Breast Lift & Breast Augmentation: Do It Together or Separately?

Hello.

I’m Dr. Shin Seung-han, Director of Moms Surgery and Plastic Surgery Clinic.

Today, I’d like to talk about lift augmentation.

Lift augmentation is, as the name suggests, a breast lift surgery combined with augmentation surgery—lifting the breasts while placing implants at the same time.

It is mainly performed for older patients who, despite having insufficient tissue, have severe sagging.

Even among younger patients, if they have tuberous breast deformity,

this surgery can provide

appropriate volume and improvement in sagging.

Sagging usually occurs more easily when the breasts are somewhat large, but among those whose breasts grew rapidly and then suddenly shrank through childbirth or breastfeeding, or those who lost an enormous amount of weight, more than 10 kg, there are actually quite a lot of cases where there is no breast tissue at all and only the skin is stretched out.

In such cases, while lifting the drooping nipples, excess skin is removed and implants are placed beneath the muscle through a lift augmentation procedure.

In effect, it means performing two surgeries with opposite characteristics at the same time.

Just thinking about it,

it may seem contradictory to say that something is left over and cut away while something else is also inserted at the same time.

'What kind of contradiction is this?'

You might think that way.

Because such contradictory situations must be taken into account, this surgery is quite difficult and the outcome is hard to predict.

So while it means you may gain double the satisfaction by both lifting and augmenting, it also means that the side effects of both procedures can occur, so double the caution is required.

Dr. Spear, an authority in the breast surgery field,

has even argued that in the case of lift augmentation, the possibility of side effects increases by as much as 10 times compared with augmentation alone.

This may be somewhat exaggerated, but it is true that lift augmentation does tend to involve more side effects and often requires revision after surgery.

In particular, because the breasts are expanded with implants while the skin is being removed at the same time, wound-related problems often occur.

Hypertrophic scars Delayed wound healing Inflammation Capsular contracture Implant protrusion through the skin, etc.

Various side effects can occur.

For this reason, the debate over whether lift surgery and augmentation surgery

should be done all at once or separately

has continued endlessly to this day.

Those who argue that lift augmentation should be done in two separate surgeries base their position on a report from 2007.

According to this paper, the rate of revision due to dissatisfaction with the results in lift augmentation surgery was reported as 14.6%.

Some reports claim even higher rates, so if that is the lowest estimate, then in fact it can be said to be a fairly high rate.

Their argument is that, because revision is needed this often, doing lift and augmentation at the same time is not appropriate.

On the other hand, the argument in favor of doing the surgery all at once is also strong.

If the two surgeries are done separately, you are having surgery twice anyway, and isn’t that essentially the same as 100% revision?

They counter by arguing that, in the end, 14.6% correction is better than having to undergo two surgeries 100% of the time.

To summarize from the patient’s perspective:

If you have enough time, undergoing lift and augmentation as separate surgeries may be a good way to reduce the occurrence of side effects or the possibility of corrective surgery.

If it is difficult to make time for surgery more than once, or if you are burdened by repeated general anesthesia, having lift augmentation done all at once may be the better option.

Personally, I recommend having the two surgeries separately.

Even when done separately, I recommend doing the lift first and the augmentation surgery later.

The reason comes purely from experience.

That is because I have seen so many cases where patients are satisfied with just one surgery.

Usually, about 90% of patients are satisfied with the results of the first surgery and say they do not think they need the second surgery.

Of course, that one surgery is the lift surgery.

Beauty generally means something that is somewhat small in size.

No matter how pretty a rose may be, if it were as large as a pumpkin blossom, no one would describe that flower as beautiful.

In terms of how we view breasts, more importance is placed on the aesthetic aspect than the sexual aspect, so I think the focus should be on creating a beautiful shape rather than on size.

Today, I talked about lift augmentation, a topic that is difficult to settle conclusively.

There has been some criticism that the topics I cover are too technical, but in fact, these topics are based on questions patients have directly asked me.

These days, patients do a lot of studying in advance before visiting, so their questions seem to be getting sharper day by day.

I hope today’s post was helpful.

Thank you.