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In certain situations, a Breast Lift and Breast Augmentation may be needed to obtain the best possible breast appearance. Breast Lift with Breast Augmentation is a highly specialized form of breast surgery that is difficult to master. Toronto plastic surgeon Lawrence Tong, MD has significant experience with combined Breast Augmentation/Mastopexy. During your consultation, he will determine whether you should consider this type of breast enhancement.

What a Breast Lift with Breast Augmentation Does

Breasts can become ptotic (droopy) due to aging, weight changes, pregnancy, or breast feeding. These same factors also cause the breasts to lose volume and become smaller. A Breast Augmentation combined with a Breast Lift will help reverse these changes.

This combination procedure is designed to:

  • Add volume and fullness to the breast
  • Build a rounder breast shape
  • Raise the descended nipple and the surrounding darker skin
  • Reduce the areolar size

Issues to Consider with Breast Augmentation Plus Breast Lift

Breast Implants Alone Do Not Lift Droopy Breasts

There is a common misconception that breast implants will correct breast drooping. This is partially correct; breast implants can ‘lift’ the breasts to a certain degree, but they cannot correct for all degrees of ptosis (drooping). In contrast to Breast Augmentation alone, adding the Breast Lift allows for a much more significant degree of lifting. Some surgeons will try to use a (much) larger implant in lieu of performing a Mastopexy, often leading to poor results and a dissatisfied patient. During any Breast Augmentation consultation, Dr. Tong evaluates for breast ptosis. He may recommend a combined procedure if there is breast ptosis that will not be corrected by implants alone.

A Breast Lift Alone Does Not Increase Your Bra Size

A Breast Lift will provide more fullness to the upper pole of the breast, but it will not increase the overall cup size. In contrast to the Breast Lift alone, adding a Breast Augmentation allows for a much more significant volume enhancement.

You may benefit from this procedure if:

  • you want to increase your cup size AND want your breasts lifted
  • you need a Breast Lift, but want more fullness than what a Breast Lift alone can provide
  • you have breast changes due to bariatric surgery, or significant weight loss
  • you want a Breast Augmentation but have more breast drooping than can be corrected by a Breast Augmentation alone
  • you have a type of breast development known as a ‘constricted breast’

Other Criteria for Candidates:

  • Patients should be generally fit and relatively healthy Dr. Tong always makes an assessment of your general health and suitability before undergoing any type of surgery.
  • Smokers should quit smoking at least 2 weeks prior to surgery
  • Patients who are breast feeding/pregnant should wait 4-8 weeks after completing breast feeding before having surgery so that the true breast size can be determined
  • A patient should have realistic expectations about what can be accomplished though Breast Augmentation with Mastopexy

Incisions for Breast Augmentation with Mastopexy (Breast Lift)

Any surgical procedure will leave some type of scar. A plastic surgeon specializes in obtaining the least visible scars and putting them in the least visible places.

There are three types of Breast Lift incisions that correspond to three techniques of Breast Lift.

Technique: Incision:
Periareolar Mastopexy
around the areola
Short Scar Mastopexy
around the areola plus a vertical incision below the areola
Traditional Mastopexy
incision for a short scar Mastopexy plus a horizontal incision in the breast fold

A combined breast implant and Mastopexy will utilize the Breast Lift incisions as a means to place the implant. In general, no additional incisions are required for implant placement when being performed together with a Breast Lift.

Which Type of Mastopexy Will I Need With Breast Augmentation?

The method of Breast Lift performed in conjunction with Breast Augmentation depends on the amount of drooping. In general, less drooping requires less incisions and more drooping requires more incisions. Wearing any type of clothing (including low cut) will cover all of these scars, regardless of which method is performed.

  • The peri-areolar scar is placed along the areola, at the border between darker and lighter skin. It tends to hide quite well.
  • The breast fold scar is placed in the breast fold, in a naturally concealed area. It is also hidden by the breast.
  • The vertical incision starts at the bottom of the areola and extends to the breast fold. In the nude, the vertical incision scar tends to be more visible than the other scars.

During your consultation, Dr. Tong will inform you which method is recommended for your particular anatomy.

