Breast Lift with Implants
A breast lift, or mastopexy, reshapes and adds volume to the breasts, which may have been lost due to aging, weight loss, genetics, or pregnancy. Often, the nipple and areola are shifted to a higher, more youthful position. Breast implants are silicone envelopes filled with saline or cohesive silicone gel, which add volume to existing breast tissue. The two surgeries can be combined in a procedure known as a breast lift with implants or an augmentation mastopexy.
This surgery combines the reshaping techniques of a breast lift with the volumizing effect of breast implants. Since a lift doesn’t significantly change the size of the breasts, women who may want additional volume may choose this option or use fat transfer instead.
A breast lift is performed by “restructuring the breast tissue,” says Knoxville plastic surgeon Dr. David Reath. “In many women, a delicate incision around the nipple area is all that is needed. In others who have a large amount of excess skin, the incision will need to be extended.”
There are three major kinds of breast lifts, depending on incision type:
Breast implants, meanwhile, come in a number of shapes and sizes but fall into two main groups based on the implant’s filling.
Most women who seek a breast lift with implants have noticed changes to their breasts brought on by age, pregnancy, and/or gravity. Over time, there’s typically more volume loss on the upper portion of a woman’s breast. Those choosing to undergo this procedure want the additional volume a traditional breast lift can’t provide, even if it’s just to fill the upper portion without increasing bra size.
When deciding between your own options, consider what you want your breasts to look like after surgery. Do you want them to look like they do now, only perkier? More youthful? Fuller? All of the above?
If the latter, a lift with implants or fat transfer may be right for you.
“There are a couple of criteria that plastic surgeons use to determine if a patient needs a lift or not,” says Atlanta plastic surgeon Dr. Edwin Pound, III. “If the nipple is below the level of the crease under the breast then a breast lift is probably necessary. We also measure the distance from the small notch at the base of the throat to the nipple. Ideally, for most, this distance should be 18 to 22 centimeters. Anything more than that probably means a breast lift is indicated.”
Talk to your doctor about your goals to develop a surgical plan that works best for you. “How perky do you want to be? What shape do you want to have?” asks Newport Beach plastic surgeon Dr. Larry Nichter. “The answer to your question [about whether a breast lift with implants is right for you] lies in letting your surgeon know specifically what you would like to look like following the surgery.” Dr. Nichter finds that having patients bring in “wish pics” from a plastic surgeon’s website is especially helpful in recommending the best procedure.
The price of a breast lift with implants varies, but expect an average price tag of around $8,800. This is typically more than a breast lift or breast implants alone. The price range varies due to factors such as type of lift, type of implants, experience of the surgeon, where the surgery takes place (office, surgical center), the length of the procedure, and geographic location, among others.
As with any elective procedure, the most important factor in choosing a doctor is experience. We recommended having multiple consultations before selecting a surgeon.
Here are some guidelines to follow when researching a doctor:
Check Qualifications
While any doctor can legally offer a breast lift or breast augmentation, you want to look for a board-certified plastic surgeon who performs the procedure frequently and has proven safe results. “There are a lot of doctors who are cosmetic surgeons or board-certified in other fields,” says Atlantic plastic surgeon Dr. Johnny Franco. “They do not have the same training as a plastic surgeon.” Check the American Board of Plastic Surgery website to verify certification.
Verify Hospital Privileges
“Hospitals often examine qualifications of doctors applying for hospital staff privileges and restrict these to only surgeons best trained and qualified to do certain procedures,” explains Dr. Nichter. “Non-surgeons and other physicians that are not plastic surgeons (e.g. OB/GYN, dermatologists, emergency physicians, general surgeons, etc.) circumvent this process by performing surgery in their offices or in outpatient surgery centers where the credentialing is less rigorous or nonexistent. In these settings, non-plastic surgeons may perform procedures in which they have no formal training.”
Dr. Nichter does not warn against having a breast lift with implants performed in-office or at outpatient centers. In fact, most of these surgeries are. However, he recommends you verify that your physician does have hospital privileges for this procedure.
Ask About the Operating Facility
“It is critical to ask about the surgery center where your procedure will be performed,” explains Raleigh plastic surgeon Dr. Michael Law. “You need to know about accreditation, sterile processing procedures, and who will be with you in the surgery.”
