Breast Augmentation or Breast Lift: Which is Right for You?

I don’t like the way my breasts look. Am I a candidate for a breast augmentation or a breast lift? What is the difference between the two?

Due to a patient’s natural morphology, or due to changes associated with pregnancy, weight fluctuation, or with natural aging in the presence of our friend, gravity, many women are unhappy with the shape or appearance of their breasts. Breast augmentation and mastopexy (or breast lift) are two distinct surgical procedures that create different changes in a breast.
Breast augmentation involves placing an implant underneath the breast tissue and/or the muscle underneath the breast tissue to increase the volume of a breast. This gives the breast mound more projection and makes it appear fuller. This surgery is best suited for women who want to be bigger. In other words, even with a supportive bra the patient wishes her breasts were larger and is unhappy with her current volume. Most of my patients who have had this have felt their breasts were small their entire lives, or noticed significant deflation after childbirth.

Mastopexy, or breast lift, is a surgery that aims to decrease the amount of excess skin on the breast, while maintaining its current volume. It also places the nipple in a higher, more forward-pointing position as some patients may have noticed their nipples “moving” lower and lower on their breast mound over time.

I always ask my patients if they are happy with their current breast size when they are wearing a supportive bra. If their answer is “yes, but I would like for my nipple position to be where it was when I was younger,” then that patient would likely benefit from a mastopexy. If the answer is, “No, I would prefer to be bigger/have more volume,” then that patient would likely benefit from a breast augmentation, with or without a lift.

What if I want my breasts to be more youthful and bigger?

Some women notice both sagging and deflation of their breast tissue after weight loss or pregnancy. These patients desire a more youthful position of their breasts and are unhappy with their volume of breast tissue while wearing a supportive bra. These patients are candidates for augmentation-mastopexy, which involves placement of an implant under the breast tissue while at the same time performing a breast lift. This may be performed in a single operation safely for many patients. In some situations, it is safer to separate the two procedures by about 3 months. This is a decision that is made based on the volume of breast tissue a patient already has as well as the extent to which the breast needs to be lifted.

If my breasts appear saggy, can an implant make them look perkier?

Yes….and no. If the main cause of the sagging appearance is deflation and the breast is in a good position with respect to the rest of a woman’s body, an augmentation can restore volume in a deflated appearing breast and make it appear “perkier.” However, the amount of “lift” that comes from placing an implant on nipple position is mild. For patients who have had significant descent of their breast tissue and have significant amount of excess skin, it would take too large of an implant to create a “lifting” effect. The key to deciding between an augmentation vs. a mastopexy is an open dialogue between the patient and the plastic surgeon. Good communication will allow for a clear definition of the specific concerns a patient has regarding her breasts, which allows for an appropriately selected treatment plan.

Mommy Makeover Surgery

What procedures does a “Mommy Makeover” Surgery include?

The joys of becoming a mommy come with the frustrating bodily changes caused by pregnancy. “Mommy makeover” is a general term that refers to surgery of the breast and abdomen that aims to create a more youthful and aesthetic contour. Typically, a mastopexy (or breast lift) is performed to lift and tighten the breasts that have deflated and begun to sag due to breast feeding/aging. An abdominoplasty (or tummy tuck) is also performed at the same time to remove excess skin and bring the rectus (or six-pack) muscles back to the midline, which helps to narrow the waist and restore an “hour-glass” silhouette.

Every patient is different and, therefore, their concerns and treatments will be uniquely tailored to them. Some women may benefit from a mastopexy, while others may benefit from an augmentation with an implant. Finally, some women may benefit from both an augmentation and a mastopexy to restore both volume and a more youthful position of the breast. Likewise, a full abdominoplasty is appropriate for some patients, while others may benefit from a mini-abdominoplasty and/or liposuction. The key is for me to listen to the patient’s concerns, understand her goals, and for us to pick a plan that can safely achieve them.

How much weight should I lose before having a Mommy Makeover?

Each patient is different so there is no magic number for weight loss. However, the closer someone is to their ideal body weight the less likely they are to suffer from post-operative complications. This has been shown in many medical studies. I encourage patients to be safe and methodical about losing weight at a moderate pace in a sustainable manner. After surgery, weight gain can affect the results to varying degrees. For this reason, it is best for the patient to be at or close to their goal weight for at least a month or two prior to surgery.

How long after having my last baby should I wait to have a mommy makeover?

