Breast Implants with a Breast Lift: Do You Really Need Both?

Decide on Breast LiftThroughout the years plastic surgeons have often had strong opinions about when to do a breast lift alone, when to just put in breast implants, and when to do both. In addition to this, over the past several years there have been new developments in breast augmentation surgery, including short scar breast lifts (or mastopexy), fat grafting, and new breast implant options. These have provided surgeons with even more tools to help patients obtain more youthful, uplifted breasts. If you look in the mirror and you don’t like what you see – perhaps the breasts have become droopy after children or weight loss, or they just seem to have deflated after breastfeeding – there are now more options than ever before. But how do you know what is right for you – breast implants, a breast lift, or both?

Every surgeon has a different way of guiding patients through these options, but the first, most critical step is to really understand what your goals are. Patients may come in for a consultation saying something like “I’m not sure what I want, really. I just know I don’t like the way my breasts look now. I want to look fuller up top, but I don’t want to be too big either, and I want to look natural.” This is very helpful; however, it doesn’t answer the question about a lift, an implant, or both. Separating a lift or implants in your mind can bring a lot of clarity. One way to do this is to simply hold your breast up (replicating a lift) so that the breast is no longer in a low hanging position. This is something your surgeon can do for you during your consultation, or you can even do at home in front of the mirror. This will help you get a sense of your actual breast volume without an implant. If you like the relative size when the breast is manually lifted up, then you may be a great candidate for a breast lift alone. On the other hand, if the breasts are held up and the size just doesn’t give you what you want, then you need to think about breast implants, either with or without a lift.

To figure out this part, you’ll want to rely heavily on the judgment of your surgeon, who will make some measurements of the breast and note the degree of ptosis, or droopiness. If there is very little ptosis, then an implant alone (without a lift) will probably serve you very well. If the ptosis is severe, then putting in an implant alone will not look right, as the breast will appear to “fall off” of the implant. Therefore, a breast lift would be needed in addition to the implant. Not infrequently, however, a patient may lie in a gray zone somewhere in between: in these cases an implant alone may suffice, however will give a more mature or slightly low hanging appearance. The decision then becomes one of personal preference. If you feel that getting the breast as “perky” as possible is important, then a lift in addition to the implant is in order. If you feel that a more mature look is desirable, then you can forgo the lift and the additional scars that are required.

Of course there are advantages and disadvantages of each of the options – a lift alone, a lift with implants, or implants alone. Implants alone typically have the shortest scar, but have only a limited effect in making the breast look more uplifted. When implants are placed there is also the risk that the implants may become mal-positioned, may become encapsulated (firm with scar), or may need to be replaced, all of which may require additional surgeries in the future. A lift alone typically produces longer scars; however, it doesn’t carry the implant-related risks for additional surgery. A combined implant-lift provides control over both breast size and shape, but it also produces both the longer scars and the risk of additional “maintenance” surgeries related to implants. The differences in recovery between these options are usually small, and most women feel they can return to work in about a week after any of these options.

The surgeons at the Emory Aesthetic Center are experts in helping you think through all your options. We use the most up-to-date techniques, implants, imaging systems, and adjunct therapies (like scar therapy) to help you achieve the results that you want. We’ll take the time to thoroughly explore your goals and get a deep understanding of your desires. At the same time, we will work hard to make sure you really understand what options will give you the best results in the long run.

About Dr. Eaves

Felmont Eaves, MDDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

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