You can check accreditation with the American Association for Accreditation of Ambulatory Surgery Facilities [AAAASF] or another nationally recognized body.
Look at Before & After Photos
Ask how many breast lifts with implants the doctor has performed and how frequently they do them. Then “insist on seeing before and after photos,” says Dr. Law. “A plastic surgeon with experience and expertise should have dozens of images from different angles, all with the same lighting, distance from the camera, and cropping.” Also consider looking at before and after photos posted online by other patients, to be certain you’re seeing real results.
If you’re looking for a licensed and qualified plastic surgeon to perform your breast lift with implants, use the RealSelf Doctor Finder.
Breast implants are measured in cubic centimeters (ccs). The same size of implant or amount of fat will look different on each individual. It’s important to discuss expectations and desired results with your surgeon so he or she can help you decide what’s right for you. Many doctors use digital imaging software as a way to see how you might look with different levels of ccs, but this technology may not be accurate. Bringing “wish pics” to your consultation is very helpful, as is using implant sizers placed in your bra preoperatively.
“It is important to be in good medical condition before any elective plastic surgery,” says Seattle plastic surgeon Dr. Mary Lee Peters. This includes, but isn’t limited to, being physically active, eating well, and avoiding certain products before surgery that may contribute to bleeding (your surgeon will provide these details as they apply).
Just as important as good physical health is good mental health. “Before going into any cosmetic surgery,” says Chicago plastic surgeon Dr. Sam Speron, “it’s important to have a positive and realistic frame of mind.” There is only so much any surgery can do, so be sure you’re clear on your surgeon’s plan and the expected results, including scarring.
Also, check out this list of 13 things to do before your procedure, courtesy of the RealSelf community.
A breast lift usually takes between 90 minutes and four hours. With the addition of implants, expect the procedure to be at the longer end of that spectrum. Typically, a patient is put under general anesthesia (goes to sleep).
During the procedure, your surgeon will likely use one of these three breast lift incisions: donut, lollipop, or anchor. Read more on these incision types here.
Breast lifts with implants are most often outpatient procedures, so you’ll need someone to drive you home and monitor your recovery for the first one to two days post-op.
Recovery from a breast lift with implants varies person to person, but expect an average recovery of seven to 10 days, if no physical activity is required.
For the first six weeks, your doctor will likely recommend that you avoid exercise or lifting anything over 10 pounds. After this time, you should be able to assume all normal activity; however, it may take several months for your breasts to settle into their new place, with complete healing often taking at least a year.
Your doctor may also recommend massaging your breast implants. The body naturally forms a thin inner membrane or “capsule” around the implant. Massage helps create room in the “pocket” so that your implant doesn’t sit too tight. Depending on the recommendations of your surgeon, massage may not be needed for textured implants.
“Although there is very little science behind this, anecdotal experience shows me that my patients who do not massage their implants tend to have a higher risk for high-riding implants and capsular contracture,” says Denver plastic surgeon Dr. Gregory A. Buford, who recommends his patients massage several times a day until their implants have completely settled, which could take anywhere from a week to several months. Your doctor will advise you on what routine is best for you and when you should begin implant massage. (This may range from 24 hours to a week or two after surgery or, in the case of some doctors, never.)
As for pain, it depends. A traditional breast lift by itself is typically not very painful. Adding the implants, however, may increase the level of discomfort, especially if placed below the muscle which gives a sensation of pressure or tightness.
“Of the two procedures, a breast lift is often the less painful, especially when [compared to] breast augmentation done by placing the implants under the chest wall muscle,” says Nashville plastic surgeon Dr. Alexander G. Nein. “Nevertheless, it is sometimes better to place the implants underneath the muscle in order to achieve the best cosmetic result.” Discuss which option — above or below the muscle — is best for your desired post-surgical results.
After swelling has subsided, which may take months to fully resolve, expect your breasts to be higher, perkier, and larger than they were before surgery. There will be scarring with the incisions red and/or pink immediately following surgery. These will heal and fade over time, but they will never fully disappear.
