Ask a Surgeon - Breast Lift - I have had consultations with four board certified plastic surgeons concerning...

Submit your question below about any cosmetic procedure to be considered for posting with an answer from one of our board-certified plastic surgeons.

Submit a Question

Procedure: *

Procedure related to this question.

Question: *

A good title will help more Doctors find your question. Your question title is limited to 90 characters.

Description:

Enter an optional description here for futher detail. Your description is limited to 500 characters.

Name:

E-Mail Address: *

City:

State:

Country:

Are you considering cosmetic plastic surgery?: *

How did you hear about us?: *

Age: *

Gender: *

Would you like to receive e-mail news from ASAPS?: *

Click here to review the terms of use agreement.

By checking this box you agree to the terms of use.

What code is in the image?: *

Enter the characters shown in the image.

If your question is about the cost of a procedure, click here. For referral to a qualified surgeon in your area, see find a surgeon.

Note: ASAPS cannot give advice about specific medical problems nor should answers provided by responding surgeons be substituted for a complete medical history, work-up and an in-personal medical/surgical consultation. Sorry we can't answer all questions. We try to select questions that have the widest general interest.

I have had consultations with four board certified plastic surgeons concerning a...

Q:

I have had consultations with four board certified plastic surgeons concerning a breast lift. All have told me that with the lift I would probably lose a cup size which I do not desire. Only two would do an implant in conjunction with the lift. The other two said they do not do the implant at the same time. Since I am two for two what would be the best decision. At 48 years old I really don’t want to go through two surgeries, but do not want to jeopardize my well-being either.

A:

There is no standard way of lifting and augmenting the breasts, which is the reason why you are getting different recommendations. It is much more complicated and therefore more risky to do both a breast lift (mastopexy) and an augmentation at the same time. That being said, there are a number of plastic surgeons like myself who do one stage mastopexy-breast augmentation procedures on acceptable candidates routinely. After a consultation to evaluate your goals and anatomy, it is therefore up to your individual surgeon's judgment and his/her experience as to whether it is advisable to do as a single stage or two stage procedure. Basically, there is no correct answer, just individual surgeon's expertise. Consult with board certified plastic surgeons that perform both one stage and two stage mastopexy-augmentation to get an unbiased opinion, and then trust your instincts. Obviously an informed opinion can only be provided after a comprehensive consultation.

Joseph N. DiBello, M.D., FACS - View Other Answers by this Doctor

Huntingdon Valley, PA

Practice Website

A:

Many surgeons have traditionally performed breast augmentation and mastopexy surgery in stages, usually mastopexy first followed by augmentation at a later date. In the recent past more and more surgeons have adopted a non-staged, single surgery approach to augmentation and mastopexy, and that is what I propose for the vast majority of patients who I see in consultation that need both procedures. I believe that the results of simultaneous augmentation mastopexy are as good or better than a staged approach in most cases, and of course patients quite naturally prefer a single trip to the operating room if at all possible.

Michael Law, M.D. - View Other Answers by this Doctor

Raleigh, NC

Practice Website

A:

The issues you address regarding the aging breast are important. The two components of the appealing breast are the patients nipple position and size of the breast in relation to your body size. A mastopexy is a lift of the breast and often repositions or restores the nipple/ areolar area to a more appealing or youthful position. There are various types of mastopexy’s or breast lifts. Some entail quite large incisions. A breast augmentation enhances the natural appearance of the breast. They typically evolve very small incisions.

So, why the differences in options of your plastic surgeons? Often it is related to your expectations and patient safety. Many plastic surgeons believe that it is safer with less complications to the patient (i.e. re-operation, infection, tissue loss, etc.) to perform major breast lifts (large incision mastopexy’s) first and then follow with a breast augmentation at a latter date. Especially, if the patient is considering a very large implant/ augmentation at the time of the mastopexy.

We commonly perform minor mastopexy’s (creasant, circle, lolly pop, etc.) with breast augmentation. But, with major mastopexy’s or lifts I separate the procedures because I do not want my patients to take the risk of the higher complication rates. My practice is not in a large city. There are not another 100,000 patients waiting outside my door for plastic surgery. So, I must provide and recommend to my patients surgical procedures with high success rates and low complications. Besides, it has always been my philosophy that practitioners should do what is in the best interest of their patients and not their pocket book. Best,

Gary R Culbertson, MD, FACS