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Choosing the Right Procedure: Breast Lift, Breast Augmentation, or Both?
Jan 17, 2018

Do I need a breast lift or implants? This is a question patients frequently ask us. Generally speaking, a breast lift reshapes and sculpts the nipples and breast mound, whereas a breast augmentation enhances cleavage and upper-pole fullness. Depending on your anatomy and desired outcome, you may choose to undergo a breast lift, a breast augmentation — or maybe both. Here’s what you need to know before making this critical decision for a surgical procedure in Paramus.


What’s the difference between a breast augmentation and a lift?

Breast lift and breast augmentation surgeries are in many cases complimentary, but aim to achieve very different aesthetic goals.

All breasts, with or without implants, owe their unique shape to a combination of three tissues:

  • Structural tissue that provides a “footprint” for the breast on the chest wall and tethers the breast against gravity. This includes the pectoralis and serratus muscles of the chest.
  • Soft tissue that plumps the breast and provides its pliable form. This can be augmented with silicone or saline implants.
  • Skin that drapes the breast and molds to the soft tissue, but does not provide structural support.

Sometimes, patients are happy with the volume of their breasts and simply want to give them a perkier, more youthful appearance. In such cases a breast lift is generally recommended.

A breast lift, also known as mastopexy surgery, is an operation that changes the shape and positioning of the breast tissue. This can mean moving the nipple up, reducing the breasts’ volume, or removing loose skin.

Removing and tightening loose tissue in the lower area of the breast can provide a dramatic rejuvenating effect to patients with sagging, droopy breasts. This isn’t a one-size-fits-all operation, but for simplicity’s sake let’s think of a breast lift as a “sculpting” of existing tissues.

On the other hand, breast augmentation surgery involves the use of silicon or saline implants to add volume to the breast’s soft tissue.

Implant shapes and sizes vary, but most breast augmentation patients undergo the procedure to enhance upper pole fullness and projection. Your surgeon will help you choose the ideal implant that takes into account your existing breast tissue, anatomy, and aesthetic goals.

breast enhancement surgery

RELATED: Over vs Under the Muscle Implant Placement

Will implants help lift my breasts?

According to recent studies, most men and women agree that the ideal location of the nipple-areola complex is in the middle of the breast gland vertically, and slightly lateral to the midpoint horizontally.

Unfortunately, nipples that are excessively low or point downwards can’t be repositioned through breast augmentation surgery. Breast implants may also fail to correct the overall shape of the breast, especially if there’s a lot of loose skin.

In short, breast augmentation surgery will not lift drooping breasts and nipples — in fact, it can actually make matters worse by further stretching the skin.

Your surgeon might recommend a breast lift in addition to breast implant surgery if:

  • The nipples are at or below the breast fold (the crease or bra-line under the breast). This is called nipple “ptosis.”
  • There is a significant amount of loose skin on the breast due to breast-feeding, weight loss or aging.

Still wondering which approach is best suited for you? Feel free to ask us. Drs. Gary D. Breslow and Jordan P. Farkas are widely recognized as leading authorities in breast enhancement surgery, and have successfully performed these procedures on countless patients from New Jersey and beyond.

breast lift and augmentation surgery

Breast augmentation with lift — This very athletic mother of two children was concerned about the deflated appearance of her breasts. A lift and a breast augmentation with silicone implants were performed to restore their shape and volume. Credits: Dr. J. P. Farkas. View more breast surgery before and after pictures here.

How does my natural anatomy influence the operation?

The human body is a dynamic structure, and the breast plays important functional and aesthetic roles. Your plastic surgeon will likely consider many complex and interrelated factors when advising you on the best procedure for your individual needs.

In puberty and adulthood the soft tissue of the breast naturally expands, contracts, and remodels in relation to hormonal stimuli (sexual development, monthly cycles, and menopause), weight changes, pregnancy, and breastfeeding. For most women, the breast naturally sags over time. Later on in life, breast tissue is usually slightly atrophied and the nipples point downwards.

Aside from aging, there are several other factors that may bring patients to consider breast surgery. For someone who is trangendered, is recovering from breast cancer, or suffers from a genetic condition that impedes the natural development of the breasts, plastic surgery can be a transformative experience.

Regardless of your reasons for considering a breast lift and/or a breast augmentation, the important thing is to have a clear understanding of each procedure’s purpose and limitations. An open discussion with your surgeon will allow you to determine the best approach to achieve your desired outcome.

Additional Reading and References

About the Author

Dr. Gary Breslow, MD, FACS

Dr. Gary Breslow, MD, FACS

Is a highly regarded plastic surgeon in Paramus New Jersey, known by both patients and peers as a problem-solver with a warm, engaging personality, and an instinctive ability to identify and truly understand the goals of his patients and the patients, themselves. Dr. Breslow has dedicated his efforts to providing results of only the most unsurpassed quality, continually staying abreast of the most advanced techniques in cosmetic surgery for the benefit of his patients. Dr. Breslow is Board-Certified by the American Board of Plastic Surgery, is a member of the American Society of Plastic Surgeons, is a Fellow of the American College of Surgeons, and is licensed to practice plastic & reconstructive surgery in both New Jersey and New York.

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