Breast Augmentation and Lift Surgery (Mastopexy with Implants)

Breast augmentation and lift surgery (mastopexy with implants) is the combined application of two surgical procedures to increase breast volume and reshape sagging breast tissue. It can be preferred especially in people who have both volume loss and sagging in their breasts as a result of pregnancy, breastfeeding, weight changes and aging.

In this surgery, while volume is increased using breast implants, excess skin is removed and the breast tissue is brought to a more upright position. In this way, the aim is to adjust the size, shape and nipple position of the breasts together.

Breast augmentation and lift procedures do not have to be applied together in every patient. The suitable surgical approach is determined according to the existing breast structure, the degree of sagging and the person’s expectations.

What Is Breast Augmentation and Lift Surgery?

Mastopexy with implants is the performance of breast augmentation surgery and breast lift surgery within the same operation.

The breast augmentation procedure aims to increase breast volume using implants. A breast lift is applied to reshape sagging breast tissue and move the nipple to a more suitable position.

In some patients, placing only an implant may not be enough to correct the existing sagging. In cases where the nipple has shifted downward and excess skin is marked in particular, an additional lift procedure may be needed.

Similarly, when only a breast lift is applied, the breast tissue can be positioned higher but the desired fullness in the upper part of the breast may not be achieved.

For this reason, the two procedures can be planned together in patients for whom both volume increase and correction of sagging are targeted.

Implants Used in Breast Augmentation Surgery

The implants used in breast augmentation surgery can differ according to their filling materials, surface characteristics, shapes and sizes.

Silicone Breast Implants

Silicone implants are prostheses that contain silicone gel and are used to increase breast volume.

There are options with different shapes, sizes and surface characteristics. The choice of implant is made according to the patient’s existing breast tissue, chest wall measurements and the desired volume.

Saline (Salt Water) Implants

Saline implants are breast prostheses filled with a sterile salt-water solution.

The use of these implants varies according to the country, the approval status of the product and surgical preferences. Silicone and saline implants have their own advantages and risks.

How Is Breast Implant Size Determined?

The volume of breast implants is expressed in cubic centimeters (cc).

However, choosing the suitable implant is not done only according to volume. The width of the chest wall, the thickness of the existing breast tissue, skin elasticity and breast base measurements are also evaluated.

Implants of the same volume can create different results in different body structures. For this reason, the implant size must be determined individually.

What Is Breast Lift Surgery?

Breast lift surgery (mastopexy) is performed to reshape breasts that have sagged over time and move the nipple to a more suitable position.

Aging, pregnancy, breastfeeding, weight loss and genetic factors can affect the elasticity of the breast skin and the position of the breast tissue.

In lift surgery, excess skin is removed and the existing breast tissue is reshaped. When necessary, the nipple and the darker-colored area around it, called the areola, are positioned higher.

Breast Lift Techniques

The surgical technique to be applied is determined according to the degree of sagging in the breast and the amount of excess skin.

Periareolar Technique

This is a method applied with an incision around the areola. It can generally be considered for mild sagging.

Vertical Technique

In addition to the incision around the areola, a vertical incision extending from the nipple to the inframammary fold is made.

It can be used for moderate sagging and allows the breast tissue to be reshaped.

Inverted T (Anchor Scar) Technique

Incisions around the areola, downward from the nipple and along the inframammary fold are used.

It can be preferred in patients with marked sagging and excess skin. While it offers the possibility of more extensive shaping, it can create longer surgical scars.

Who Is Breast Augmentation and Lift Surgery Suitable For?

Mastopexy with implants can be a suitable option for people who have both volume loss and marked sagging in their breasts.

It can be considered especially in patients who have experienced a decrease in breast tissue volume after pregnancy and breastfeeding, whose nipple has shifted downward or who have lost fullness in the upper part of the breast.

People who have laxity in the breast skin and a lack of volume after marked weight loss can also be candidates for the surgery.

