A woman’s breasts can change quite drastically as she gets older. For many, this means both a loss in breast volume and some level of sagging or drooping. Our team of board-certified plastic surgeons can help to restore a naturally youthful appearance of the breasts by performing a combination of a breast lift (mastopexy) with breast implants.

Dr. Carlino is a rarity. It is not often you find top skill, experience, and an amazing bedside manner. He has an unprecedented patient-centric approach. He is highly skilled and very honest. The time and patience he gives to his patients in order to set realistic goals and outcomes is a true gift. No matter if you have a minor cosmetic desire or a reconstructive need due to a health condition - he would 100% be my choice again.

Who Should Consider a Breast Lift with Augmentation?

This combination breast enhancement procedure is an effective solution for women who are unhappy with the physical changes to their breasts with age, as well as mothers whose breasts have been affected by pregnancy and childbirth. Many mothers will have both a breast lift and breast augmentation performed as part of a mommy makeover.

Combining breast lift surgery with the use of implants allows our surgeons to address two common issues:

  • A loss of breast volume
  • Drooping or sagging of the breasts

When a woman is experiencing both issues, treating just one may result in an unnatural outcome. For example, if the breasts are lifted, but volume isn’t restored, they may appear flat despite being in a more youthful position. Or, if breast implants are inserted but nothing is done to correct sagging, the breasts will likely appear too low or unnatural. Performing both breast enhancement surgeries together allows us to achieve the most natural results for our patients.

Expectations for Your Breast Lift with Augmentation

This combination of breast procedures is traditionally performed as a single surgery, allowing us to cut down on overall surgery and recovery time. The breasts can be lifted and augmented through the same incision to minimize any post-surgical scars.

Prior to your surgery, you will have a private consultation with one of our board-certified surgeons to discuss expectations for your procedure. Together, you will create a personalized treatment plan designed to achieve your specific goals. Each woman’s breast enhancement surgery will vary in terms of her breast implants and incision location.

How is a breast lift with augmentation performed?

When a woman has decided to have a breast lift performed by the team at Specialists in Plastic Surgery, this is also an ideal time to add implants to return the volume to the breasts or to change the size of her breasts. Our board-certified surgeons adapt each breast lift procedure to the unique needs of every patient. These surgeries begin with the breast lift portion to remove excess sagging skin and to bring the breasts back to a higher position on the chest. Once the incisions have been made, implants are then added at the end of the lift before the incisions are closed. Different incisions are used depending on the degree of sagging and excess skin involved. There are three incision options. 

  • Areolar incision — A donut-shaped incision is made around the areola. This is also known as a small incision mastopexy. This method can be used with women with smaller breasts who have minimal sagging and minimal excess skin. 
  • Lollipop incision — This starts with the donut-shaped incision, but it then extends downward, ending at the breast crease. In cases of moderate sagging and skin excision, this method should provide adequate access. 
  • Anchor incision — This follows the lollipop incision but then extends in both directions along the breast crease. The anchor incision provides the most access for removing fatty tissue and trimming excess skin. 

Once the incision has been made, our surgeons lift and reshape the breast tissue to reverse the effects of sagging and stretching. In the lollipop and anchor incisions, the nipples and areolae will be relocated to a higher position on the breasts to match the new profile. We often reduce the size of the areolae. The final step is to trim away excess sagging skin.  

For your augmentation, implants are added at this point. Using the incisions made for your lift we create a pocket for each implant and then they are placed. 

After Your Breast Lift with Augmentation

After your surgery is complete, there will typically be a recovery period of about a week depending on your specific case. There will be some bruising and swelling, but the general effect of your procedure will be immediately noticeable.

Once fully healed, your breasts will be lifted to a more youthful position. They will also have a naturally fuller shape and contour to them. Women who undergo this procedure often experience a boost in self-confidence and are more comfortable with the look of their bodies.

What are the types of implants available for the augmentation portion of my procedure?

Your choices for implants are saline, silicone, and newer “form-cohesive” implants (also known as gummy bear implants). While technically silicone, gummy bear implants are different enough to merit a separate description. 

