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Breast Lift with Implants Q&A - Dr. Hayes Answers the Most Popular RealSelf Questions

9/30/2016

 
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Learn about breast lift with implants surgery. Dr. Hayes explains how this procedure can restore fullness and shape to your breasts. 

What is a breast lift with implants?
A breast lift with implants is a surgical procedure that elevates the nipple, removes sagging breast skin, and adds volume to the breast with a breast implant.

What are the benefits of adding a breast augmentation to a breast lift?
It's obvious that a breast implant adds volume to the breast. This is helpful during a breast lift surgery not only to add volume to the entire breast, but importantly to add volume at the top of the breast (upper pole). 

A breast lift alone gives the breast a natural appearance. A lift creates a teardrop appearance, but tends to lack some of the upper pole fullness that some women desire. This is where a breast implant is helpful. The implant restores fullness to the top of the best giving a "full" look.

What would someone need a lift if they're having a breast augmentation?
It's important to understand that a breast augmentation does not lift the breast or nipple. If the nipple is in a youthful position (above the crease) then only an augmentation is needed. However, when the nipple is at, or below, the crease beneath the breast then a lift may be needed.

Do I need a lift with implants if I only have minor sag to my breast? If so, what type of lift would I need?
When deciding whether to add a lift, I look at the position of the nipple in relation to the crease below the breast.
  • Nipple above the crease: Augmentation only
  • Nipple at the crease: May do well with an augmentation only, but I inform the patient that they may need a lift as a second stage.
  • Nipple below the crease: Needs augmentation AND lift.
    • Depending on the desired implant size and how far the nipple needs to be lifted, this is performed as a single stage or two stage procedure.​

The type of lift depends on the amount of lifting needed:
  • Minimal lifting: Donut (incision around the areola)
  • Moderate lifting: Lollipop (a donut plus an incision from the areola to the crease below the breast)
  • Significant lift: Anchor (lollipop plus a third incision within the breast crease)

What type and size of breast implant should I get?
The most important factor when sizing implants, is working closely with your surgeon in-person to find the implant size that gives you the look that you desire. Careful measurements of your breasts and chest wall will help determine which size implants will fit within your natural breast footprint. Taking into account your desired look, and your measurements, an implant is chosen that specifically fits your body.

For a single stage augmentation and lift (augmentation/mastopexy) I typically use a smooth round silicone implant that is between 200-350cc. For women that would like a larger implant, I separate the two procedures and perform a breast lift (mastopexy) first. I wait six months for everything to heal completely. I then place an implant within the breast during a second stage procedure. Separating the two procedures allows me to use a larger implant, because it eliminates issues caused by the competing goals of expanding the breast size while also removing skin to during the lift. Regardless of the implant size, separating the breast lift and the breast augmentation decreases the chance of needing a revision procedure.

Approximately how big will my breasts get after an augmentation?
This is a good question and it seems obvious that by knowing the implant size you could then predict the final bra size. However, it's actually more difficult than that. Unfortunately, bra cup sizes are not standardized and vary between manufacturers. In my office, I encourage my patients to not focus on the cup size of the bra, but instead find a "look" that they like. If we accomplish that goal look, then the procedure is a success and we only find out the bra size once a formal bra fitting has been performed. It's a rough estimate, but in general every 150-200 cc of breast implant will increase the size by one cup.

Do I need two surgeries for breast lift and augmentation? Why do some surgeons perform a single surgery, while others do it in two steps?
This is a common question and every plastic surgeon has their own preference regarding when to perform a single stage aug/pexy vs. separating the procedure into two surgeries. A two-stage procedure decrease of the risks of having a wound healing problem and decreases the revision rate.

In my practice I performed:
  • Single stage operation: if implant<300-350cc AND nipple moving <6cm
  • Two stage operation: Implant>350cc OR nipple moving >6cm

What is the average cost of a breast lift with implants?
The cost will vary between surgeons and regions of the country. Make sure that you are quoted a total price that includes everything (surgeon's fees, the cost of implants, anesthesia fees, and the fees for the operating room). In our office the price is about $9,000-10,600, but varies based on the specific procedure details. When considering any cosmetic surgery of the breasts, make sure that you see only board certified plastic surgeons.

How do I make an appointment?
To book an appointment, or for further information, contact us online or call (503) 297-9340.

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    Dr. Austin Hayes is a Board-Certified Plastic Surgeon with offices in Portland, Seattle, and Hood River. 

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