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Do I need a Breast Lift or Implants?

One of the most common questions that comes up in the office is, “Do I need a breast lift, or should I get breast implants?” In this blog, we will investigate the answers to this question and share the reasoning to help you understand your choices.

Breast lift and breast augmentation with implants are both very popular procedures that enhance the shape of the breast and help you look and feel better about your body, the way you fit into bras and clothing, as well as your overall sense of femininity. So how do you know which is right for you? Keep reading to learn more…

Breast augmentation is safe, effective, and produces consistently
excellent results.

As a stand-alone procedure, breast augmentation with smooth round silicone gel implants is one of the most commonly performed aesthetic plastic surgery procedures performed
worldwide each year. At PSS, we use our Vectra 3D imaging system to provide realistic simulations of what different implant sizes and profiles look like on your unique body features. Being able to “try on” different implants using this amazing 3D software is one of the most fun parts of the consultation process and you even go home with a photo of your favorite simulation.

Very simply, breast augmentation is designed to add volume to the breast. The volume and profile of the implant will depend on your individual body features, your cosmetic goals, and how much natural breast volume you are starting with. Don’t get too hung up on the sizes and profiles of implants that your friends or relatives may have – your breast implant solution will be customized specifically to your body and desired goals. In general, every 100-150cc of breast implant volume will increase your bra cup size by one level. The implant is placed underneath the chest muscle through a 4cm incision that is hidden in the natural lower breast crease. Breast augmentation is best for women who have a small amount of natural breast tissue that does not match up to the rest of their body proportions or women who have lost a bit of volume after breastfeeding but still have good skin quality.

Breast lift gets a little more complex, but the underlying principle is to restore the shape and position of the breast to a full and youthful appearance. Breasts sag over time for a variety of reasons. Most commonly, the shape and skin quality of the breasts change after breastfeeding. During pregnancy, the breasts enlarge, and the skin stretches. After you finish breastfeeding, the hormones of pregnancy subside, and the breast tissue shrinks back down. This is a process called post-partum involution and the overall changes can leave you with stretched out skin and drooping breasts. When you look in the mirror, it is a definite change from life before babies and you may ask what options exist to restore your breasts to an earlier time. Fortunately, breast lift is a very good option and is very effective in improving your appearance and the way you fill out a bra and look in your clothes.

Breast lift is best for women who are happy with their overall breast volume but want to
remove the excess, stretched-out skin and re-position the breasts to achieve a more youthful look.

There are three main incisions used for breast lift surgery and each has specific indications.

Crescent-Lift

The simplest incision is the crescent-lift which removes a crescent-moon shaped piece of skin from above the nipple/areola complex. The nipple/areola is then lifted, and the resulting scar is nicely hidden at the junction between your normal skin tone and the more darkly pigmented skin of the areola. This procedure is best suited for women who have good shape and volume, but the breast has dropped an inch or two and has lost some fullness up top.

“Lollipop Lift”

The next variation is called a “lollipop lift” and has an incision that goes around the nipple/areola and straight down to the natural breast crease. This technique is used when there is moderate drooping of the breast and some skin needs to be removed to re-shape the breast and transfer the volume from down-low to up-high. A “lollipop lift” works best on round breast shapes where the overall shape can be maintained, and the natural breast volume elevated to a higher position on the chest to restore a nice full and round appearance.

“Anchor” or “Upside Down T”

The last technique is the most common and is very versatile. This involves a “anchor” or “upside down T” incision pattern that offers the most powerful means of lifting the breast tissue and removed excess skin. Using your own natural tissues, we create an “internal bra” of supporting tissue that keeps the breast in an ideal position for many years.


During any kind of breast surgery, it is important to know that nipple sensation may change and that your ability to breastfeed any future children may be impacted. In general, the majority of patients experience some temporary decrease in nipple sensation that returns to normal or near normal in 2-3 months. As for breastfeeding, about half of all breast lift patients are able to breastfeed again without any difficulties. About 25% need to augment breastfeeding with pumping, and the remaining 25% just choose not to breastfeed after having prior breast surgery.

The big question has to do with when to combine breast lift and breast augmentation, a
procedure commonly called an “aug-mastopexy”. The combination of a breast implant with a lift is best for women who want to add some breast volume but also have a good deal of loose skin. If only breast augmentation with implants was performed, the result would be a larger breast that is in poor position due to skin laxity. If only a lift was performed, the resulting breast shape and size would not be attractive to the patient. The augmentation-lift combination often uses low- or moderate profile implants to add breast volume while using the anchor incision to lift the existing natural breast tissue over top of the implant and create a truly remarkable result.

The decision to have an augmentation and lift together is often the best of both worlds and creates the ideal breast size and shape.

The newest addition to this combination is fat transfer to the breast. Fat is collected from common trouble spots like the lower tummy, flanks, and thighs then transferred to the breasts to add volume. About 60-75% of the fat that is transferred will survive and become a permanent part of your breast tissue. Twenty years of fat transfer to the face and buttocks has led to the very stable statistic of fat transfer survival. The importance of stating this is that what you see right after the procedure will change. After fat transfer, you can expect a 25-40% decrease in volume until it stabilizes. At PSS, our three board-certified plastic surgeons have over 75 years of combined experience and will work with you to create a treatment plan that is customized to your individual features, cosmetic goals, budget, and lifestyle.

When you are ready to experience the best cosmetic breast surgery in Marin County and the greater San Francisco Bay Area, look no further than the experts at Plastic Surgery Specialists. We have multiple financing options available and offer virtual consultations to make connecting with us easier than ever.