It depends on sagging and volume goals.
During the consultation, one of the most frequent issues women bring up is whether to choose a breast lift (mastopexy) or breast augmentation. It might be the case that you notice your breasts have deflated after breastfeeding or sagging after weight loss and think that “maybe a big implant alone would be enough to fill this loose skin.” On the flip side, you might be so scared of the scars a lift would leave that you hope getting an implant alone is the easiest way. At Lin Europe Clinic, we are experts in delicate “Augmentation-Mastopexy” cases—the combination of these two procedures. We explain why, for a majority of women, going only one route without the other is an unsatisfactory compromise.
The decision “Do I need both?” depends basically on two different aspects:volume and position. Breast implants add volume; they work like a balloon inflating the sac. A breast lift changes position; it shrinking the skin envelope and moving the nipple. Therefore, if you have had significant breast ptosis, an implant alone will not be able to fix the problem—on the contrary, it may worsen the situation. However, if your breasts are very “empty,” a lift only will result in the breasts becoming perky but slightly smaller than what you expect. If you combine them, you get the best of both worlds: the youthful shape and the fullness.
The Problem with Implants Alone: The “Snoopy” Effect
There comes a time when people realize that the use of breast implants will never be able to lift the breast by themselves. Even though a large implant may create some tension in the skin, it cannot do so much. If your nipple is positioned lower than your inframammary fold, simply using an implant will not be able to raise the nipple.
Moreover, putting an implant behind a hanging breast most of the time results in the appearance of a “Double Bubble” or “Snoopy Deformity.” The implant is positioned high on the chest muscle where it was put, but the natural breast tissue goes hanging off the front, drooping downwards. The end result is the cartoon dog’s nose pattern: a rounded mound (the implant) with a drooped snout (your breast) hanging off it. To prevent this disconnected appearance, the skin envelope should be held tightly to the new volume.
The Problem with a Lift Alone: The “Deflated” Look
Furthermore, some patients might decide to only lift because they are not interested in having foreign bodies inserted inside them and since they want to keep the maintenance minimal. A breast lift does not only just reshape but also it removes the skin that has been stretched, elevates the nipple, and rounds out the lower curve. Nonetheless, a lift presupposes no volumetrical increase; it is just a way of compressing your existing tissue.
It might be the case when you have lost most of your glandular tissue after pregnancy or due to extreme weight loss that a lift only will give you a very nice shape but small breasts. You would probably end up with no “upper pole fullness“—the cleavage and roundness at the top of the breast. If you want your breasts not only to be high but also full, a lift on its own will definitely be insufficient. Those who want a natural look and feel can still opt for a small-to-moderate implant use during the lift. This way, they will get the top-notch combination: final volume and great shape.
The Nipple Position Test
How do you determine if you will benefit from the combo surgery? The easiest test is self-diagnosis by simply looking at the nipple relative position to the breast crease (inframammary fold).
- Nipple above the crease: There is a good chance that you only need an implant.
- Nipple at the crease: This is the “borderline” area. A high-profile implant could be enough, but a lift would certainly produce a better outcome.
- Nipple below the crease: A lift is absolutely necessary here. No implant can defying gravity enough to pull a nipple up from the bottom of the breast to the center.
Understanding the Trade-Off: Scarring
The reluctancy to go for a lift mostly arises from the panic that everybody has for the scar. A breast implant needs a very short 3-4cm cut only. On the other hand, the amount of skin removed during a lift is usually a pretty big piece. Based on the extent of your ptosis, you could end up with either a “Lollipop” scar (around the areola and vertically down to the crease) or an “Anchor” scar (plus a horizontal line along the crease).
This is a matter of trade-off, and you must decide what to prioritize. The question is: Do you want a scar-free breast that is going to be on a downward sloop and that will look pretty much like a deformed one after putting an implant or a nice, perky breast, with scars, but the latter would be thin and almost invisible? Most women agree that the scars fading over time to the extent that they are only thin whitened lines is definitely the price they are willing to pay for a lifted, youthful contour that is clothing and swimwear compatible.
One Stage vs. Two Stages
Typically, at Lin Europe Clinic, we carry out the lift and augmentation at the same time. The patient goes through one anesthesia and one recovery period. Nonetheless, in the event of massive weight loss or severe sagging, the two-stage approach is a safer solution.
When there is skin slackness to an extreme and the lift is very tight, putting in a large implant at the same time may cause too much tension at the incision lines thus leading to wound dehiscence or nipple necrosis (failure of blood supply). In extraordinarily risky situations, we advise doing only the lift with the addition of an adequate waiting period, i.e., 6 months, and then coming back for a simple augmentation. Your surgeon will evaluate your skin’s elastin level so that the safest option is selected.
Augmentation-Mastopexy in Turkey
Lin Europe Clinic is your choice for a combined procedure in Turkey because “Aug-Pexy” is technically one of the most challenging procedures in plastic surgery. It is a conscious balancing of two opposite forces: the implant pushing out and the lift tightening in. Our Istanbul-based surgeons are experts in this challenging art. We apply exact measuring instruments to be sure that the implant pocket is not only safe but also the skin is just snugged enough to lift without endangering the blood supply.
Your stay in Istanbul is thoroughly arranged with the comfort of the slightly longer recovery from the combined surgery in mind. We arrange VIP limousine transfers and provide a luxury hotel where you can have a comfortable rest. Our nursing staff offers you a set of aftercare instructions for your lift incisions so that you heal without complications. The Lin Europe Clinic approach is such that patients are no longer faced with a choice between size and shape; we do it perfectly to bring back your total self-confidence.
Frequently Asked Questions About Lift with Implants
Recovery after the surgery is a bit longer than if you just had one augmentation because your body has to heal more incision areas but the pain level isn’t significantly higher. Most of the time, the only feeling you get is the muscle soreness which is mainly caused by the implant.
Usually, yes. We operate in such a way as to save the milk ducts and the nerve supply to the nipple. Nevertheless, no matter what breast surgery you have, there is always a minor risk of less milk production.
Often the answer is yes. After the lift, the skin becomes tighter, so if the surgeon places a huge implant, it can result in excessive tension on the wounds which are in the process of healing. We generally advise sizes that are moderate for the safest and most beautiful results.
Yes, if you are satisfied with your size and either have enough natural tissue to rearrange (auto-augmentation) or simply want a lift, then lift alone is a great option.
This situation happens when someone places implants without doing a lift on breasts that are sagging. The implant remains on top of the muscle, and the breast tissue slips off the implant and hangs below, as if it were a double bubble. A lift is the way to avoid that.
Spear, S. L., et al. (2006). Augmentation/mastopexy: “Surgeon, beware”. Plastic and Reconstructive Surgery.
Stevens, W. G., et al. (2004). One-stage augmentation mastopexy: a review of 1192 simultaneous procedures. Aesthetic Surgery Journal.
Swanson, E. (2013). Prospective outcome study of 225 cases of breast augmentation and mastopexy. Plastic and Reconstructive Surgery.
