Breast Lift with Implants

A breast lift with implants, also known by the medical term augmentation mastopexy, is two operations performed together. The lift component reshapes the breast and repositions the nipple. The implant component adds volume. The combined procedure may be considered when both lower breast position and a loss of fullness are present, and where neither operation on its own would address what the patient is looking for.

It’s a more complex procedure than either operation done in isolation, and that complexity affects the conversation we have about risks, the chance of needing revision surgery in the future, and the trade-off between performing the surgery in a single stage or splitting it into two separate operations. The decision to combine the two procedures or to stage them is made on an individual basis, and there’s no single right answer that applies to every patient.

Some patients have both a change in breast position and a loss of fullness. The breast tissue sits low on the chest, the nipple is below the fold, and the upper part of the breast looks deflated. A lift on its own reshapes the breast and lifts the nipple but doesn’t add volume, which can leave the upper pole looking flat. An implant on its own adds volume but doesn’t lift the breast, which can leave the breast looking heavy or push the implant into a poor position. When both concerns are present, combining the two operations can produce a more balanced outcome than either alone.

It’s worth being clear about the trade-off. Augmentation mastopexy carries the combined risks of both operations, plus some additional considerations relating to blood supply and healing where the two procedures interact at the same site. The revision rate is higher than for either operation done by itself. Patients who go in expecting a single perfect outcome from a combined procedure often need to be prepared for the possibility that a touch-up procedure may be needed down the track. We discuss this honestly at consultation.

Augmentation and lift can be performed in a single operation or in two separate stages. Each approach has advantages, and the right choice depends on the specific anatomy and the priorities of the patient.

The single stage approach has the advantage of one anaesthetic, one hospital admission, and one recovery period. For patients with relatively simpler anatomy and modest lifts, single stage surgery is often the appropriate choice. The staged approach involves performing the lift first, allowing the breast to heal and settle, then performing the augmentation as a second operation some months later (or, less commonly, the augmentation first followed by a lift later). This can reduce some specific risks, particularly when more complex lifts are required, when the blood supply to the nipple is a concern, or when the breast has been operated on previously.

Whether single stage or staged surgery is the better fit for your situation is a judgement made at consultation, and Dr Shepherd will explain the reasoning behind his recommendation.

Dr Shepherd uses silicone gel implants. Implants vary in shape, surface texture, profile, base diameter and total volume, and the choice is made together at consultation, weighing your anatomy, tissue quality, lifestyle, and what you want the final result to look like. The conversation is similar to the one for a standalone augmentation, with the additional consideration of how the implant will interact with the lift component, where the implant will sit in relation to the reshaped breast tissue, and how the lift technique will need to be modified to accommodate the implant.

Like any breast implant, the implants used in augmentation mastopexy aren’t lifetime devices and may need to be replaced or removed at some point in the future. Long-term follow-up of the implants and of the breast itself is recommended.

Augmentation mastopexy is performed under general anaesthesia in an accredited hospital, with the operation typically taking between two and four hours depending on the lift technique and the implant approach. Most patients stay in hospital for one night and are discharged the following day.

During surgery, the lift component reshapes the breast and repositions the nipple on a pedicle of tissue that maintains its blood supply. The implant is placed either behind the breast tissue (subglandular) or in a dual plane position (with the upper part behind the muscle and the lower part behind the breast tissue), depending on what’s been planned at consultation. Excess skin is removed and the incisions are closed in a way that minimises tension on the suture lines.

Recovery brings together elements of both lift and augmentation. Most patients describe moderate discomfort and tightness across the chest for the first week, easing steadily after that as the swelling settles and the tissues begin to mature. You’ll wear a surgical bra continuously for several weeks, including overnight, to support the reshaped breasts and reduce tension on the suture lines.

Heavy lifting, vigorous exercise and overhead activities should wait around six weeks. If your work is desk-based, you’re usually right to return after a week or two, with longer for physical roles. Final breast shape develops over several months as swelling settles and the implants find their position behind the reshaped breast tissue. Scars take 12 to 18 months to mature.

This combined procedure carries the risks of both operations together. The recognised risks include:

Dr Henry Shepherd, BMed MD MS (Plast.) FRACS (Plast.) | Specialist Plastic Surgeon | AHPRA registration: MED 0001860545