar figure might need or want, so make sure your surgeon is one who takes an interest in your individual needs and desires—and clearly explains your options for a breast lift vs. breast augmentation.
How to Decide if You Need a Breast Lift vs. Breast Augmentation
A breast lift is needed when there is extra skin or excessive sagging of the breasts due to weight loss, pregnancy and breastfeeding, hormonal changes, gravity and/or age. Another factor is skin elasticity: some women have thicker skin or skin that “snaps back” rather than stretching permanently (after weight loss, for example).
Some women’s skin may hold its shape better than others due to heredity. Lifestyle habits, like smoking and sun exposure, on the other hand, can make skin less elastic. Personal taste comes into play as well, with some women simply preferring breasts that sit higher on the chest. With all these factors in play, there is no specific age group or body type that “needs” a breast lift.
Breast augmentation provides some lift
If you have only a little sagging, and your nipple is above the level of your breast crease, breast augmentation may be used to lift your breasts—essentially “filling up” the excess, or droopy, skin (called ptosis). Often, however, the nipples will need to be repositioned higher on the breast at the same time the implant is placed to achieve a natural, perky and youthful look.
This creates a type of hybrid surgery. Top breast surgeons will offer you the surgical solution you need to achieve your desired outcome and won’t be too concerned if it’s a lift (mastopexty), an augmentation (augmentation mammoplasty) or both a lift + augmentation.
Need a lift? Check the mirror
One rule of thumb that women may use to determine if they are a candidate for a breast lift (with or without an augmentation) is “nipples below the crease.” Stand in front of a mirror and see if your nipple falls below the level of the under-breast crease. If so, you may decide to look into a breast lift and/or augmentation.
If your nipples are pointed downward, that is a common reason many women choose to have a breast lift. Remember that there is no absolute test that can tell you in advance which type of surgery you will need to achieve your goals, whether that means a breast lift vs. breast augmentation. Let an expert breast surgeon advise you at an in-person consultation.
The effect of a breast lift alone
If you are happy with your breast volume, but not the position, a breast lift alone may work well for you. In this case, your surgeon will remove excess skin and reshape the breast so that it sits higher on the chest. The result will be higher, tighter, firmer breasts.
A breast lift alone will not meaningfully change your breast size, nor will it round out the upper part of the breast (where volume is typically lost as sagging occurs). Typically, the nipple must be moved up on the newly reshaped breast mound after a breast lift in order to create a naturally youthful look.
In many cases, when you’re seeking to re-create your youthful look after breast sagging, implants (augmentation) must be used to get the desired effect that you’d like to recapture. Although only skin, not breast tissue, is removed during a lift (unless you undergo a combination breast reduction and lift), the breast may appear smaller in its new, higher chest position. For this reason, many women choose to have breast augmentation as well as a breast lift.
Breast Lift vs. Breast Augmentation: Comparing Procedures, Incisions and Scars
Breast Lift
In some cases, where little excess skin is being removed, your surgeon can use only an incision around the edge of the areola (sometimes referred to as the donut procedure) to move the nipple up and possibly decrease the size of the areola, if desired. (The areola may stretch as breasts sag and many patients request that it be made smaller.)
When more skin must be removed, your surgeon will often make an incision in the skin below the breast (in the crease) and a perpendicular one running up to the areola and around it (sometimes referred to as the lollipop procedure). In this way, your breast surgeon removes excess skin, moves the breast tissue up higher on the chest wall and reshapes it.
The nipple is also generally moved up to a new position for a perky-but-natural look. The breast crease effectively hides one part of the scar and the areola’s edge hides the other. The scar from connecting the two incision sites will typically fade to a thin line over time.
Breast augmentation
If you get breast implants without a lift, you may have the same incision pattern as above. In some cases, saline implants can be inserted through a small incision under the arm, around the edge of the areola or in rare cases, through the belly button—and filled after placement. The implant is placed into a “pocket” (or space) made for it, either under or over your chest muscle.
Decisions about placing the implant above or below the muscle, and about the type (saline or silicone), shape (high profile, low profile, teardrop and others) and size of implant require careful thought. Your surgeon can advise you and help you determine the best course to get the results you desire from your breast surgery.
Proper timing of breast lift vs. breast augmentation
If you need both a breast lift and breast implants, both procedures are typically done at the same time. However, in some cases, the procedures may be done as two separate surgeries. For either or both surgeries, it’s ideal to wait until you have finished childbearing and are at a stable weight before having the procedure.
Changes in your body weight may negate the benefit received from a breast lift or augmentation, causing renewed sagging. Keep in mind that, depending upon your age, breast implants may not last a lifetime and breasts will continue to sag with age, even after a breast lift.
Making the Right Choice for You about Breast Surgery
When you are ready to learn more about whether to choose a breast lift vs. breast augmentation in your specific case, contact Cohen/Winters Aesthetic & Reconstructive Surgery in Bergen County. We offer a consultation to help you learn about your options.
