Eventually, subtle changes stop being subtle. Clothes don’t drape the same way, necklines feel off, and you start to notice that skin feels softer, breast tissue sits a little lower, and the fullness has faded.
That’s usually when the research begins. You’ll come across two common procedures, breast augmentation and breast augmentation with lift, and realize they often overlap but aren’t interchangeable. They’re different procedures designed for different goals: one restores volume, the other restores position. Understanding exactly what you're looking for is the key to a result that feels natural, balanced, and entirely your own.
The Short Explanation
Breast augmentation (also called augmentation mammoplasty) focuses on size and fullness. It enhances the shape and structure of your breasts using implants or fat transfer, improving contour and proportion.
A breast lift, or mastopexy, focuses on breast position. It lifts sagging breasts, removes excess skin, and reshapes the underlying tissue to restore firmness and a more youthful shape.
When combined, a breast augmentation with lift creates the best of both worlds—improved volume and improved placement. The right choice depends on how your breasts look and feel now. Your existing breast tissue, your skin elasticity, and your long-term aesthetic goals all contribute to which procedure is most fitting.
What a Breast Augmentation Does
At its core, breast augmentation surgery is a volume enhancement. It’s one of the most common plastic surgeries worldwide and can be performed using saline implants, silicone implants, or your own fat.
They're ideal for women who’ve lost volume after pregnancy, weight loss, or natural aging, or who simply want to create more symmetry between breasts. During the breast implant surgery, your board-certified plastic surgeon makes small, discreet incisions (usually under the breast crease, around the areola, or occasionally in the armpit) and inserts the implant either beneath the breast tissue or under the chest muscle.
The procedure typically lasts up to three hours, depending on your implant type and whether other procedures like a breast lift are being combined.
Implant Options: The Details That Matter
Saline implants are filled with a sterile saltwater solution after placement, allowing for small adjustments in volume during surgery. They’re known for their firm shape and are FDA-approved for patients 18 and older.
Silicone implants, on the other hand, are pre-filled with cohesive silicone gel. They feel more like natural breast tissue and tend to move and settle more naturally. These are FDA-approved for patients 22 and older.
There’s also a newer version known as “gummy bear implants,” a highly cohesive silicone that maintains shape even if the shell is compromised. Your surgeon will help you decide which implant works best for your body type, breast size, and desired outcome. The decision usually comes down to feel, appearance, and personal preference.
What a Breast Lift Does
A breast lift surgery is less about adding and more about elevating. It’s designed to correct drooping breasts by tightening the surrounding tissue, removing excess skin, and repositioning the nipple and areola for a more youthful position.
If your nipples sit below the breast fold or point downward, a lift is likely part of what you need. If your breasts still have some firmness and the nipples sit above the crease, a lift may not be necessary. During a breast lift procedure, your plastic surgeon may use one of several techniques, depending on how much skin and tissue need to be repositioned:
- Periareolar lift (crescent): for mild sagging, incision around the areola.
- Vertical or “lollipop” lift: for moderate sagging, incision around the areola and down to the breast fold.
- Anchor lift: for more severe sagging, incision around the areola, down to the crease, and along the fold for maximum lift.
While a lift doesn’t dramatically change your breast size, it creates a firmer, more youthful contour and can make the breasts look rounder and higher without an implant.
Understanding Sagging vs. Volume Loss
This is one of the biggest sources of confusion for patients. Sagging breasts and volume loss can look similar in clothes, but they stem from different issues beneath the surface. Volume loss happens when the breast tissue itself deflates or thins. It’s common after pregnancy, breastfeeding, or significant weight loss, when fat and glandular tissue shrink but the skin envelope remains. The breast may look smaller or flatter, especially at the top, but the nipple usually stays in a natural position. In this case, breast augmentation is often the most effective solution.
