Breast Lift and Implants: Why Choose Two Operations?

When considering breast enhancement, many patients aim to address both the positioning and volume of their breasts. A breast lift, or mastopexy, lifts and reshapes sagging breasts, while implants add volume for a fuller, enhanced cleavage appearance. For patients seeking both, there are two main options: combining the lift and implants in a single operation or opting for a two-stage approach with separate procedures. While a single surgery might seem more convenient, there are significant benefits to spacing the procedures over two operations.

In this article, Dr Turner, a Specialist Plastic Surgeon in Sydney with years of experience in cosmetic breast surgery, will explore why choosing two operations may offer the best results for many patients.

Understanding the Goals of Breast Lift and Augmentation

A concept to understand is that breast lift and breast augmentation require the surgeon to perform two opposing actions:

• Breast lift repositions the breasts higher on the chest, corrects sagging, and reshapes the breast tissue for a firmer appearance. However, it doesn’t increase breast size.
• Breast implants, on the other hand, increase breast volume and fullness, particularly enhancing the upper pole of the breast.

While these two procedures can complement each other beautifully, achieving optimal results in a single session can be challenging due to the distinct nature of each procedure.

Challenges of Breast Lift with Implants in a Single Operation

Combining a breast lift and augmentation in one operation presents several challenges:

• Skin and Tissue Tension: The breast lift involves removing excess skin and tightening the tissue for a firmer look. When an implant is added, it introduces weight and volume, which can create additional tension on the newly lifted tissue. This can affect healing and the longevity of the lift.
• Implant Positioning: Proper implant positioning is essential for enhanced cleavage and symmetrical appearance. Newly adjusted tissue may not be ready to support the added volume, increasing the risk of issues like implant displacement, asymmetry, or further sagging.
• Blood Supply Concerns: Adding an implant can compromise blood flow to the nipple, especially with the manoeuvres required for a lift. Reduced blood supply can lead to complications, including poor healing and nipple compromise.
• Difficulty in Predicting Results: In a single operation, it can be challenging to predict exactly how the skin and tissue will respond to both lifting and added volume. This can make it difficult to achieve the desired shape and symmetry, especially as the tissue settles and heals.

Advantages of a Two-Stage Breast Lift and Implant Approach

Opting for two separate surgeries offers a more gradual and controlled approach, often leading to superior results. Here are the primary benefits of choosing two operations:

• Optimal Healing and Stability: By spacing out the procedures, the breast tissue has time to heal and stabilize following the initial lift. In the first stage, the breast lift is performed to remove excess skin and reshape the breast. After healing, the tissue has adjusted, providing a solid foundation for implant placement in the second stage. This minimizes the risk of complications and allows for more predictable results.
• Enhanced Precision in Implant Selection and Placement: Once the breast has healed from the lift, it is easier to assess the final shape and positioning, enabling the surgeon to select the most suitable implant size and placement. This flexibility can lead to a more personalized outcome, enhancing the overall symmetry, shape, and volume of the breasts.
• Lower Risk of Complications: Each procedure carries its own risks, but by separating them, the surgeon can reduce cumulative risk. For example, waiting until the lift is fully healed lowers the chances of implant-related complications, such as displacement or capsular contracture, as the breast tissue is better prepared to support the implant.
• Improved Longevity of Results: When done in two stages, the breast tissue undergoes less stress, reducing the likelihood of re-sagging and implant-related complications down the road. A staged approach can thus help maintain the results longer, with less need for future corrective surgeries.

The rationale for a two-stage approach is straightforward: the initial breast lift improves shape and positioning. After the lift heals, adding an implant enhances volume, which is easier to achieve on a now aesthetically improved shape. Some patients even find they are satisfied with just the lift and choose not to proceed with augmentation.

Additionally, in a staged approach, the surgeon can safely use larger implants if desired, as the tissue has had time to adjust and heal.

Who Should Consider a Two-Stage Breast Lift and Implant?

A two-stage approach is often recommended for patients with significant ptosis or those who have experienced substantial breast tissue changes due to pregnancy, breastfeeding, or weight loss. Patients with thinner skin or a history of fluctuations in weight may also benefit, as their breast tissue may be less resilient in supporting both a lift and implants in a single procedure. Additionally, individuals who prioritize long-term results and lower complication rates may find a two-stage approach to be the ideal solution.

What to Expect During Each Stage of the Procedure

Stage 1: Breast Lift (Mastopexy)

• Excess skin is removed, and the nipple and areola are repositioned.
• Tissue is reshaped to achieve a lifted contour.
• Healing typically takes 3-6 months, depending on individual recovery rates.

Stage 2: Breast Augmentation

• Implants are chosen and placed to enhance shape and volume.
• Proper alignment with the lifted tissue is ensured for symmetry and stability.
• Healing from augmentation is usually shorter, as tissue has already adapted.

Making the Right Choice: Consultation with an Experienced Surgeon

Every patient’s body and aesthetic goals are unique and choosing between a single or staged approach is a highly personal decision. Dr. Turner, with his extensive experience in breast surgery, is dedicated to helping patients make informed choices that align with their lifestyle, expectations, and desired outcomes. During a comprehensive consultation, Dr. Turner assesses each patient’s anatomy, skin quality, and goals, providing personalized recommendations on whether a one-stage or two-stage approach is best suited.

Next Steps

If you’re considering breast lift procedure and want to know the benefits of a two-stage approach, here are your next steps.

1. Schedule a Consultation: Contact us at 1300 437758 or visit drturner.com.au to book your appointment.
2. Prepare for Surgery: Follow any preoperative guidelines provided, such as avoiding certain medications and arranging for post-surgery care.
3. Plan for Recovery: Set aside time for rest and healing and arrange for assistance during your initial recovery phase if needed.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Consult with a qualified healthcare professional to determine the best treatment options for your individual needs.