Ep.3 Considering a Breast Lift with Implants? 5 Critical Facts About Breast Augmentation

An In-Depth Look at Breast Implants

For a significant number of patients, particularly those who have experienced pregnancy, breastfeeding, or major weight loss, sagging is accompanied by a noticeable loss of breast volume, especially in the upper part of the breast. In these cases, a breast lift alone may create a perkier but smaller and less full breast. The ideal solution is a combined procedure known as an Augmentation-Mastopexy, which is a breast lift with implants, pairing the mastopexy with the placement of breast implants to restore both shape and volume simultaneously. This synergistic approach, also known as breast augmentation, allows for a comprehensive rejuvenation. The choice of implant, whether round or natural-looking teardrop implants, is a key part of the pre-operative discussion and allows for further customization of the final aesthetic result.

Implant Composition

• Saline Implants: These implants consist of a durable silicone elastomer shell that is filled with sterile salt water (saline) after it has been placed in the breast. They are generally less expensive than silicone implants. A primary advantage is that in the event of a shell rupture, the saline is harmlessly absorbed by the body, and the deflation is immediately apparent. However, they can sometimes feel less natural and may have a higher incidence of visible or palpable rippling, particularly in patients with very little natural breast tissue to cover the implant.
• Silicone Gel Implants: These are the most popular type of implant worldwide. They feature a silicone shell that comes pre-filled with a soft, cohesive silicone gel. This composition is widely preferred because it very closely mimics the look and feel of natural breast tissue, providing a softer and more realistic result. Modern silicone gels are highly cohesive, meaning the gel tends to stick together, reducing the risk of migration in the unlikely event of a shell rupture. They are also less likely to show rippling compared to saline implants.
• Highly Cohesive “Gummy Bear” Implants: This term refers to the latest generation of form-stable silicone implants. The gel inside is exceptionally thick and cohesive, allowing the implant to maintain its shape consistently, much like a gummy bear candy. This form stability makes them an excellent choice for creating a specific, predictable shape. They are available in both round and anatomical forms and are particularly beneficial for patients with minimal breast tissue who rely on the implant to define the majority of their breast shape.

Implant Shape

• Round Implants: As the name suggests, these implants are perfectly round and symmetrical. They tend to provide more fullness and projection in the upper part of the breast, resulting in a rounder, fuller appearance and enhanced cleavage. They are a popular choice for patients seeking a more glamorous or “augmented” look.
• Anatomical (“Teardrop”) Implants: These implants are shaped to mimic the natural contour of a breast, with a tapered appearance at the top and more fullness and projection at the bottom. They are often chosen by patients who desire a very natural, subtle enhancement that follows the gentle slope of a youthful breast.

Augmentation-Mastopexy: The Synergistic Approach

The augmentation-mastopexy is a powerful, synergistic procedure that offers a complete and total breast rejuvenation in a single operation. It recognizes that for many women, the issues of ptosis (sagging) and volume deflation are intrinsically linked. A lift alone cannot restore lost volume, and an implant alone cannot correct significant sagging and may even worsen it by adding weight. By combining the two, the surgeon can comprehensively address both concerns, creating a breast that is not only lifted and perkier but also fuller and more beautifully contoured.

This procedure is particularly transformative for women who have completed childbearing and breastfeeding, as it directly corrects the most common post-pregnancy changes to the breasts. It is also a cornerstone procedure for patients who have undergone massive weight loss and are left with significant skin laxity and deflated breast tissue.

From a technical standpoint, the procedure is elegant and efficient. The breast implants are typically inserted through the same incisions made for the mastopexy (usually the vertical or anchor pattern), meaning no additional scars are required to perform the augmentation portion of the surgery. However, the combined operation is more complex than either procedure performed alone. The surgeon must simultaneously account for the reshaping of the patient’s own tissue and the volume and shape added by the implant. Because of this complexity, and the way the implant and natural tissues settle together during the healing process, there is a slightly higher possibility of needing a minor “touch-up” or revision procedure at a later date to perfect the final result.

Works cited

1. Mastopexy (Breast Lift) – StatPearls – NCBI Bookshelf, accessed August 19, 2025, https://www.ncbi.nlm.nih.gov/sites/books/NBK610682/

2. Breast Lift | American Society of Plastic Surgeons, accessed August 19, 2025, https://www.plasticsurgery.org/cosmetic-procedures/breast-lift

3. Breast Uplift ( Mastopexy) | The British Association of Aesthetic Plastic Surgeons, accessed August 19, 2025, https://baaps.org.uk/patients/procedures/5/breast_uplift_mastopexy

4. Breast lift – Mayo Clinic, accessed August 19, 2025, https://www.mayoclinic.org/tests-procedures/breast-lift/about/pac-20393218

5. Breast Lift (Mastopexy) – Columbia University Department of Surgery, accessed August 19, 2025, https://columbiasurgery.org/conditions-and-treatments/breast-lift-mastopexy

Chokchai S., M.D., 

Chief Operating Officer.

Allied Health (Thailand)Company Limited

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