Silicone implants

The silicone gel used to fill today’s implants is much more cohesive than the silicone used in the 80s and 90s. Today’s silicone consistency is more akin to Jell-O. The consensus is that silicone implants feel the most like natural breast tissue. If a silicone implant ruptures, silicone can leak into the breast pocket created for the implant. This will need to be removed, but when you consider the ruptured implant will need to be removed and replaced anyway, removing any minor silicone gel leakage won’t be difficult. 

Gummy bear implants

Gummy bear implants were approved by the FDA in 2012, based on seven years of usage data. The gel used in these implants is thicker than other silicone options. If one of these implants is cut in half there isn’t any movement of the gel and the implant retains its shape. Gummy bear implants are anatomically shaped to match the natural breast, which projects more at the bottom than at the top. If these implants rupture, the gel stays within the shell. 

Saline implants

Saline implants require smaller incisions to place because they are filled after placement in the breast pocket. If a saline implant ruptures, the body simply absorbs the saline solution. But you’ll still need to have the ruptured implant removed and replaced. 

One newer type of saline implant is of interest for our Specialists in Plastic Surgery patients. It’s called the Ideal Implant, and it uses a unique construction method where a series of implant shells are nested together, and two separate chambers hold the saline solution. The unique internal structure controls the movement of the saline for a more natural feel while reducing folding and wrinkles, which is thought to be the main cause of saline implant rupture and deflation. On the outside of these implants, the edges have been lowered for more natural contouring to the chest wall. 

What is recovery like after a breast lift with augmentation?

For the first couple of days after your surgery, you’ll need pain medication. You will wear a surgical support bra for the first few days at home. A softer support bra that will need to be worn 24-hours-a-day for one month will replace this. The swelling will last a couple of weeks and will depend in part on your incision type. Most patients can return to work in about one week, but any strenuous exercise or heavy lifting needs to be avoided for six weeks after surgery. This is especially important for the activity that causes your breasts to move. By being prudent with this advice, your scar tissue can reach its maximum strength. This will also allow the scarring to fade more dramatically with time. 

How long will my results last after having a breast lift with augmentation?

These are permanent changes made by our four surgeons at Specialists in Plastic Surgery. The sagging and excess skin removed with your breast lift are permanently gone. Of course, your body will continue to age, and your tissues will continue to weaken and sag. Still, any future sagging will start from a much younger, if you will, starting place. 

The only way to really negate any of your results would be to gain and lose a large amount of weight, or to become pregnant again. 

With the augmentation portion of your procedure, implant longevity and durability are increasing but implants do have a lifespan. Manufacturers guarantee their implants for 10 years, paying for a replacement if there is failure prior to that time. Still, depending upon your age, you should plan on having probably two, and possibly more, revision procedures to replace your implants over your lifetime. 

What are the risks with breast lift with augmentation?

Breast lifts with augmentation are major surgery, so they include risks involved with surgery: bleeding or the formation of a hematoma, reaction to anesthesia, infection, and slow incision healing. 

Risks related to this particular procedure include:

  • Changes in nipple or breast sensation (these usually revolve within a few months) 
  • Irregularities in breast contour or shape
  • Breast asymmetry
  • Necrosis of fat tissue
  • Fluid accumulation
  • Possibility of the need for revision surgery

For the augmentation portion of your procedure, these are the risks:

  • Capsular contracture 
  • Implant leakage or rupture
  • Implant shifting
  • Changes in nipple sensation
  • Impaired ability to breastfeed
  • Breast asymmetry
  • The visible rippling of the implant

What will my scarring be like from my breast lift?

The amount of scarring you will have depends on the incision method that you and your surgeon agreed upon during your consultation. This depends on the amount of excess tissue that needs to be removed. If your incisions are around the areola, your scarring will be virtually unnoticeable. However, if your incision runs from the areola to the breast crease, or from the areola to the crease and then outward (anchor incision), you will have scarring. These scars will fade dramatically with time.

Schedule Your Plastic Surgery Consultation in Raleigh

Our plastic surgeons have over 75 years of combined experience in cosmetic plastic surgery. If you’re ready to learn more about Breast Lift with Augmentation, please contact our office in Raleigh to schedule a consultation.


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