Sagging (or breast ptosis), on the other hand, is about skin laxity and gravity. The natural breast tissue hasn’t necessarily lost much volume—it’s just shifted downward. When the nipple falls below the breast crease or points toward the floor, it’s a clear sign that a breast lift surgery is needed. Sometimes, the two issues overlap, and a combined breast augmentation and lift restores both the structure and the position, giving the breasts a naturally lifted, fuller look without exaggeration.
If you’re unsure which applies to you, try this: stand in front of a camera or mirror and note where your nipples sit in relation to the breast fold. Above the crease? You may only need implants. Below it? A lift is likely necessary. A board-certified plastic surgeon will confirm this during your consultation, using precise measurements and your aesthetic goals to recommend the right plan for your anatomy.
When to Combine Breast Augmentation and Lift
Many women come in expecting one procedure and leave realizing they need both. That’s because volume and position are often connected. Fullness alone can’t fix sagging, and a lift alone can’t restore upper breast volume. A combined lift and breast augmentation offers a more holistic approach to breast rejuvenation.
During this surgical procedure, your surgeon first lifts and reshapes the breasts by removing excess skin and repositioning the tissue. Then, a breast implant is placed to restore fullness and create a smoother, more proportionate shape. With the combination procedure, you get fuller, lifted, firmer breasts that look natural and balanced. This combination is especially beneficial for women who’ve experienced weight changes, pregnancy, breastfeeding, or age-related changes that affect both shape and volume.
At a glance, combined breast lift with augmentation:
- Restores lost volume and corrects sagging in one operation.
- Reduces the need for multiple surgeries and recoveries.
- Improves breast shape, symmetry, and upper breast fullness.
- Creates a natural, youthful contour with long-lasting results.
While it’s technically more complex, a board-certified plastic surgeon can perform this safely with exceptional outcomes.
Deciding Which Is Right for You
Choosing between a breast augmentation and an augmentation with lift starts with understanding what your breasts are doing now. If you’re dealing with deflation but not drooping, implants alone might be perfect. If your breasts have descended or the nipples point downward, a breast lift is likely needed. And if both are true—sagging and volume loss—the combined procedure delivers the most complete result.
A breast enhancement consultation is where you’ll get clarity. Your surgeon will evaluate your natural breast tissue, skin elasticity, and overall health, and help you understand how to achieve your desired results. The goal is to ensure the results feel harmonious—not overdone or underwhelming—just right for your body shape and confidence.
Common Questions
Is a breast lift cheaper than augmentation?
Not necessarily. The complexity of removing excess skin and reshaping the breast often makes a lift slightly more expensive.
Can I combine a lift and implants?
Yes, and many patients do. It’s often the most efficient way to get both volume and lift in one recovery period.
Will I have scars?
Yes, but they fade over time. A skilled surgeon places incisions strategically along the breast crease or areola to minimize scarring.
Can I breastfeed after surgery?
Often yes, though it depends on your anatomy and the type of surgical procedure performed.
When will I see my final results?
You’ll see early improvement within weeks, but final results take time—usually three to six months for implants to settle and tissue to fully heal.
The Emotional Side of Breast Surgery
This part is harder to measure, but often the most meaningful. Patients describe an increase in confidence that goes beyond appearance. Clothes fit differently, movement feels lighter, and posture improves. There’s a sense of ownership over your body again.
It’s not vanity. It’s self-alignment. It’s the feeling that your reflection finally matches the way you’ve always felt inside.
Breast Augmentation vs Augmentation With Lift
Breast augmentation enhances volume and shape.
A breast lift reclaims position and firmness.
A combined procedure delivers balance—volume where you want it, lift where you need it.
Schedule a consult with our Mobile plastic surgery clinic to map the right plan with Dr. Park or Dr. Rebowe, who can guide you through every stage from your first consultation to your breast augmentation recovery and beyond.
Because the best outcomes aren’t just about breast size or shape, they’re about confidence, proportion, and feeling like yourself again.
