Breast Lift vs Implants: Pros and Cons of Both Procedures

It is common for me to see patients who are not sure whether they need a breast lift or a breast implant, or perhaps both.

In truth, many patients do not understand the differences between the two, or the pros and cons of each. They are extraordinarily different surgeries with different outcomes and different expectations.

If you’re struggling to understand which procedure is right for you, then hopefully this post will help. I’ll compare breast lifts vs implants and explain when you should consider either (or both!).

How do breast implants and lifts differ?

Breast implants add size to the breast. A natural breast takes on a teardrop shape, whereas an implanted breast is full and bulgy up top – like wearing a push-up bra.

While technically less natural, many patients prefer this pushup bra look.

Implants can also give a slight elevation to the breast, but if a patient is excessively droopy it will not do enough, which is where a breast lift comes in.

A breast lift simply takes what is already there (no implant) and puts it back in a better place by tightening loose skin.

Think of a bra that is too large. A breast lift is like removing fabric to make the bra tighter, only the fabric is the skin itself.

Lifted breasts will take on a tear-drop shape, and there will still be some droop, but far less. A breast lift allows the elevation of the nipple to a more youthful position.

A breast lift does not give long-term upper beast fullness like an implant, but it gives a more natural-looking breast.

Do I need a breast lift or implants? Or both?

Breast implants are an option for women who desire larger breasts or hope to restore lost volume. As a result, they’re generally appropriate for:

• Patients with smaller breasts who wish for a fuller, better-proportioned figure
• Patients who wish to increase their breasts by at least one cup size
• Breasts that have lost volume after childbirth or weight loss

However, if a patient likes her size and just wants a less droopy breast, they should consider a lift. A breast lift is often more appropriate for:

• Proportionate, but sagging or drooping breasts
• Breasts with nipples that point downward
• Breasts that have lost their firmness
• Breasts that are asymmetrical, where one hangs lower than the other

In some cases, it may be appropriate to consider a combination of both. For example, if your breasts are sagging and lack volume, then a lift with implants can help.

Either way, it should all start with a consultation with an expert plastic surgeon.

At my practice, the start of the consult tries to get to the heart of the matter. If a patient likes her size while in a bra, but when the bra comes off, the breasts “go south” then that patient is a likely candidate for a lift alone. If that patient wishes she were larger while wearing her bra, then I will need to place an implant.  

Depending on the degree of droop, some patients who want to be larger will need a lift and implant combination. 

What about other options?

There are cases where I might suggest a different approach.

For example, if a patient wants to lift an excessively large breast, I might suggest a lift along with a breast reduction. This is because heavy breasts will always “go south” – simply put, gravity wins.

And if a patient needs a lift and an implant, but the breasts are very large, I might suggest a lift and reduction first, followed by a staged augmentation. The heavier the natural breast, the more variable the outcome when lifts and implants are combined.

Furthermore, many patients want what I refer to as gravity-defying breasts. This breast can only be achieved in a patient with little natural tissue. They are all implants, and there is nothing natural to droop. To achieve this in a larger-breasted patient, they’ll first need a reduction followed by a staged implant.

Essentially, this creates a situation where there is less natural tissue to respond to gravity.

However, aggressive reduction of natural tissue at the same time as augmentation can increase the risk of healing problems, which is why I prefer to stage it. In practice, it is very rare for patients to want to go smaller just to then add implants, but I hope this concept makes sense.

The Pros And Cons Of A Breast Lift vs Breast Implants

Droopiness 

Whether droopiness is a pro or con is subjective and depends on your goals.

A lifted breast will take on a teardrop shape breast and regain some droop. This is what natural breasts do and will be considered a “pro” by patients desiring natural-looking results.

However, in this country, perhaps because of surgeons like me, we are more used to seeing implanted breasts and considering them ideal. So, some may consider the droopiness after a breast lift a “con” and instead favor the non-droop of implants.  

Scars

Scars are a “con” of any surgical procedure, and it’s no different for implants or lifts.

Generally, implant procedures alone (no lift or reduction) result in fewer, smaller scars.

Breast lifts leave more scars. And while there are different types of lifts, they are essentially all skin-removing procedures, and by definition, result in scarring to varying degrees.

Scars can be good or bad, but either way, they’re controlled far more by your genetics than your plastic surgeon.

The risks of these scars must be worth it to you.

Fullness

Implants give a bulge in the top of the breast — we call this upper pole fulness. It is seen in much younger women because developing breast tissue is pushed against tight skin.

As the skin relaxes, the teardrop or mature breast begins. While technically less natural, many consider this a “pro”. 

Many patients say, “I just want a small implant to give me upper pole fullness with my lift”. The problem is that a small implant is often not enough. To achieve fullness up top, the implant must be tall enough and wide enough, and this will determine the size of the implant.

The pros of implants are upper pole fullness and an increase in breast size, but there is a lot more to think about.

Lifted breasts belong to you. While they may droop over time and can be lifted again, they are all yours, and you need to do nothing further.

Implants are not yours. Implants are not forever and, as a mechanical device, they will eventually break, leak, or fail and will require maintenance and exchange.

Risks

While each surgery has its own risks, leaks, ruptures, MRI follow-ups, and capsular contractures are unique to implants. More time, more thinking, more surgeries, and more future dollars, so these cons need to be far offset by the pros for a patient.

Summary

Deciding between a breast lift and implants is an individual choice, but one that can be guided by an expert surgeon.

A consultation is vitally important. It is an opportunity to hone in on specific goals and create realistic and honest expectations.

It’s also a chance to make sure patients understand the differences between surgeries, and their future implications.

Only 10% of what I do is the surgery, the other 90% is making sure that patients understand the path they are embarking on – its risks, rewards, and long-term consequences

Can’t Decide Between A Breast Lift Or Implants? Let Us Help

Dr Adam G. Tattelbaum, MDPC, is a double-board certified plastic surgeon specialising in breast implant and breast lift procedures. If you are considering either procedure and want to know more, call Dr Tattelbaum’s office at (301)-656-6398 or contact us online.

Dr Tattelbaum offers in-person consultations at his offices in Mclean, Virginia, and Rockville, Maryland. Virtual consultations are also available.