Dr Scott J Turner | Specialist Plastic Surgeon (FRACS) | Sydney
One of the most common questions I’m asked at consultation is whether a patient needs a breast lift, a breast augmentation, or both. The confusion is understandable. Online research blurs the distinction. The way the two procedures are marketed can make them sound interchangeable when they aren’t. Getting this decision right matters, because using one procedure to address a problem it isn’t designed for may leave the original concern inadequately addressed.
Dr Scott J Turner is a Specialist Plastic Surgeon (FRACS) with Sydney clinics in Bondi Junction and Manly. He sees patients across Sydney’s Eastern Suburbs and Northern Beaches for breast surgery planning, including whether breast augmentation in Sydney, breast lift surgery, or breast lift with implants may be appropriate for your anatomy.
The Core Difference
This is the simplest way to think about it.
Breast augmentation adds volume. The procedure uses implants, or in selected cases fat grafting, to increase breast size. It doesn’t change where your breasts sit on your chest or how the breast tissue is shaped. If your nipples sit in a good position and your breast shape is fine, but you’d like more volume, augmentation is the procedure.
Breast lift repositions and reshapes. A lift removes excess skin, repositions the nipple and areola higher on the chest wall, and reshapes the underlying breast tissue. It doesn’t add volume. If your breasts have adequate volume but sit lower than you’d like, or have changed shape after pregnancy or weight loss, a lift is the procedure.
Breast lift with implants does both. Where volume loss and low position both apply, a single operation can often address them in one stage. This is the most common scenario I see in patients coming in for assessment after pregnancy or significant weight loss.
The decision isn’t preference. It’s anatomy. The right procedure matches what your breasts are doing now to what you want the result to look like.
Quick Decision Guide
- You mainly want more volume and your nipples sit above the breast crease: breast augmentation may be considered.
- Volume is adequate but the nipples sit low or the skin envelope is stretched: breast lift may be considered.
- You have both volume loss and low breast position: breast lift with implants may be considered.
- You have significant sagging and want larger implants: a staged approach may sometimes be safer than doing everything in one operation.
Quick Comparison
| Feature | Breast Augmentation | Breast Lift | Breast Lift with Implants |
|---|---|---|---|
| Primary issue addressed | Low volume | Low position, excess skin, altered shape | Volume loss and low position |
| Uses implants | Yes | No | Yes |
| Removes excess skin | No | Yes | Yes |
| Repositions nipple | No | Yes | Yes |
| Surgery time | 1 to 2 hours | 2 to 3 hours | 2.5 to 4 hours |
| Scar extent | Implant incision only | Periareolar, vertical, or inverted-T | Periareolar, vertical, or inverted-T |
| Recovery to desk work | Usually 1 to 2 weeks | Usually 2 to 3 weeks | Usually 3 to 4 weeks |
| Full activity | 6 to 8 weeks | 6 to 8 weeks | 8 to 12 weeks |
| Indicative cost | From $11,000 | $14,000 to $20,000 | $18,000 to $26,000 |
| Medicare eligibility | No, cosmetic | Possible if criteria met | Possible for lift component only |
How to Assess Which Procedure You Need
There’s a rough self-assessment framework I use in consultation that patients can apply at home to get a general sense of where they sit. It isn’t a substitute for proper clinical assessment, but it helps frame the conversation.
The Inframammary Fold Test
Stand in front of a mirror with your arms by your side. Look at where the centre of your nipple sits relative to the inframammary fold, the natural crease underneath the breast.
- Nipple above the fold. Breast position is generally good. Volume loss is the likely issue if there is one. Augmentation, or fat grafting in selected cases, is typically the answer.
- Nipple at the fold level. Borderline. Depending on overall shape and volume, the answer may be augmentation, a mild lift, or a combined approach.
- Nipple below the fold. Ptosis is present. A lift is required. Whether implants also need adding depends on volume.
- Nipple below the lowest point of the breast and pointing down. Severe ptosis. A more extensive lift is required, almost always with careful consideration of whether implants should be added in one stage or two.
The Pencil Test
Place a pencil horizontally in the crease underneath your breast. If the breast tissue holds the pencil in place, there’s some degree of ptosis and skin laxity. The heavier and lower the pencil sits, the more significant the ptosis.
Upper Pole Fullness
Look at the top third of your breast in profile. In a breast with adequate volume, the upper pole has a gentle fullness. In a breast that has lost volume, typically after pregnancy or weight loss, the upper pole looks flat or concave.
