Getting cosmetic work done on your body is a big decision, especially when it comes to your breasts. Deciding which breast enhancement is best for you can be a long process. One of the first aspects of the decision is to determine whether you want a breast augmentation, breast lift, or a combination of the two, or something else entirely. Sure, you know you want to improve the appearance of your chest, but which parts of it? While it may seem as simple as whether you want your breasts bigger or taller, it’s a little more nuanced than that. Here, plastic surgeons help you pinpoint how to decide whether a breast augmentation, breast lift, or combination is right for you.
First, consider your anatomy
The biggest factor when it comes to considering breast augmentation is your own anatomy and your doctor’s opinion of what might be right for you. “During the consultation, it’s important to discuss with your patient not only their goals, but their physical anatomy and how that will play into their results,” says Houston plastic surgeon Henry Mentz, MD, and physician assistant Nadia Hafeez, PA-C. . “Anatomy is the key to determining whether your patient needs breast augmentation alone versus a breast lift versus a combination of both.”
If you are looking for volume, you will need a breast augmentation
“When do you need a raise? Comfortably. When you want to be older. That’s the easiest,” say Tucson, AZ plastic surgeons Raman C. Mahabir, MD, and Silvia Kurtovic, MD. New York plastic surgeon B. Aviva Preminger, MD notes that many women experience loss of breast volume, as well as sagging, after pregnancy, breastfeeding or weight loss, which may lead them to seek breast augmentation.
“Breast augmentation increases the volume and projection of the breast to create a fuller, more enhanced appearance,” say Drs Mentz and Hafeez. While a raise is great for adding volume, there are some aspects it can’t adjust. “Breast implants alone do not change the shape or position of your breasts on the chest wall, nor do they change the size of the nipple or the position of the nipple-areola complex. Think of it like adding air to a balloon—the balloon already has its shape,” they explain. If the breasts are sagging, an augmentation will not do much to lift them, which may lead people to choose to combine a breast augmentation and a breast lift.
Consider nipple placement
While deciding whether one might benefit from a breast augmentation is a little more straightforward, Drs. Mahabir and Kurtovic say deciding when someone might use a lift can be a little more difficult. The key to deciphering who is a good candidate for a lift is “standing nipple position.” If the nipple is a certain distance below the breast crease, Dr. Pregminger says a lift may be needed.
“Sometimes adding volume achieves enough lift without a formal lift,” says Dr. Preminger. “In other cases, implants can be combined with a surgical lift, or a lift alone can be used to reposition the volume in the upper midpole of the breasts where most women want it.”
Drs. Mahabir and Kurtovic note that you may need to get a second lift down the road if you do a lift without an increase. In addition, they point out that some surgeons offer patients “mesh” or internal support, but none of these options are FDA-approved and warrant a larger debate about the risks versus benefits.
If you are a candidate, you can have both procedures done at the same time for a total breast lift
Many patients choose to do both at the same time to have fuller and more perky breasts. “Adding breast implants to a lift will help improve overall shape and fullness, especially in the upper poles,” Drs Mentz and Hafeez say. However, those who have a significant amount of their own breast tissue often do not need the addition of an implant over a lift to gain shape and volume.
Fat grafting can come into play
Fat grafting, which uses the patient’s own fat to add volume, can be used during a breast lift or augmentation. “In some cases where an implant is not needed or needed, I will perform a breast lift with fat grafting to improve the overall appearance of the breasts,” Dr. Mentz and Hafeez say. “Fat grafting is an excellent way to provide volume and has become extremely popular with patients who desire a more natural appearance.”
Dr. Preminger says she sometimes combines implants with fat for a “complex breast augmentation” to achieve a natural result. “These days, this can also be achieved with fat or by rearranging your breast tissue,” she adds.