However, it is not necessary to do the implant and lift procedures together in every patient.

In people whose breast volume is sufficient but who have marked sagging, only a breast lift can be preferred. In people with no sagging or very mild sagging, only breast augmentation can be enough.

In the evaluation of suitability for surgery, general health, breast anatomy, skin elasticity, smoking and personal expectations are taken into account.

Postponing surgery can be recommended for people who plan to become pregnant soon or who expect marked weight changes.

Advantages of Breast Augmentation and Lift Surgery

Applying breast augmentation and lift surgery together allows the volume and position of the breasts to be adjusted during the same operation in suitable patients.

Volume increase provides more fullness in the breasts through the use of implants. It can be considered especially in patients with volume loss in the upper breast area.

Correcting sagging is done by removing excess skin and repositioning the breast tissue.

Positioning the nipple aims to move a nipple that has shifted downward to a more suitable anatomical level.

Reducing breast asymmetry can be possible in some patients who have a volume or position difference between the two breasts. However, completely symmetrical results cannot be guaranteed.

Performing the two procedures together can, in suitable patients, allow intervention directed at both aesthetic goals with a single anesthesia and surgical process. However, combined surgery has its own particular risks.

Preparation Before Breast Augmentation and Lift Surgery

A detailed examination and health evaluation must be performed before surgery.

The surgeon examines the size of the breasts, the degree of sagging, the position of the nipple, skin elasticity and the characteristics of the existing breast tissue.

According to the patient’s expectations, the type and size of the implant, the placement plan and the lift technique to be applied are determined.

Health Checks

Before surgery, the patient’s health history, medications used, allergies and previous surgical procedures are evaluated.

The necessary blood tests and an anesthesia examination can be performed. Depending on age, family history and risk factors, breast ultrasonography or mammography can be requested.

Smoking and Medication Use

Smoking can negatively affect tissue blood supply and wound healing. For this reason, avoiding smoking before and after surgery is recommended.

Medications that can increase the risk of bleeding may need to be adjusted. However, prescription medications should not be stopped without the doctor’s recommendation.

Realistic Expectations

Breast augmentation and lift surgery can change the volume and shape of the breasts. However, achieving a specific bra size or a completely symmetrical appearance cannot be guaranteed.

Before surgery, it is important to be informed about long-term follow-up of the implants, possible additional surgery needs and surgical scars.

How Is Breast Augmentation and Lift Surgery Performed?

Mastopexy with implants is generally performed under general anesthesia.

During surgery, the surgical plan determined beforehand is applied for placing the implant and lifting the breast tissue.

Placing the Implant

Depending on the patient’s anatomical features, the breast implant can be placed behind the breast gland, under the chest muscle or in a different tissue plane considered suitable.

The placement plan of the implant is determined according to the thickness of the existing breast tissue, the characteristics of the implant and the surgeon’s evaluation.

Lifting the Breast Tissue

Together with the placement of the implant, excess skin is removed and the breast tissue is reshaped.

When necessary, the nipple is positioned higher. At this stage, care is taken to preserve the blood supply of the tissues.

The surgical incisions are closed with appropriate suturing techniques.

How Long Does the Surgery Take?

Breast augmentation and lift surgery generally takes a few hours. The duration can vary according to the surgical technique used, the way the implant is placed and the extent of the lift.

After surgery, the patient is kept under observation for a certain period. Some patients can be discharged on the same day, while in some cases a night in the hospital may be necessary.

Recovery After Breast Augmentation and Lift Surgery

In the first days after surgery, swelling, tenderness, tightness and pain can be seen in the breasts.

These symptoms generally decrease as recovery progresses. It is important to use the medications recommended by the doctor and follow the wound care instructions.

Using a Supportive Bra

After surgery, using a special medical bra can be recommended.

This bra can help support the surgical area and control swelling.

The duration of use is determined according to the surgeon’s recommendations.

Returning to Physical Activities

In the first weeks, heavy lifting, intense exercise and movements that strain the chest area must be avoided.