Flat upper pole and good nipple position points to augmentation. Flat upper pole and low nipple position points to a combined lift with implants. Full upper pole and low nipple position points to lift alone.
When You Need a Breast Augmentation
The patient profiles I see for augmentation alone tend to share a few common features. Breast position is good. The nipple sits above the inframammary fold. There’s no significant skin laxity. The issue is volume.
Common scenarios:
- Women who’ve always felt their breasts are smaller than they’d prefer, without any other concern about shape or position
- Patients who’ve lost volume after weight loss but retained good breast position because skin elasticity held up
- Patients with asymmetry where the smaller breast needs volume added to match the larger side
- Women who’ve completed breastfeeding, feel deflated in the upper pole, but whose breast position is still satisfactory
If this describes you, the breast augmentation procedure page explains implant options, sizing, recovery, risks, and consultation planning in more detail. The breast implant size guide covers how implant volume is matched to chest wall measurements, and the dual plane breast augmentation guide walks through the implant pocket technique used in most primary cases.
When You Need a Breast Lift
Lift alone is the right procedure when position and shape are the problem but volume is adequate.
Common scenarios:
- Post-pregnancy changes where the breasts retained volume but dropped significantly on the chest wall, often with stretched or relaxed skin
- Post-weight-loss where skin elasticity didn’t fully retract, leaving the breast tissue lower than its original position but reasonably volume-intact
- Breast asymmetry where one breast sits significantly lower than the other
- Congenital breast shape concerns that need reshaping rather than enlarging
If this describes you, the breast lift Sydney guide walks through the different incision patterns and what to expect.
When You Need Both: Lift with Implants
The largest group of patients I see for breast surgery consultation falls into this category, particularly those coming in after their families are complete.
The scenario is usually this. Breastfeeding and multiple pregnancies reduced breast volume, particularly in the upper pole. The skin stretched during pregnancy and didn’t fully retract afterwards. The breast tissue also shifted lower on the chest wall. The result is a breast that is smaller than it used to be, sits lower than it used to, and has lost the fullness at the top that clothing used to flatter.
Implants alone won’t address the sagging. A lift alone won’t address the volume loss.
The combined breast lift with implants procedure addresses both in one operation in most cases. In specific higher-risk cases, such as severe ptosis, compromised soft tissue, or blood supply concerns, a two-stage approach is the safer option, with the lift performed first and implants added in a separate operation three to six months later.
Why Implants Alone Cannot Correct Significant Sagging
This is the key clinical decision point, so it’s worth being explicit.
Breast implants add volume. They don’t reliably lift a low nipple position. If the nipple sits below the breast crease, placing an implant alone can leave the implant sitting higher on the chest while the natural breast tissue remains lower. The result is an unbalanced shape sometimes called a “double bubble,” and it may require revision surgery to correct.
For patients with significant ptosis, a breast lift or a combined breast lift with implants is the more appropriate plan. Where ptosis is borderline, an augmentation alone may produce a satisfactory result, with a lift added later if needed. Which approach suits your anatomy is assessed at consultation. It isn’t decided by preference.
Cost Comparison
Dr Turner’s breast surgery pricing in Sydney falls within these ranges.
| Procedure | Typical Cost (all-inclusive) |
|---|---|
| Breast augmentation (standard) | From $11,000 |
| Hybrid breast augmentation | From $15,000 |
| Breast lift (mastopexy alone) | $14,000 to $20,000 |
| Breast lift with implants | $18,000 to $26,000 |
Where you sit within these ranges depends on implant selection (where applicable), hospital choice, length of stay, anaesthetic requirements, and the specific surgical plan. Medicare rebates through item 45558 may apply to breast lift cases where clinical criteria are met, such as severe ptosis following pregnancy or massive weight loss. This reduces out-of-pocket cost for eligible patients.
A detailed cost quote is provided after consultation. The breast augmentation cost Sydney guide covers pricing across the augmentation pathway in more detail.
Recovery Comparison
Recovery timelines are similar across the three procedures, but the combined lift with implants is slightly longer and more demanding.
Breast augmentation. Most patients return to desk-based work within one to two weeks. Light exercise from four to six weeks. Full strenuous activity around six to eight weeks.
Breast lift. Two to three weeks before returning to desk work. Light exercise from four to six weeks. Full activity around six to eight weeks. Scars continue to mature over 12 to 18 months.
