Combine volume enhancement with elevated contours.
Augmentation with lift adds volume and raises the breast in the same surgery. By combining cohesive gel implants with a surgical mastopexy, we restore a youthful, perkier position while achieving the patient's desired fullness.
InquireUnder general anesthesia, the augmentation-mastopexy begins with precise preoperative markings delineating the new nipple-areolar position and skin resection pattern - most commonly a Wise pattern or vertical mastopexy design. A pocket is created for the implant, typically in the dual-plane position beneath the pectoralis major, which provides additional soft-tissue coverage. The chosen cohesive silicone gel implant is inserted and positioned symmetrically. The mastopexy component reshapes the breast parenchyma using an internal suture technique to create durable upper pole projection, followed by careful skin closure. Implant sizing is intentionally conservative to minimize tension on the overlying skin envelope.
This procedure works best for women who want more fullness and also need the breast lifted. The classic patient has nipple-areolar complexes positioned at or below the inframammary fold combined with loss of upper pole fullness and skin envelope laxity that cannot be corrected by an implant alone. You should be non-smokers, in overall good health, at a stable weight for at least six months, and have clear expectations about scarring and the combined recovery.
Recovery mirrors that of a standard mastopexy with the added consideration of implant settling. A surgical bra is worn continuously for the first three to four weeks. Swelling and bruising are most pronounced in the first week and resolve substantially by three weeks. Most patients get back to desk work within ten to fourteen days. Strenuous activity, lifting, and overhead movements are restricted for six weeks. Implants settle into their final position over three to six months.
Surgical bra worn continuously. Pain managed with medication. Limited arm movement; drains removed if placed.
Return to desk work. Swelling and bruising diminish significantly. Incisions healing without tension.
Light lower body exercise permitted. Implants begin to settle. Upper body restrictions continue.
Full activity resumed. Implants settle into final position over three to six months. Scars mature and fade.
The main added risk with the combined approach is tension at the T-junction scar where three incision lines converge, which may lead to delayed healing or widened scarring. Implant-related risks include capsular contracture, malposition, and rupture. Mastopexy risks include nipple-areolar sensory changes, asymmetry, and suboptimal scar appearance. All risks are mitigated by careful patient selection, conservative implant sizing, and staged procedures when clinically indicated.
For patients with mild sagging and adequate volume, a breast lift alone may be sufficient. Patients desiring only volume enhancement without significant ptosis may be candidates for augmentation alone. Non-surgical options such as fat grafting to the breast can add modest natural volume but cannot adequately correct significant ptosis.
Performed by Dr. Ruben Castro in Newport Beach, California