Do I Need Breast Augmentation or a Breast Lift To Address Breast Sagging?

The answer to this common question is, “It depends.” If you want to fix sagging, a breast lift is usually required to improve their shape and position, while implants are optional for added volume. Breast augmentation can be enough to fill out mild sagging.

Deciding between breast augmentation and a breast lift to address sagging breasts can be challenging. Your plastic surgeon will guide you based on your goals, but understanding more about these procedures and how they affect breast shape can help you make an informed decision. 

What Causes Sagging Breasts?

Breast sagging, technically called ptosis, can result from various factors, including: 

• Multiple pregnancies and breastfeeding that cause the skin to stretch several times
• Naturally large breast size
• Weight fluctuations
• Not wearing a supportive bra
• Natural aging process

These factors contribute to the loss of elasticity in breast skin, causing breasts to lose volume and position over time. 

Do Breast Implants Fix Sagging?

In some cases. If you have very mild sagging, implants can add fullness to the upper breast, making it appear lifted. Breast augmentation primarily improves the size, shape, and projection of the breasts. However, breast implants alone won’t correct moderate or severe sagging. 

Implants are ideal for restoring lost volume, but they don’t lift breasts or improve their shape if sagging is significant. If your breasts hang below the breast crease or have an oval or pointy shape, a breast lift will be needed to restore the contour. 

Does a Breast Lift Improve Breast Sagging?

A breast lift (mastopexy) is the best option for addressing breast sagging. During a breast lift, your plastic surgeon will remove excess skin and reshape the breast tissue, giving your breasts a lifted, more youthful appearance. Your surgeon can also reposition the nipples and areolas to a more central position, which helps improve the overall aesthetic.  

How Do You Know If You Need a Breast Lift, Just Augmentation, or Both?

Breast sagging requires a lift. Not enough or loss of volume requires implants. Breasts that are too small and saggy, require both. There are some simple ways to assess your needs at home:

Questions To Ask Yourself 

• Have you had children or experienced significant weight fluctuations? 
• What is your current cup size? 

If you answered yes to the first question and are larger than a small B cup, a breast lift is usually necessary. However, this isn’t definitive, and your plastic surgeon will provide personalized recommendations during your consultation. 

Assessing Your Breasts 

• If your breasts hang below your breast crease, you likely need a lift.  
• Deflated or collapsed upper breasts without significant sagging may benefit from implants alone. 

Mirror and Photo Assessment 

• Stand in front of a mirror at a 45-degree angle to evaluate the shape of your breasts. Look at whether your breasts hang over the crease. 
• You can also take a photo of your breasts at this angle and compare them to similar cases online to help identify the right procedure for you. 

While these self-assessments can help guide your decision, a consultation with a skilled plastic surgeon is essential to determine the best approach to achieve your desired results. They’ll provide expert insights tailored to your anatomy and aesthetic goals.

What Is the 45-55 Rule for Breasts?

A natural-looking, aesthetically balanced breast typically has about 45% of its volume in the upper pole (above the nipple) and 55% in the lower pole (below the nipple). This proportion creates a youthful breast shape with a gentle upper slope and a round, well-defined lower pole (underboob). Surgeons often consider this upper-to-lower pole ratio when evaluating breast shape and planning breast enhancement procedures.

A common misconception is that upper pole fullness alone makes the breasts attractive. In reality, lower pole shape and proportion are just as important.

As breasts sag, volume shifts downward. The lower pole can become elongated and less defined, while the upper pole appears flatter, creating a less balanced appearance. A breast lift reshapes the breast to restore a round lower pole and improve proportion. Implants add volume and upper fullness but do not correct sagging or reshape the lower breast. If both sagging and volume are concerns, combining a lift with implants may be the best option.

Should I Combine Breast Augmentation With a Breast Lift?

If you want to add volume to your breasts while correcting sagging, a combined breast lift and augmentation is an excellent choice. This combination gives you both a more lifted appearance and enhanced fullness, particularly in the upper pole of the breasts. Many women who have experienced changes after pregnancy or weight loss opt for this combined approach, especially as part of a Mommy Makeover that addresses multiple areas of the body. 

How Many Years Does a Breast Lift Last?

Many women enjoy the results of their breast lift for 10 to 15 years or longer. While a breast lift delivers long-lasting results, it doesn’t stop the aging process. Over time, factors such as aging and skin elasticity can lead to additional sagging.

To help prolong your results, you can: 

• Wear a supportive bra that fits you properly
• Sleep on your back to support your breasts
• Take care of your breast skin so it retains as much elasticity as possible
• Avoid pregnancy, breastfeeding, or significant weight fluctuations 

While no procedure can entirely halt the effects of time and gravity, following these tips can help you enjoy the benefits of your breast lift for years to come.

Am I a Good Candidate for a Combined Breast Augmentation and Breast Lift?

You may be a good candidate for a combined procedure if you meet the following criteria:

• You are in good physical health. Because recovery can be slightly more complicated with a combination procedure, your overall health plays a significant role in how smoothly you recover. 
• You are a non-smoker and avoid alcohol before surgery. Both can interfere with healing. 
• You have realistic expectations for your results. While breast augmentation and a lift can provide significant improvements, they won’t make you look like a celebrity.

A positive mindset and realistic goals are essential. It’s also essential to entrust your care to a qualified plastic surgeon with extensive breast surgery experience and proven results.

Ready To Take the Next Step?  

Our patients have experienced successful results with both breast augmentation and breast lifts, as shown in our before-and-after photos. If you’re ready for fuller, perkier breasts, call our office today at (303) 278-2600 or request a consultation.