Light walks can be started at the time the doctor considers appropriate.

Many patients can return to light daily activities in about 1–2 weeks. However, this time can be longer in people who work in physically demanding jobs.

The return to heavy exercise can generally take 4–6 weeks or longer. The appropriate timing should be determined according to the patient’s recovery.

Settling of the Breast Shape

Right after surgery, a change in the volume and position of the breasts can be noticed. However, because of the initial swelling, the final appearance cannot be fully evaluated.

It can take several months for the breasts to adapt to their new shape. The maturation of surgical scars can take longer.

Risks of Breast Augmentation and Lift Surgery

Mastopexy with implants is a surgical procedure that includes placing a breast implant and reshaping the breast tissue. For this reason, the risks specific to both applications must be evaluated together.

Bleeding and hematoma are among the complications that can occur after surgery.

Infection can affect wound healing and the condition of the implant. In serious infections, the implant may need to be removed.

Capsular contracture is the hardening of the scar tissue that forms around the implant, causing a change in breast shape, firmness or pain.

Rupture or displacement of the implant can develop over time. In some patients this can require additional surgery.

Breast asymmetry and contour irregularities can be related to the two breasts healing differently or to changes in the position of the implants.

Sensation changes in the nipple can be seen temporarily or permanently.

Circulation problems in the nipple and areola are among the rare but serious complications. If blood circulation is impaired, tissue loss can develop.

A change in breastfeeding capacity can occur because of interventions on the breast tissue and milk ducts.

In addition, risks associated with breast implants, such as the rare breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) and other very rare capsule-associated malignancies, should be evaluated before surgery. The risk of BIA-ALCL has been associated especially with certain textured-surface implants.

It cannot be guaranteed that breast implants will last a lifetime. For this reason, it is important to inform patients about long-term follow-up and that implant replacement or removal may be needed in later years.

Alternative Methods to Breast Augmentation and Lift Surgery

Applying breast augmentation and lift procedures together is not necessary in every patient. Alternatives are evaluated according to the existing breast structure and aesthetic expectations.

Breast Augmentation Only

In people who want to increase breast volume but have no marked sagging, breast augmentation surgery alone can be enough.

However, placing an implant may not correct marked breast sagging by itself.

Breast Lift Only

In patients who are satisfied with their breast volume but want a change in appearance because of sagging, only a mastopexy can be applied.

In this procedure, excess skin is removed and the breast tissue is reshaped. Using an implant is not mandatory.

Increasing Breast Volume with Fat Transfer

In some patients, fat tissue taken from the person’s own body can be transferred to the breast area to provide a limited volume increase.

However, some of the transferred fat can be absorbed over time, and fat transfer alone may not be enough in people with marked sagging.

Fat transfer also carries risks such as fat necrosis, cysts and calcification.

Non-surgical methods can include supportive bras, exercise and skin care applications. However, these methods do not permanently correct marked breast sagging.

Results of Breast Augmentation and Lift Surgery

After mastopexy with implants, the aims are to increase breast volume, move the nipple to a more suitable position and reshape the breast tissue.

A certain change in appearance can be noticed right after surgery. However, as the swelling decreases and the tissues adapt to their new position, the results become clearer over time.

The results of the surgery can last for a long time. However, aging, pregnancy, weight changes and gravity can affect the appearance of the breasts.

It should not be forgotten that breast implants require long-term follow-up and that some patients may need additional surgical intervention in later years.

Conclusion

Breast augmentation and lift surgery (mastopexy with implants) is a combined aesthetic surgical procedure that can be considered when volume loss and sagging are present together in the breasts.

While volume is increased with breast implants, the breast tissue is reshaped with the lift procedure and, when necessary, the nipple is positioned higher.

Before deciding on surgery, it is important for a plastic surgery specialist to evaluate in detail the breast anatomy, skin elasticity, implant options, possible surgical risks and personal expectations.