Breast Lift with Augmentation

Author: Dr. Michael Bogdan

Most women who are interested in a combined mastopexy-augmentation are interested in a youthful and perky appearance to their breasts. Because of the need for low tension across incisions to optimize healing, simultaneous mastopexy-augmentation procedures inherently have a more "relaxed" look. If that is the appearance you desire, then you might be satisfied with a combined operation--but you will still end up with wider scars than if the procedures were staged. If you are really trying to get the perkiest breasts, with the best looking scars, and want to achieve it with the lowest risk, then staging the two procedures makes the most sense.

If you are interested in learning more about breast augmentation & mastopexy surgery in the Dallas-Fort Worth area, request a consultation with Dr. Michael Bogdan.


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Breast augmentation with lift before photo Before
Breast augmentation with lift after photo After

This athletic 48 year old mom visited Dr. Bogdan for a makeover. Despite an intense exercise regime, she could not regain her flat stomach. Pregnancy had stretched out both her skin and muscles. After a combined breast lift and abdominoplasty, she was so happy with her appearance that she came back later for breast volume enhancement to complete her staged Mommy Makeover!

Before & After Photos

Keep in mind that each patient is unique and your results may vary.

Choosing an Augmentation Mastopexy

Patients visiting my office who are interested in both breast volume enhancement (augmentation) and a lift (to address skin excess, large areola, or just overall droop) would love to do the procedure in one stage! Most are attracted to my work by looking at the end results in the photo gallery, noticing the good scars, nice symmetry, and a perky / youthful appearance. The best results (from the standpoint of youthful look and scar appearance) is acheived with a staged approach. Because of this, I repeatedly have the same discussion with potential patients, reviewing the pros and cons of the combined procedure vs. a staged approach. To review some of the main points:

Pros for the Combined Breast Lift & Augmentation

  • One operation (but you have a higher chance of needing a revision)
  • Less expensive (the first hour is the most expensive for anesthesia / OR time)
  • One recovery period

Pros for a Staged Breast Lift & Augmentation

  • More control over the end result
  • Better looking scars (because of lower tension)
  • Ability to achieve a perkier result
  • Lower complication rates
  • You might be happy with just a lift and not need an augmentation!

Patients often request a combined mastopexy augmentation because they are trying to "get it all done at once" to avoid a second recovery period. What they often don't understand is that the combined procedure has less control over the surgical outcome (changing more variables at the same time), inherently has worse scars, and has higher complication rates. A famous surgeon once said that plastic surgery is "a battle of beauty vs. blood supply," and this directly applies to the Aug-Mastopexy. The breast lift component of the operation is performed with scars below the breast, so you should think of it more as a "push" operation rather than a "lift" (the scars are effectively pushing the breast tissue upward to create the lift). Because of this, the weight of the breast is pushing down onto the scars, trying to stretch them out. Tension-free incisions tend to heal with very thin scars, while incisions healing under tension tend to widen. If you simultaneously add the weight of an implant above the incisions, you will automatically end up with wider scars than if you were only lifting the breast tissue.

You might remember from math class that it is relatively simple to solve equations with a single variable, but things become more complex as more variables are added. The same holds true with surgery. In a combined mastopexy augmentation, the surgeon is working with multiple variables (nipple position, skin envelope dimensions, breast volume removal, implant volumes, scar contracture), and "getting it right" becomes inherently more difficult. If the operation is staged, less variables are being addressed during each operation, and it is far simpler to achieve the desired result.

Finally, the issue of safety. Incisions heal best in a tension-free environment with good blood flow. In the case of the combined mastopexy augmentation, the skin envelope has been tightened, the weight of the implant is pressing down on the incisions, both of which decrease blood flow. With decreased blood flow, healing is impaired, and scars tend to be wider, wound healing complications are more likely, and infection rates are higher.

If you still want to get it all done at once, can you? Yes – as long as you have a full understanding of the risks / benefits and are accepting of a reasonable result from an inherently more difficult operation.

Dr. Michael Bogdan

Dr. Bogdan is a board-certified plastic surgeon with a passion for his craft who is known for working closely with patients to get excellent results.

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Your Next Step

A staged breast lift and augmentation can both enhance your breast volume and restore the perky appearance to your breasts. Planning to do the procedure in two stages gives the ultimate control in the result and maximizes the conditions to get the best looking scars. Scar care is an important component of the surgery, so please review Dr. Bogdan's informational page on scar care. While it is convienent to perform a combined augmentation / mastopexy, the results are superior with a staged approach. Visit Dr. Bogdan to fully discuss your desired outcome, and review the options available.

If you would like to find out if a mastopexy / augmentation procedure is right for you, click here to request a consultation with Dr. Michael Bogdan, a board-certified plastic surgeon specializing in breast enhancement surgery in the Dallas-Fort Worth area. Or, you can call our office at (817) 442-1236 to schedule your appointment.

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Southlake: (817) 442-1236

Michael A. Bogdan, MD, FACS
410 North Carroll Avenue #170
Southlake, TX 76092
Phone: (817) 442-1236
Fax: (817) 442-1247
Mon–Fri: 9 a.m.–5 p.m.

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Keep in mind that each patient is unique and your results may vary.

Board-certified plastic surgeon Dr. Michael Bogdan offers a range of cosmetic plastic surgery options in Southlake, Texas, including rhinoplasty, facelift, tummy tuck, breast lift, and Mommy Makeover surgery. He serves Fort Worth, Frisco, and other communities in the DFW metro area.

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