In most cases, breast implant results last a long time. While there’s a common misconception that implants need to be replaced every 10 to 15 years, Toronto plastic surgeon Dr. Frank Lista says this isn’t necessarily true. “If you have no problems with your implants, then nothing needs to be done with them.”
That said, it’s important to monitor the status of your implants on a regular basis. Those with saline implants can check their status on their own by simply looking in the mirror. Leakage will be obvious as a ruptured implant will deflate and the saline absorbed by the body. Women with silicone implants are recommended to have an MRI three years after initial placement and every two years thereafter to ensure they’re functioning correctly.
In March 2017, the FDA released a report highlighting the possible association between breast implants and the development of a rare type of non-Hodgkin's lymphoma called anaplastic large cell lymphoma.
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare form of lymphoma that can develop following breast implants, according to the FDA's report. The FDA said the condition occurs more frequently with textured surface implants compared to smooth surface implants.
"All of the information to date suggests that women with breast implants have a very low but increased risk of developing ALCL compared to women who do not have breast implants," read the FDA statement. "Most cases of breast implant-associated ALCL are treated by removal of the implant and the capsule surrounding the implant and some cases have been treated by chemotherapy and radiation."
If you have breast implants, the FDA says there is "no need to change your routine medical care and follow-up." The report says to continue to follow your doctor's instructions on how to monitor your breast implants, including routine mammography screening and periodic MRIs to detect ruptures in silicone gel implants.
If you are considering breast implants, the FDA suggests you discuss the benefits and risks of textured implants compared to smooth implants with your doctor.
What is a breast lift with implants surgery?
This surgery combines the reshaping techniques of a breast lift with the volumizing effect of breast implants. Since a lift doesn’t significantly change the size of the breasts, women who may want additional volume may choose this option or use fat transfer instead.
A breast lift is performed by “restructuring the breast tissue,” says Knoxville plastic surgeon Dr. David Reath. “In many women, a delicate incision around the nipple area is all that is needed. In others who have a large amount of excess skin, the incision will need to be extended.”
There are three major kinds of breast lifts, depending on incision type:
- The donut, Benelli, or circumareolar technique achieves a lift by making a donut-shaped incision around the areola. The amount of lift is limited, so the technique offers mild correction to sagging.
- Lollipop or vertical incisions circle the areola and extend downward. This option is rapidly becoming more popular and can be used for moderate to severe sagging correction.
- The anchor technique starts with lollipop incisions and add a horizontal incision along the breast crease. This older technique is particularly helpful in more extreme cases of sagging.
Breast implants, meanwhile, come in a number of shapes and sizes but fall into two main groups based on the implant’s filling.
- Saline implants are filled with sterile salt water. In the event of a leak the implant will deflate. There are two types of saline implants: single lumen (traditional) and the newer double lumen. The double lumen have internal shells designed to make them feel more like silicone and maintain their shape better with less chance of capsular contracture.
- Silicone implants are filled with an elastic gel prior to surgery. They may require a longer incision. In the event of a leak, the body does not absorb the silicone, so you may need regular check-ups and MRIs every few years to monitor the status of the implants.
- You may also hear about cohesive gel breast implants. These implants use a silicone gel that’s thicker than traditional silicone filling and has more of a tendency to maintain its shape. These are also known as “form-stable” or “gummy bear” implants.
Is a breast lift with implants right for me?
Most women who seek a breast lift with implants have noticed changes to their breasts brought on by age, pregnancy, and/or gravity. Over time, there’s typically more volume loss on the upper portion of a woman’s breast. Those choosing to undergo this procedure want the additional volume a traditional breast lift can’t provide, even if it’s just to fill the upper portion without increasing bra size.
When deciding between your own options, consider what you want your breasts to look like after surgery. Do you want them to look like they do now, only perkier? More youthful? Fuller? All of the above?
If the latter, a lift with implants or fat transfer may be right for you.
“There are a couple of criteria that plastic surgeons use to determine if a patient needs a lift or not,” says Atlanta plastic surgeon Dr. Edwin Pound, III. “If the nipple is below the level of the crease under the breast then a breast lift is probably necessary. We also measure the distance from the small notch at the base of the throat to the nipple. Ideally, for most, this distance should be 18 to 22 centimeters. Anything more than that probably means a breast lift is indicated.”