Details of the Breast Lift with Breast Augmentation Procedure

Dr. Tong performs your surgery in the private surgical suites within the same medical building where he has his office, at 199 Avenue Road. You will be asleep and completely unaware of your surroundings while under general anesthesia or deep IV sedation.

Breast Augmentation with Mastopexy is performed in two steps: the first stage is the Breast Augmentation, followed by the Mastopexy. Dr. Tong chooses the breast implant incision to minimize scars, generally utilizing part of the planned Mastopexy incisions. He first surgically creates a breast implant pocket (space for the implant) under the chest muscle. The implant is then placed into the pocket. Dr. Tong then verifies proper position, shape, and symmetry of the implants.

After the Breast Augmentation, the Breast Lift begins by removing the excess (stretched) skin of the breast. Dr. Tong reshapes the breast mound itself around the implant by manipulating the internal breast tissues. The nipple is elevated to a higher position on the breast mound. Finally, he reduces the size of the areola to better match the new breast proportions. While you are still asleep, the bed is positioned so that you are sitting upright, allowing the breasts to be judged in the most precise manner. Dr. Tong will make surgical refinements to the breasts as needed, to obtain the best possible appearance. Finally, he meticulously sews the wounds closed with plastic surgical technique. After the last stitches are placed, you will be placed in a surgical bra, and then gently awakened from anesthesia.

Recovery from Breast Lift with Breast Augmentation

As the effects of anesthesia subside, our registered nurses closely monitor you in the post-operative recovery area. After recovery from anesthesia, Dr. Tong allows you to go home, accompanied by your friend or family member.

We advise you to rest once at home. You may partake in non-strenuous activities such as watching television and reading, but avoid doing anything more demanding. Expect to feel sore in the chest for 3-7 days; your pain medication will help with the discomfort during this time. The breasts will look swollen and may have bruising in the first 1-3 weeks. Most patients are able return to work (non-strenuous) in 5-7 days.

Dr. Tong sees you to remove stitches and assess your progress at one week after surgery. Patients are generally allowed to start light exercise (e.g. walking) at 1-2 weeks after surgery. Strenuous activities (jogging, martial arts, weight lifting, yoga, pilates, aerobics) are typically started at 4-6 weeks after surgery. In addition to the one week visit, you will see Dr. Tong at 6 weeks and 6 months after surgery. Post-op photos are also taken at some of the visits.

Be aware that the breasts will initially have a slightly unnatural shape to them. This is entirely normal, and it takes between 3-6 months for them to fully settle. As the settling occurs you will gradually notice that the breasts take on a much more natural look, feel, and shape.

Risks and Complications of Breast Augmentation with Mastopexy

As with any surgery, there are risks involved with having Breast Augmentation combined with Breast Lift. Although the procedure has a low risk profile, Dr. Tong will make sure to go through the pertinent potential problems associated with Breast Augmentation plus Mastopexy at the time of your consultation.

Get Educated about Breast Lift (Mastopexy) with Breast Augmentation

There is much information to digest during your Breast Lift/Breast Augmentation consultation. Dr. Tong will take the time to answer all of your questions and address any concerns. You will never be rushed or pressured into a decision. Our goal is to make you an educated patient. We believe that an educated patient will make better choices about their surgery and their choice of surgeon.

To learn more about how Toronto plastic surgeon Lawrence Tong, MD can help you with your Breast Lift and Breast Augmentation goals, set up a consultation by giving us a call at (416) 972-0999. Alternatively, let us give you a call: just fill out our contact form and we will contact you on the same or the next business day. No physician referral is needed.

See Dr. Tong’s work in our Breast Lift with Breast Augmentation before and after photos.

Breast Lift with Implants at a Glance

What the procedure does
Makes the breast fuller and rounder, lifts the breast, lifts the nipple position, and reduces nipple size
Duration of the result
Usually permanent, although breasts may sag with weight gain and aging; implants may need replacement (10-20 years)
Length of time to perform the procedure
3.5-4.5 hours
Type of anesthetic most commonly used
General anesthesia
Length of time off of work
5-7 days
Time to get back to exercise
2 weeks light exercise, 4-6 weeks heavy exercise
Pitfalls your Plastic Surgeon should avoid
  • failing to appreciate the complexity of the procedure
  • ending up with the ‘long breast’ look
  • nipples placed too high