Whether or not a patient can have a combined procedure, i.e. breast augmentation with a breast lift or mastopexy, depends upon a variety of factors. If your nipple and areola need to be moved up quite a distance, it may potentially compromise the blood supply to the nipple if the procedures are combined. It also depends on the surgeon as well. Too much excess skin may also make it difficult. Some plastic surgeons are more comfortable performing the combined procedure than others. If you have developed a relationship with your board-certified plastic surgeon, you might consider visiting him again to review your options. You may also consider getting a second opinion of another board-certified plastic surgeon. It is not unreasonable to undergo a staged procedure if all factors point to it being the safest path for you.