That is the question.
In fact, that is a really good question. Before answering it, however, I would like to clarify one important point about the difference between breast implants and a breast lift. Breast implants will make your breasts larger, but will not raise the nipples. A lift will raise the nipples (and will often improve the shape of the breasts), but will not change the size of your breasts. This is important, because some women believe that implants can be used in place of a lift…and unfortunately, some plastic surgeons propagate this misperception. At the risk of overstating this: implants do NOT raise the nipples.
I recommend that women decide whether they want augmentation and/or lift based on the individual merits of each operation. If you want your breasts larger and are willing to accept the risks of breast augmentation, then implants are for you. If you have breast droop and are willing to accept the drawbacks (most notably the scars) associated with breast lift, then breast lift (mastopexy) is for you. If you want your breasts both higher and larger, then both operations can be performed at the same time. Sound simple? Well, it is not always as cut-and-dried as that. Here’s why….the trade-off of droop for scars is not always a straight-forward decision. In general, I have found that women who have mild droop are not eager to exchange their droop for scars. Those with severe droop can’t wait to trade in their droop for scars. Women with moderate droop fall in-between. Some are willing to do so; others not. It is a matter of personal preference. For the women who are on the fence, I usually recommend that they have implants alone and then decide whether they want a lift after they see the effects of implants. The main downside of having implants alone when you have droop is that you might end up with a bulge or double-bubble. The good news is that if you get a bulge or double-bubble, a lift will usually improve or resolve it. Please visit the section on breast lift on this website for more details on these important issues.
Click here to see Breast Augmentation Before and After Images
Click here to see Augmentation Lift Before and After Images
Jean M. Loftus, MD
Plastic Surgeon and Author