Talk to your doctor about your goals to develop a surgical plan that works best for you. “How perky do you want to be? What shape do you want to have?” asks Newport Beach plastic surgeon Dr. Larry Nichter. “The answer to your question [about whether a breast lift with implants is right for you] lies in letting your surgeon know specifically what you would like to look like following the surgery.” Dr. Nichter finds that having patients bring in “wish pics” from a plastic surgeon’s website is especially helpful in recommending the best procedure.
How much does a breast lift with implants cost?
The price of a breast lift with implants varies, but expect an average price tag of around $8,800. This is typically more than a breast lift or breast implants alone. The price range varies due to factors such as type of lift, type of implants, experience of the surgeon, where the surgery takes place (office, surgical center), the length of the procedure, and geographic location, among others.
How do I choose a doctor for a breast lift with implants?
As with any elective procedure, the most important factor in choosing a doctor is experience. We recommended having multiple consultations before selecting a surgeon.
Here are some guidelines to follow when researching a doctor:
Check Qualifications
While any doctor can legally offer a breast lift or breast augmentation, you want to look for a board-certified plastic surgeon who performs the procedure frequently and has proven safe results. “There are a lot of doctors who are cosmetic surgeons or board-certified in other fields,” says Atlantic plastic surgeon Dr. Johnny Franco. “They do not have the same training as a plastic surgeon.” Check the American Board of Plastic Surgery website to verify certification.
Verify Hospital Privileges
“Hospitals often examine qualifications of doctors applying for hospital staff privileges and restrict these to only surgeons best trained and qualified to do certain procedures,” explains Dr. Nichter. “Non-surgeons and other physicians that are not plastic surgeons (e.g. OB/GYN, dermatologists, emergency physicians, general surgeons, etc.) circumvent this process by performing surgery in their offices or in outpatient surgery centers where the credentialing is less rigorous or nonexistent. In these settings, non-plastic surgeons may perform procedures in which they have no formal training.”
Dr. Nichter does not warn against having a breast lift with implants performed in-office or at outpatient centers. In fact, most of these surgeries are. However, he recommends you verify that your physician does have hospital privileges for this procedure.
Ask About the Operating Facility
“It is critical to ask about the surgery center where your procedure will be performed,” explains Raleigh plastic surgeon Dr. Michael Law. “You need to know about accreditation, sterile processing procedures, and who will be with you in the surgery.”
You can check accreditation with the American Association for Accreditation of Ambulatory Surgery Facilities [AAAASF] or another nationally recognized body.
Look at Before & After Photos
Ask how many breast lifts with implants the doctor has performed and how frequently they do them. Then “insist on seeing before and after photos,” says Dr. Law. “A plastic surgeon with experience and expertise should have dozens of images from different angles, all with the same lighting, distance from the camera, and cropping.” Also consider looking at before and after photos posted online by other patients, to be certain you’re seeing real results.
If you’re looking for a licensed and qualified plastic surgeon to perform your breast lift with implants, use the RealSelf Doctor Finder.
How do I choose the right size implants for a breast lift with implants?
Breast implants are measured in cubic centimeters (ccs). The same size of implant or amount of fat will look different on each individual. It’s important to discuss expectations and desired results with your surgeon so he or she can help you decide what’s right for you. Many doctors use digital imaging software as a way to see how you might look with different levels of ccs, but this technology may not be accurate. Bringing “wish pics” to your consultation is very helpful, as is using implant sizers placed in your bra preoperatively.
How should I prepare for a breast lift with implants?
“It is important to be in good medical condition before any elective plastic surgery,” says Seattle plastic surgeon Dr. Mary Lee Peters. This includes, but isn’t limited to, being physically active, eating well, and avoiding certain products before surgery that may contribute to bleeding (your surgeon will provide these details as they apply).
Just as important as good physical health is good mental health. “Before going into any cosmetic surgery,” says Chicago plastic surgeon Dr. Sam Speron, “it’s important to have a positive and realistic frame of mind.” There is only so much any surgery can do, so be sure you’re clear on your surgeon’s plan and the expected results, including scarring.
