Just get a breast lift, or do I need an augmentation too?

Should I just get a breast lift, or do I need an augmentation too? I think that I could possibly be mixing up what each of these procedures do. I am 42 and my breasts have lost a lot of their perkiness over the years. I think I just need a lift but what are the reason I would get an augmentation too?


F, 45, Kentucky

Tags:age 35-44 sagging breasts

Dear StacieLeo:


This is a most confusing and difficult question for many women. Thanks for asking it!

There are several issues to consider:

  1. If you are pleased with your breast size when you cup your hands around your breasts and push then into lifted perky position, you will be happy with a mastopexy (breast lift) only. Since your breasts are slightly different, a small reduction on one side will create better symmetry too.
  2. If you are unhappy with breast size, then you will wish a augmentation as well.
  3. A breast lift removes skin in order to reposition and “tighten-up”, ie. make the breasts perky. This is opposite to the stress placed on the skin and breast tissues with augmentation which enlarges and “pushes-out” the incisions and tissues.
  4. The Plastic Surgery literature and my experience finds added risk of skin separation, infection and loss of the implants when a traditional mastopexy is combined with breast augmentation. Yes, I am more conservative and others will take on this risk but ultimately you are the patient with the additional complication if it occurs.
  5. You can always start with a breast lift (my recommendation based only on the one photo you have kindly shared) and once healed consider:
  • Breast implant augmentation
  • Fat grafting augmentation with the advantage of slimming elsewhere if you desire it.

I hope this helps! All the best!



Dean Kane, MD, FACS


Hi.  Thank you for your question.  You will definitely need a breast lift to make your breasts more perky.  If you are happy with your current breast volume/size, then a breast lift is all you may want.  If you want to be larger or more full and round at the top, then you can have a breast lift and implant.  Both options are great!  It just depends on what your goals and expectations are.  Best to speak to your PS so that he/she can show you what to expect in each scenario.  Best of luck!