I would recommend at least a year from a medical standpoint. That being said, most women wait longer than this to have surgery. From a personal standpoint, it is usually easier on the patient to wait until the youngest child is old enough to be a little self-sufficient and not have to be carried around. Between the actual child and that bag with the “child’s stuff,” being a mother is a very physical job. This is particularly true in the first few years of the baby/toddler’s life, which would make the recovery period very difficult for most people. Ultimately, it’s a personal decision for each patient. I encourage patients to do as much as they possibly can with diet and exercise. When they get to a point where they just can’t see any more results, it’s usually a good indication that it may be time for surgery.

How long does a complete Mommy Makeover Surgery take (the actual surgeries)?

Depending on the needs of the patient, the surgery can vary from 4 to 6 hours. It is typically performed on an outpatient basis and patients will usually go home the same day. In some cases, it may be better for the patient to spend the night in a hospital with nursing supervision. This is decided during the preoperative consultation and is specific for each patient.

How long is the recovery period if I have multiple procedures done together?

The recovery period is not extended for combined surgical procedures and is largely dictated by the abdominoplasty portion of the surgery. Patients are encouraged to ambulate and move around the house the day of surgery. Strenuous activities like yoga, running, abdominal crunches can be resumed after 6 weeks. When surgeries are combined, the activity restrictions are very similar and the time to normal/strenuous activity is not increased.

I still plan to have more children. Should I consider having a mommy makeover now?

If having children is in the works for the future, then surgery should be put on the back shelf for now. The effects of surgery can be completely reversed with pregnancy which would really take away from the financial and personal investment of the patient. The goal of the surgery is to have a successful outcome that lasts as long as possible.

Do you offer a Daddy Makeover?

“Daddy makeover” is probably a less-recognized term in today’s society. However, we are all aware of the potential “dad-bod” that can ensue after time with the kids supplants time at the gym. I always encourage patients to do everything they can with a healthy lifestyle regarding diet and exercise. When they get to a point where the stubborn areas declare themselves, we can address them appropriately and safely with the best surgical option available.

Frequently Asked Questions About Aging Hands

I don’t like the way my hands look. Is there anything that can be done to improve the aged appearance?

With the exception of the head and neck, our hands are typically the most visible part of our bodies to the public eye. There is a lot of attention given to treatment modalities that aim to reverse the effects of aging in the face, as well as other areas like the breasts, arms, abdomen, etc. Due to sun exposure and the loss of soft tissue volume over time, our hands age and demonstrate the effects of aging as much as anywhere else on the human body. With advances in surgical techniques, there are options available to patients that can reverse some of these effects of aging.

What is it that makes my hands look older?

Similar to the face, hands display the effects of aging through loss of soft tissue volume and skin changes from chronic sun exposure. As we age, the soft tissue in our hands begins to shrink. As the soft tissue shrinks, the “cushion” effect it had been creating for the veins and tendons in the back of the hand is lost, leaving a harsher and more skeletonized appearance. Also, with chronic sun exposure, pigmentary changes begin to arise which also gives a more aged appearance.

What can be done to reverse these changes?

As there are two potential causes for and aged appearance, there are two aging hands treatments. First, restoring volume in the back of the hands can help blunt the appearance of veins and tendons, which leaves a much more youthful appearance. This can be accomplished with the injection of fillers, which are temporary, or fat taken from a different part of the body, which is permanent. Second, some of the pigmentary changes can be treated with topical therapy like chemical peels and laser therapy.

Where is the fat taken from and how do you get it? Can it be performed at the same time as another surgery?

Typically, fat is taken from the abdomen or inner thigh region. It can be harvested from anywhere in the body where fatty deposits reside. It is harvested through liposuction with small cannulas, which are blunt stainless steel tubes. Fat grafting to the hands is a relatively quick procedure that can be performed at the same time as another surgery like a facelift, or performed as an adjunct to liposuction on another part of the body.

Are the effects of fat grafting to the hands permanent?

Over the past decade, many advances have been made in techniques involved with processing fat for placement into other areas of the body. With state of the art techniques, the majority of the fat injected into the hands will survive and stay forever, as long as the patient’s weight remains stable. This is one of the main benefits to performing fat grafting to the hands as opposed to injecting synthetic soft tissue fillers, which last for about a year or so.

How do I know if I am a good candidate for fat transfer to the hands?

If you are bothered by the appearance of your hands due to prominent veins or tendons and/or feel as though your hands have a “hollow” or “deflated” appearance, you may be a good candidate for fat grafting to the hands. If there is any question, the best thing to do is to schedule a consultation with a qualified surgeon and discuss your aging hands treatment options.