Also, check out this list of 13 things to do before your procedure, courtesy of the RealSelf community.
What hapens during a breast lift with implants surgery?
A breast lift usually takes between 90 minutes and four hours. With the addition of implants, expect the procedure to be at the longer end of that spectrum. Typically, a patient is put under general anesthesia (goes to sleep).
During the procedure, your surgeon will likely use one of these three breast lift incisions: donut, lollipop, or anchor. Read more on these incision types here.
Breast lifts with implants are most often outpatient procedures, so you’ll need someone to drive you home and monitor your recovery for the first one to two days post-op.
What’s the recovery time after a breast lift with implants surgery?
Recovery from a breast lift with implants varies person to person, but expect an average recovery of seven to 10 days, if no physical activity is required.
For the first six weeks, your doctor will likely recommend that you avoid exercise or lifting anything over 10 pounds. After this time, you should be able to assume all normal activity; however, it may take several months for your breasts to settle into their new place, with complete healing often taking at least a year.
Your doctor may also recommend massaging your breast implants. The body naturally forms a thin inner membrane or “capsule” around the implant. Massage helps create room in the “pocket” so that your implant doesn’t sit too tight. Depending on the recommendations of your surgeon, massage may not be needed for textured implants.
“Although there is very little science behind this, anecdotal experience shows me that my patients who do not massage their implants tend to have a higher risk for high-riding implants and capsular contracture,” says Denver plastic surgeon Dr. Gregory A. Buford, who recommends his patients massage several times a day until their implants have completely settled, which could take anywhere from a week to several months. Your doctor will advise you on what routine is best for you and when you should begin implant massage. (This may range from 24 hours to a week or two after surgery or, in the case of some doctors, never.)
As for pain, it depends. A traditional breast lift by itself is typically not very painful. Adding the implants, however, may increase the level of discomfort, especially if placed below the muscle which gives a sensation of pressure or tightness.
“Of the two procedures, a breast lift is often the less painful, especially when [compared to] breast augmentation done by placing the implants under the chest wall muscle,” says Nashville plastic surgeon Dr. Alexander G. Nein. “Nevertheless, it is sometimes better to place the implants underneath the muscle in order to achieve the best cosmetic result.” Discuss which option — above or below the muscle — is best for your desired post-surgical results.
What results can I expect from a breast lift with implants?
After swelling has subsided, which may take months to fully resolve, expect your breasts to be higher, perkier, and larger than they were before surgery. There will be scarring with the incisions red and/or pink immediately following surgery. These will heal and fade over time, but they will never fully disappear.
In most cases, breast implant results last a long time. While there’s a common misconception that implants need to be replaced every 10 to 15 years, Toronto plastic surgeon Dr. Frank Lista says this isn’t necessarily true. “If you have no problems with your implants, then nothing needs to be done with them.”
That said, it’s important to monitor the status of your implants on a regular basis. Those with saline implants can check their status on their own by simply looking in the mirror. Leakage will be obvious as a ruptured implant will deflate and the saline absorbed by the body. Women with silicone implants are recommended to have an MRI three years after initial placement and every two years thereafter to ensure they’re functioning correctly.
Is there an increased risk of lymphoma?
In March 2017, the FDA released a report highlighting the possible association between breast implants and the development of a rare type of non-Hodgkin's lymphoma called anaplastic large cell lymphoma.
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare form of lymphoma that can develop following breast implants, according to the FDA's report. The FDA said the condition occurs more frequently with textured surface implants compared to smooth surface implants.
"All of the information to date suggests that women with breast implants have a very low but increased risk of developing ALCL compared to women who do not have breast implants," read the FDA statement. "Most cases of breast implant-associated ALCL are treated by removal of the implant and the capsule surrounding the implant and some cases have been treated by chemotherapy and radiation."
If you have breast implants, the FDA says there is "no need to change your routine medical care and follow-up." The report says to continue to follow your doctor's instructions on how to monitor your breast implants, including routine mammography screening and periodic MRIs to detect ruptures in silicone gel implants.
If you are considering breast implants, the FDA suggests you discuss the benefits and risks of textured implants compared to smooth implants with your doctor.
