Originally published on June 17, 2014. Updated May 27, 2025 with additional information
We frequently consult with women who have experienced undesirable changes in their breasts over time, usually after pregnancy and breastfeeding. Many women undergo breast volume loss (postpartum atrophy) and drooping (ptosis) after these life events. This means that the breast tissues stretch, thin out, and the nipple position can gradually descend. For these reasons, many patients desire increased fullness, improved breast shape, or both. Breast lift, or mastopexy, is designed to improve breast appearance by removing excess skin and reshaping the breast tissue. Breast augmentation is designed to restore lost volume.
In this post, we’ll take a deep dive into these two procedures, how they differ, who they are best for, and when combining both might be the ideal solution.
Why Patients Consider Breast Enhancement
Breast enhancement is one of the most sought-after types of plastic surgery, often driven by changes due to aging, pregnancy, breastfeeding, weight fluctuations, or simply personal aesthetic goals. According to the American Society of Plastic Surgeons, breast augmentation consistently ranks among the top five cosmetic surgical procedures in the U.S., with over 298,000 augmentations performed in 2022 alone. Breast lifts are also growing in popularity, increasing by 30% from 2019 to 2022, highlighting a growing trend toward restoring natural shape and firmness.
There are three main types of breast enhancement:
- Breast Augmentation: Focuses on increasing the size and volume.
- Breast Lift (Mastopexy): Focuses on improving shape and position.
- Breast Reduction: Focuses on reducing the size and weight for comfort and aesthetics.
While each serves a different purpose, today we will focus on comparing breast augmentation and breast lift to help you understand which might be best for your needs.
Breast Augmentation
Purpose:
Breast augmentation is designed to increase breast size and enhance fullness and projection. It is ideal for patients who want to add volume, improve symmetry, or simply achieve a curvier silhouette.
Method:
This procedure involves the placement of breast implants, which may be filled with saline or silicone gel, under the chest muscle (submuscular) or over it (subglandular), depending on the patient’s anatomy and desired results. The surgeon makes an incision—commonly in the inframammary fold (under the breast), around the areola, or in the armpit—then creates a pocket for the implant.
Results Provided:
- Fuller, rounder breasts
- Enhanced cleavage
- Correction of breast asymmetry
- Improved body proportions
However, it’s important to note that augmentation alone does not address sagging. In fact, adding volume to already sagging breasts may make the droopiness more noticeable.
Breast Lift (Mastopexy)
Purpose:
A breast lift is aimed at lifting and reshaping sagging breasts, giving them a more youthful, upright appearance. It’s ideal for those who are happy with their breast size but want to correct issues like drooping, loss of firmness, or downward-pointing nipples.
Method:
During a breast lift, the surgeon removes excess skin, reshapes the breast tissue, and repositions the nipple and areola to a higher, more youthful spot on the chest. The degree of lifting depends on the severity of sagging. Incision types vary from a crescent lift to anchor-shaped techniques, based on the amount of correction needed.
Results Provided:
- Firmer, perkier breasts
- Elevated nipple position
- Restored breast contour
- Minor correction of asymmetry
However, a breast lift does not increase breast volume. Some patients feel their breasts look slightly smaller post-lift due to the removal of stretched skin.
Comparing Breast Augmentation vs. Breast Lift
| Factor | Breast Augmentation | Breast Lift |
| Primary Result | Increased volume and size | Improved position and contour |
| Ideal Candidates | Those with naturally small breasts or volume loss after pregnancy/weight loss | Those with sagging, deflated, or downward-pointing breasts |
| Result Duration | Long-lasting, but implants may need replacement in 10–20 years | Long-lasting, but gravity and aging can cause future sagging |
| Recovery Time | 1–2 weeks for most activities, full recovery in 6 weeks | 2–3 weeks for most activities, full recovery in 6–8 weeks |
| Side Effects | Implant-related complications (capsular contracture, rupture, rippling) | Sensation changes, delayed healing, potential asymmetry |
| Scarring | Small scars (inframammary, periareolar, or transaxillary) | More visible scars depending on lift type (crescent, vertical, anchor) |
Will You Need A Breast Lift, Breast Augmentation, Or Both?
Assessing your nipple/areola position will give you an idea if you should have a discussion about breast lift surgery with your plastic surgeon.
If the nipple is positioned above the breast fold (inframammary fold), then it is less likely that a lift will be recommended. If the nipple is at the level of the breast fold (Grade 1 in the below image), then a lift may or may not be recommended depending on your goals. If the nipple is below the breast fold (Grade 2 in the below image), then it is more likely that a lift will significantly improve the appearance of your breasts.
It may be possible to slightly raise the nipple position with an augmentation alone. This will have to be determined by your plastic surgeon after he/she examines you.
Since breast tissue descends over time, the upper portion of the breast can end up with less breast volume than is desired. If this is the case, then a breast implant will likely be recommended to fill out this area.
It is important to be aware that a breast lift alone will not restore lost volume. Therefore if you desire increased breast size, then an augmentation should be considered.
You might benefit from breast augmentation if:
- You want larger, fuller breasts
- You have minimal sagging
- You have lost volume after weight loss or pregnancy
You might benefit from a breast lift if:
- Your nipples point downward or fall below the breast crease
- You have significant sagging or loss of shape
- Your breasts have become elongated or flattened
Breast Augmentation Combined With A Breast Lift
For many patients, the ideal solution is a combination of both procedures. This approach addresses both volume and position, providing a comprehensive enhancement. It is especially beneficial for patients who have experienced:
- Volume loss after breastfeeding or weight loss
- Significant sagging and deflation
- Changes due to aging that affect both size and firmness
By combining procedures, you can achieve:
- Fuller, more youthful-looking breasts
- Corrected asymmetry
- Perkier shape with improved projection
In fact, according to the American Society for Aesthetic Plastic Surgery, combo procedures are on the rise, with nearly 40% of breast lifts performed in combination with implants.
A combined procedure, if agreed upon by you and your plastic surgeon, can be performed in one of two ways.
- Single-Stage: This approach is beneficial because it involves a single surgery. However, there is a higher chance of complications and a higher revision rate with this approach.
- Two-Stage: This approach involves performing the augmentation first, allowing the patient to heal for several months, then performing the breast lift surgery. This sequence can be reversed depending on patient goals and surgeon preference. Though this requires two separate surgeries, it is a useful alternative and is associated with a lower revision rate.
Choosing between a breast augmentation and a breast lift—or opting for both—ultimately comes down to your anatomy, goals, and lifestyle. Consulting with a board-certified plastic surgeon is essential to assess your needs and customize a treatment plan tailored to you. Both procedures offer transformative results, but understanding their differences is the first step in making an empowered, confident decision
The post Breast Enhancement 101: Breast Augmentation vs. Breast Lift appeared first on Westlake Dermatology & Cosmetic Surgery®.
