Breast augmentation adds volume with implants, while a breast lift (mastopexy) raises the breasts by removing excess skin and reshaping tissue. The right choice depends on whether your main concern is size, position, or both.
At SVIA® Plastic Surgery, Dr. Tom Liu and Dr. Jerome Liu help patients decide between breast augmentation in Los Gatos, a lift, or a combined procedure. Both surgeons are certified by the American Board of Plastic Surgery and trained at UCLA Medical Center before completing fellowships in aesthetic plastic surgery. Dr. Tom Liu serves as Co-Medical Director of the Plastic and Breast Program at El Camino Hospital, and patients have rated the practice 4.7 stars across more than 700 reviews.
In this blog, we cover how the two procedures differ, how to tell which one fits your anatomy, and how recovery compares.
What Is the Difference Between Breast Augmentation and a Breast Lift?
The difference is that augmentation increases breast volume with implants, while a lift changes breast position and shape without adding size. Key distinctions:
- Goal: Augmentation enlarges the breasts, and a lift raises and reshapes them.
- Implants: Augmentation uses silicone or saline implants, and a lift alone uses none.
- Skin: Augmentation does not remove skin, while a lift removes excess and tightens what remains.
- Nipple position: Only a lift repositions the nipple and areola higher.
Both procedures are common. ASPS reported 306,196 breast augmentations and 153,616 breast lifts in 2024, based on procedures performed by ASPS member surgeons. ASPS also notes that a lift does not increase cup size, which only implants can do.
What Does Breast Augmentation Do?
Breast augmentation increases breast size, volume, and projection by placing an implant behind the breast tissue or muscle. It does not change breast shape or raise a breast that has descended. Patients work with Dr. Tom Liu or Dr. Jerome Liu to decide on four things:
- Implant type: Silicone gel or saline. SVIA® offers 5th generation silicone round implants, anatomic “gummy bear” implants, and the structured IDEAL IMPLANT® saline option.
- Implant size: Chosen to suit your chest width and tissue and to look natural. An implant that is too large can distort the breast and stretch surrounding tissue over time.
- Placement: Above the muscle (subglandular) or below it (submuscular), based on your anatomy and lifestyle.
- Incision location: The inframammary fold (breast crease), around the areola, or in the armpit. The crease incision is the most common in the United States and is associated with the lowest capsular contracture rates.
See our breast augmentation page and implant options for details.
What Does a Breast Lift (Mastopexy) Do?
A breast lift raises the breasts by removing excess skin, tightening surrounding tissue, and moving the nipple and areola to a higher position. It reshapes the existing breast, so it does not add upper-breast fullness. Pregnancy, breastfeeding, weight changes, and gravity are common reasons breasts descend.
The incision pattern depends on how much lift is needed. A periareolar incision suits mild sagging, a vertical pattern suits moderate sagging, and an anchor pattern is used for significant sagging. Scars are permanent but typically fade over one to two years. Learn more on the breast lift page.
How Do I Know Whether I Need a Breast Lift, Implants, or Both?
A simple starting point is nipple position relative to the breast crease, the line where an underwire sits. If the nipple sits below that line, a lift may be needed. If it sits above, an implant alone may be enough.
|
Option |
May fit when |
|
Implants alone |
The nipple sits above the crease, and your main goal is more size. |
|
A lift alone |
Nipples sit at or below the crease or point downward, areolas are stretched, and you are happy with your current volume. |
|
Both (augmentation with lift) |
Sagging and loss of upper-breast fullness occur together. |
Only an exam can confirm which applies. Dr. Tom Liu or Dr. Jerome Liu also considers skin quality, breast asymmetry, and your future pregnancy plans.
Will Breast Implants Alone Fix Sagging Breasts?
Breast implants alone usually do not fix significant sagging, because they add volume without correcting excess skin or a low nipple position. How implants affect sagging depends on the situation:
- Mild sagging: In some patients, an implant placed above the muscle can provide a “mini-lift” and avoid the need for a larger operation.
- Oversized implants: Extra weight may stretch the skin and underlying tissue, increasing sagging over time.
- More than mild sagging: Combining an implant with a lift in a single surgery often yields a more predictable result.
When Is Breast Augmentation With a Lift the Better Choice?
Breast augmentation with a lift, called augmentation mastopexy, suits patients whose breasts have both lost volume and settled lower on the chest. Signs include:
- Nipples at or below the crease
- Emptiness in the upper breast after pregnancy or weight loss
- Stretched skin or areolas
- One breast sits lower than the other
Most patients have both procedures in one surgery. A 2013 study reported by ASPS found an overall complication rate of about 23% for simultaneous lift and augmentation. The most common were capsular contracture, scarring, and recurrent drooping. The authors concluded that risks were no higher than for the two procedures performed separately.
For severe sagging paired with a large size change, Dr. Tom Liu or Dr. Jerome Liu may recommend staging the procedures. See the breast augmentation with lift and augmentation-mastopexy galleries.
How Does Recovery Compare for Breast Augmentation and a Breast Lift?
Breast augmentation recovery is typically the shortest, and combined procedures take longer. Typical timelines for each include:
- Breast augmentation at SVIA®: Recovery generally ranges from 3 days to 1 week, and most patients feel well by the 5th day. Strenuous exercise is avoided for two to three weeks. The practice’s RNR® procedures use nerve blocks and minimal opiates to support this timeline.
- Breast lift alone: The Aesthetic Society reports that a breast lift typically takes one to two weeks to recover from. Patients can usually return to work after a week or so, depending on the job.
- Augmentation with lift: Most patients return to desk work in one to two weeks and resume strenuous exercise at about six weeks.
Individual recovery varies.
How Do Drs. Liu Help You Choose at a Los Gatos Consultation?
Choosing between the procedures begins with a consultation that reviews your medical history, assesses your anatomy, and sets goals.
Augmentation consultations at SVIA® last about 45 minutes to one hour. You can see and feel sample silicone and saline implants, and touch screen displays with TouchMD software let you review your options at home afterward.
Dr. Tom Liu and Dr. Jerome Liu give an honest assessment of whether augmentation, a lift, or both best match your goals, and consultations are available in the office or virtually.
To explore breast augmentation, a breast lift, or a combination, schedule a consultation at 15055 Los Gatos Blvd #250 or call (408) 317-4682.
Disclaimer: This information is provided for educational purposes only and does not replace a consultation with a board-certified plastic surgeon. Outcomes, risks, and suitability vary from patient to patient.
Sources
- American Society of Plastic Surgeons. 2024 Cosmetic Procedure Trends 404
- American Society of Plastic Surgeons. Breast Lift vs. Breast Augmentation vs. Breast Implants
- American Society of Plastic Surgeons. Combined Breast Lift and Augmentation Is Safe, Suggests Study
- The Aesthetic Society. Breast Lift Aftercare and Recovery