Combined lift with implants. Three to four weeks before desk work because there’s more surgical trauma to recover from. Light exercise from six to eight weeks. Full activity typically at eight to twelve weeks. Scars follow the same 12 to 18 month maturation.
Individual recovery varies in all three cases. Smoking, diabetes, wound healing risk factors, and general health all affect the timeline.
AHPRA Requirements
All three procedures are classified as cosmetic surgical procedures under the Medical Board and AHPRA requirements that came into effect on 1 July 2023.
A GP referral is required before the first consultation. A minimum of two consultations with Dr Turner is required before surgery can be booked. A psychological evaluation is conducted to confirm suitability. A 7-day cooling-off period sits between the second consultation and the day of surgery. A surgical deposit of $1,000 is payable only after the second consultation, not before.
These requirements aren’t optional. They aren’t bureaucratic hoops either. They exist to protect patients, and Dr Turner’s team coordinates each step of the pathway.
Breast Surgery Consultation in Sydney
Dr Turner consults for breast augmentation, breast lift, and combined procedures at his Sydney clinics in Bondi Junction (Eastern Suburbs) and Manly (Northern Beaches). Surgery is performed at accredited Sydney private hospitals.
At consultation, you’ll be assessed against the specific anatomical factors that determine which procedure is appropriate. Chest wall measurements. Breast base width. Soft tissue cover. Nipple position relative to the inframammary fold. Degree of ptosis. Upper pole fullness. From that assessment, a surgical plan is recommended that matches your anatomy to the outcome you’re considering. Reviewing surgical galleries forms part of that discussion, and the breast augmentation before and after photo assessment guide explains how to evaluate cases when implant size and shape are being considered.
Frequently Asked Questions
Can I get a breast augmentation even if my breasts are sagging?
You can, but the outcome may not address the sagging. Implants add volume to wherever the breast currently sits. If your breasts are low on the chest, implants will make them larger, but they’ll still sit low. For patients with significant ptosis, an augmentation alone typically produces an unsatisfactory result, with the implant visible as a bulge on a sagging breast. This is why accurate assessment matters before committing to a procedure. If both volume and position need addressing, a combined lift with implants is the appropriate operation.
Will a breast lift alone make my breasts smaller?
A lift doesn’t remove breast tissue in most techniques, so it doesn’t reduce cup size significantly. What it does is remove excess skin and reshape the breast, which can make the breasts appear more compact because the tissue is consolidated into a higher, tighter shape. Some patients find their bra size stays the same after a lift. Others find they go down a cup size because the tissue that was spread out is now concentrated higher. If a significant size reduction is what you want, a breast reduction is a different procedure.
Is it cheaper to have a lift alone than a lift with implants?
Yes. A breast lift alone is typically $14,000 to $20,000 all-inclusive, while a breast lift with implants is $18,000 to $26,000. The difference covers the cost of the implants themselves, the additional surgical time required to work with implants, and the more complex planning involved. If you don’t need implants because your volume is adequate, a lift alone is appropriate and more cost-effective. Adding implants when they aren’t clinically indicated isn’t a good reason to have a more expensive operation.
Can I just have implants first and see if I need a lift later?
In specific cases, yes. For patients with borderline ptosis (nipple close to the fold line) and otherwise good volume distribution, an augmentation alone can produce a satisfactory result. A lift can be added later as a second procedure if needed. For patients with more significant ptosis, this approach doesn’t work, because the implant will make a sagging breast look worse rather than better. Which approach suits your anatomy is assessed at consultation, not decided by preference.
How do I know if I qualify for a Medicare rebate?
Medicare item 45558 applies to breast lift surgery in specific clinical cases, most commonly severe ptosis following pregnancy or massive weight loss, or breast asymmetry that meets criteria. Breast augmentation is classified as cosmetic and doesn’t qualify for Medicare. For a lift, eligibility is determined by clinical presentation, including the severity of ptosis, documented history of pregnancy or weight loss, and presence of symptoms. A GP referral is required in all cases under AHPRA requirements. Medicare doesn’t cover the full cost of surgery, but it reduces the gap you pay.
Consult with Dr Scott J Turner
The right procedure for you depends on your anatomy, not on a self-assessment or guess. The inframammary fold test, pencil test, and upper pole assessment give you a rough sense, but accurate surgical planning comes out of detailed measurements and examination at consultation.
Dr Turner consults at his Sydney clinics in Bondi Junction (Eastern Suburbs) and Manly (Northern Beaches).
To arrange a consultation, contact the practice or call 1300 437 758.
