DR. EPSTEIN’S COMPREHENSIVE Breast Augmentation Guide

Anesthesia – General, Sedation or Local?

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How is a breast lift performed?

Is a breast lift performed at the same time as the augmentation?

Breast lift and augmentation can be performed in one or two stages. In the vast majority of cases, I prefer to perform the two procedures at the same time. As I can get predictably excellent results, why subject the patient to two separate surgical procedures?

When performing in two separate procedures, I prefer to perform the lift first. Otherwise, if performing the augmentation first, as the skin envelope is going to be larger than it would be had the lift been performed first, I might end up using a larger implant than I would otherwise use had I performed the lift first. This is more commonly done when I need to reduce one breast but not the other breast as well, such as in severe asymmetry procedures (case shown below).

augmentation with severe asymmetry

Performing the augmentation first and the lift later is extremely uncommon. The only situation where that would occur is if either I was not 100% certain the patient needs a lift. In this case, I would perform the augmentation, wait six or so months and then reassess to see if a lift is needed. This is in cases where the amount of sagging is mild and the patient is on the borderline for needing a lift. So far, I have yet to have to go back on any of these patients and do a lift – the Dual Plane procedure has always taken care of the problem. The other situation is where the patient is not sure if they want the lift because of the extra scar around the nipple (as in all lifts) and from the nipple to the lower breast crease (as in most lifts). In this case, again, the augmentation is performed first, and then the patient reassessed in six months to see if a lift is needed (or desired by the patient). Some patients are fine with a little sagging, they just want to avoid the extra scars. The majority of my patients are not concerned about the scars from a breast lift because they heal so well and the improvement in breast contour is for these patients a much greater benefit.

SECTIONS – Breast Lift/Mastopexy with Implants

Chapters – Breast Augmentation Guide

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